3 am awake

I woke feeling afraid, anxious, vulnerable.  I have resisted the paranoia of the world. I’ve fought against the psychosis of modern society. I have struggled to stay open.  I began to write stream of consciousness journaling, having read Artists Way and Finegan’s Wake and seeing so much mental anguish in work. People were afraid to speak and share, living lies of ‘quiet desperation’ .

I recently explained that ‘the man who mistook their wife for a hat’ was the best little book about brain damage. It was in a discussion of dementia when a person was medicalizing forgetfulness and slippery sliding into denial of civil liberties for forgetfulness. I explained that medically dementia was a failure of neuroplasticity. The brain was a self healing organism and yet over the time the capacity to function with rationality and meaning were lost. The point was that it was ‘the little stuff’ but big stuff that counted ‘like the man who mistook his wife for a hat.’   

I was concerned decades ago that people believed ‘insaniety’ was what one ‘thought’.  I was so aware of the communist persecution and tyranny of dictatorships at the time.  I was a member of the Canadian Civil Liberties Society and Psychiatrists against the Politial abuse of Psychiatry.  I’d studied logic at university and saw that rhetoric was the norm in parliament. I was concerned reading of the Gulags and twisting thinking of Marxists whose generalizations were so appealing yet no better than the ‘deconstructionists’.  Hypocrisy. 

The oldest law of the world is the ‘Chinese Law of the Fish’.

The problem of creativity was that one’s thinking was ‘strange’ and ‘alien’.  One step ahead of the crowd you are a genius, two steps a head of the crowd you are a martyr.  The problem wasn’t in the ‘thinking’ and a need for more ‘thought police’ but rather in action.  

My Jewish genius friend told me that he is afraid to step outside anymore. “I meet people who aren’t even in the 15th century. They come from countries where the ruler is considered divine so there’s been no group consensus like the Magna Carta. Others a living before the 18th and 19th century.  They don’t know the French Revolution guillotined the poor leadership or that the American War of Independence rejected the foreign dominance.  They certainly haven’t experienced the 60’s revolution. Sex is still the ‘state’s’ And ‘my body my own’ is unheard of .  That said I’m discussing quantum entanglement in my home and mind body spiritual epistemology questioning the purpose and meaning of existence and the role of the artists in society and my new neighbour wants to live out 1950’s all over again.  When I step out of my home I find myself in this time warp recurring loop and am persecetuted by those who don’t even know the power of marketting, fringe politics of Hitler and just want consumerism and conformity.”

I wrote my blog to celebrate the breadth of ideas and that diversity was the acceptance not of the ‘state approved’ ‘groups of acceptable concerns’ but rather for the bizarre unusual and anxiety provoking.  Stephen King was an alcoholic.  The government is the primary drug and alcohol pusher for the sake of self serving taxation conveniently forgetting the 30’s referendum in Canada at least that said ‘sin tax’ was only to be used for health care not to reward politicians.  

It’s easy to be a critic. Critics are a dime a dozen.  Desire is the root of all suffering, says Buddha.  Yet Jesus said ‘take the timber out of your own eye before taking the sliver out of your neighbours’.  Jordan Peterson said that 10% of society now did not have the intellectual capacity to function in a modern society of computers and AI.  Piatian psychologists studied a cross section of society and found that the development of abstract thinking seen by Piaget in his children as occurring with adolescence wasn’t achieved by a surprising half or majority until well into their thirties.  

I just came back from a couple of months in the US and was aware of the vast differences between the political systems and government of Canada and the Us but know most Canadian media homogenizes the systems to utilize generalizations. We do. it’s communication.

I wanted my patients to realize that ‘normal’ people had all manner of fear, anger, loves, emotions , doubts and that this wasn’t insane.  I wanted to share my own ambivalence and show that yes I can be the ‘leader’ and hide my thoughts with ‘boundaries’ and all manner of ‘state approved’ deception but that this focus on the exterior in terms of thought was horribly disabling and gave rise the the greatest of tragedies.  Now we have all manner of insaniety with the term ‘emotional abuse’.  All manner of insaniety.  There is a society of malignant subjectivity, a culture of narcissism and a world of the selfie.  Whole tribes aim to be ‘influences’.  Marketting is preferred to truth. All truth is ‘my’ truth or ‘your truth’ and perspective. There’s a superficial interpretation of relativity in a world of ‘if it feels good do it’. Yet the word feeling can come from lust or love and both feel good but in an amoral society where ethics are not longer respected there’s a devil in the details.

I’m anxious because of Julian Assange and the honey traps perfected in WWII and the Cold War still being used today.  Gossip and mob violence reign.  Law and order decline. Cowardly leadership.  Weak men and long necked women.

In the middle of the night I wake afraid because I’ve tried to bare my soul to say this self reflection and expression of the good and bad is okay. It’s all about he Spirituality of Imperfection. The leaders aren’t perfect. Their power suits and pretty houses and body guards and hidden wealth are all rather passé.  I like the story Reacher.  A modern day St. Francis, the zen monk of my youthful television days.  

I have wearied of the cacophony of criticism and the demand and bullying for my time and attention and gone off alone on expeditions to the north and to sea. I’ve enjoyed solitude and not been lonely with a woman and a dog and often with just a dog and even when I had a fish or a houseplant.  So many don’t know the essence of such relationship.  I am at times aware of the great mystical wonder of being apart of the forest or the world.

I’ve found gratitude helps me adjust my attitude.  When I’m afraid and can’t sleep I write what I’m thankful for. I give up fear and replace it with faith. I believe in love. I believe the other is God. I believe I’m playing peekaboo all day with Jesus.  I pray that the saints of all religions love shine on my devotion. I am thankful for the air I breath for breathing, for the sun, for warmth and heat, for food and sustenance, for my room mate dog companion, for mobility and walking.  I am thankful for feeling. I’m thankful for showers. I’m thankful for all the well wishers. I have this fault where I hear a dozens words of praise and one word of disdain and I disregard all the positivity and focus on the negativity. I magnify disease so that I can heal it which is good in the objectivity but subjectivity I must remember Jesus said, Love God and Love your neighbour as yourself.

The weasel words are ‘God’ and ‘Neighbour’.  The natives say ‘all my relations’.  I enjoyed meeting the Jain and spending the day with him as he shared how he struggled with killing a mosquito.  He was like the Quakers who fasted for killing to but that of humans. Their neighbour was ‘humanoid’.  The war of Gods was the history at the beginning of civilizations when Yahweh and other gods were tribal gods.  

God to me is life.  All things.  All.  I loved Phillips book, Your God is too small. Then I’m talking with aetheists whose reductionism is infinitismal.  But there are no aetheists at sea or in fox holes. Aetheism is a hot house plant and the religion of communism, a dictorship.  

The movies are all ‘revenge porn’ or ‘sex porn’.  Primal stories of the Joseph Campbell variety.  The joke was if you are younger than 40 go to a Freudian because your issues are all sex and aggression but if you’re over 40 go to a Jungian because your issues are about alienation and integration.  I loved the book Denial of Death.  I fear even fleeting thoughts of suicide in depths of despair because I believe in the law of attraction.

I see depressed and angry and frightened people all day and their emotions and ideas are like infections and they are infective. I am hours on the front line knowing that the administrative class and upper class and the powerful want nothing to do with the ‘people’ .  I’m daily facing at least one ‘soul theif’.  They’re there to ‘steal my joy’ or ‘run in my day.’  They’re the kafetch and Im trying desperately to survive an hour of their fear which grates like nails on a chalkboard.  They are angry at the world and as I’m part of it I’m in their sights.  

My job is not to be their lawyer

The psychiatrist focuses on changing the invidual with psychotherapy or medications or other physical therapies.  I’m an addiction psychiatrist and trauma psychiatrist.  I am like a driving instructor who sits in the car and asks that they let me take the wheel as we crash and burn.  I walk a mile in their shoes and hope to return. I’m thoroughly buggered at the end of the day.  I’ve been spat on hit, shat on, held hostage and thoroughly abused by my superiors who hide in institutions and avoid contact with people and have the resources to walk about the wards as ‘gangs’. I’m a lone cop in a police car. I’m the priest in the battlefield.

I am holding on to life. I’m holding onto this work. I ‘m said to be at retirement age.  I’m supposed to have a referral service who screens out psychopaths and sociopaths.  Theres’ a public service and a private service but everyone is now treated as a government worker by the populace who don’t respect private business or that the damage they do to the building I’m in comes out of my income.  The government says they should be ‘free’ .  The government makes all manner of promises but takes the wealth and leaves us on the front lines like the soldiers on the beach.  I wonder how long I can do this.  

I was threatened three times today. I’ve had patients point guns at me in the office. I’ve been robbed and mugged.  So many patients live in their tv.  There are signs all over the city now don’t hurts the healing staff.  The delays and lack of services are caused by Ottawa, not me.  I’m not the enemy. The rabid dogs are bitting the hand that feeds and the police are hiding in bunkers while the corruption and greed stalk the world.

I go to work in the real world.  The majority of critics and complainers live in the safety of their screen, experiences a sanitized propaganda version of reality.

I tried explain that the diagnosis of PTSD came from what soldiers experienced not ‘emotional abuse’.  The entitled privileged narcissists screamed at me that I didn’t understand.  She had a monopoly on pain and it was always about her.

Since in the end the other is God and I am looking in a mirror I had to reflect with sadness that that was me when I was a teenager. She might be much older but the suffering I felt in her uncontrolled rage was no difference than my mother ‘s pain when I was a teen and shouting at her, blaming her for my emotional immaturity.  I sat years later in the Ashram and the Church trying to forgive myself.  I still am so ashamed that I was a toddler and shit myself.  Now am facing this in old age and wondering about compassion missing my father and brother and grand father and feeling alone.  I feel forsaken yet know I’m not.

Thank you God for the good times. Thank you God for the ‘tools’. Thank you God that I am able to recalibrate. Thank you God that I have learned what I struggle to pass on. Thank you God that I have some patience as I progress towards the only choice of acceptance on deaths bed.  Thank you God for preparing me for departure. help me to know I’m not this body, this ego, this suffering and am joy . Thank you for my being a spiritual being in a material world and knowing my mind is more than my brain.. Thank you for peace and calm and faith. Thank you God for being there with me when I feel persecuted and alone threatened and afraid.  So many threats today. So much anger.

i know these people sometimes for an hour and they say that’s they’re going to kill me as if that will solve a life of errors and defeats. I struggle to help them up while they’re flailing about having a tantrum on my office floor threatening homicide and suicide and claiming they’re going to make the world a better place by annihilating me.

Then I read that my government which paid and murdering terrorist 10 million dollars supports the Hamas terrorists and I hate that the Prime Minister is such an evil twot. As above so below.  God gives us the leaders we deserve.  Politics is the choice of the least bad alternative.  I want to go back to Israel and sit in the temple .  I remember the three markets and the disorder and sense of safety I felt or didn’t feel in each of the markets depending on the religion of the people. I don’t like the Religion of Peace that kills homosexuals.

I must find the God within to heal fron the verbal assaults and threats and abuse and the broken system with so many afraid and angry with the mismanagement of the economy and the inflation and corruption.  It’s tax time.  I’m trying to gather all the paper.  I’m pressured to meet deadliness.

I have this sense that I’m waiting for Godot. that this is where it’s’ come to.  Younger I worked and looked to a future with hope of a private plane , a family , a 

mansion a white picket fence and a family. Here I am some days feeling like the old.  My retired friends are leaving the miliaray captains or colonels knowing they didn’t make it to general and that they ‘failed’.  The rich are poor in the end. We are all 3 paychecks from eviction.  I have saved only to have the trust fund boy steal my savings and the evil witch threaten bank accounts and freeze the assets of those who love freedom. I’m afraid and can’t build up riches on earth.

There is only you God. there is no where to hide her. I went to Meteora and Cappadocia and I’ve been to the islands and to the north. There’s nowhere to hide. I have my back up against the wall of death and the abyss is there.  I walk among the delusional immortals who know no respect and haven’t been stabbed or attacked.  They’ve lived quiet lives as bullies and haven’t been to jail and asylum and haven’t seen the inside of a quiet room or solitary.  They don’t know the feeling of restraints. They’re living young without the experience of a body that betrays them, a glass spilled because the weight can not be sustained by the wrist and arm. The shaking and tremors are apparent now.  I’m laughing thinking of the shame.  

I liked Clint Eastwood, I don’t let the old man in

Trudeau wants to euthanize the mentally ill.  He claims it’s what they want.  I dentificatin with the aggressor.  Power and homeless, Solyet GReen eappeals but the rich and powerful aren’t leading the way.  Trudeau leads from the rear.  Communist leaders do.  

But then wars are for old men to kill young men.  They play their families against another’s families.  The gangs go on ….It’s like the animal and insect behaviour. All the poetry doesn’t change the barbarism.

You’ve survived.

Thank you God. thank you Jesus. Thank you for the heat. Thank you for this body. Thank you for sleep and wakeful. Thank you for the mind and heart and soul . Thank you for this day and night. May I know you more truly and surely.  

 

Projection, Sex and Aggression

“You want to make love to me,”  said the troll to the princess.
The princess thinks, ‘well, not really….maybe I would like to make love to somebody…but not you,"
Then the troll persists and insists and insinuates and eventually the defences of the princess break down.  Indeed, the troll might well actually  ‘rape’ the princess and later say, “you wanted that.”
But the princess never really did.
If she was drinking or smoking dope though she couldn’t know for sure because drugs and alcohol cloud one’s judgement and impair one’s sense of reality.
“You asked for it.”  says the troll.
But the princess doesn’t ‘remember’ ‘asking for it.
Worse, after the fact, she feels terrible and is sure it’s all a horrible mistake.
It is a mis-take. But whose.
Trolls are great salesmen and saleswomen.
You go into a car store and the sales man says to you as you’re admiring the Lexus, “You'd really like to be in the drivers” seat".  And yes, you might consider that but not if the cost of the experience is going to result in your children not going to university.
Projection is the experience of having my feelings attributed to another persons.  It’s the experience of having another person “attribute’  their feelings or desires to me.
In 70’s communications psychology therapists attempted to have people ‘own’ their feelings and desires.  To this end, they taught and encouraged people to use “I” statements.
“I feel you want to make love to me,” said the troll to the princess.
“Those may be your feelings but they’re not mine,” replied the princess.
On the flip side, the paranoid, says, “You want to hurt me.”  or “I feel you want to hurt me."
Freud said that fundamentally our human drives reduce to ’sex or aggression’.
As a metaphor ‘fuck or fight’ are places of discussion where one can get greater clarity because of their ‘extremes’.  It’s similar to a process of discussing “straw men”, extreme arguments to understand where the ‘middle position’ is.
The princess says to the troll, “I want to be your friend but I don’t want to have sex with you or kill you."
Projection is normally ‘unconscious’ but may actually be a conscious process when used by a psychopath or sociopath.
It’s critical to understanding this because the ‘good feelings’ people have when they are drinking or smoking marijuana or using GHB is that of being among friends.  Drugs break down our fundamental immunological sense of self and ‘other’ or self and the ‘stranger’.
Women, especially, the young in general, when they are drinking or using drugs can be ‘suckered’ by the projections of others.
“You want to kiss me."
“You want to fight me don’t you?"
When I was younger I was raped by a person who consciously utilized these techniques manipulatively.  Being older and trained specifically in these ‘boundary busting’ projective strategies and utilizing drugs to “lower my inhibitions” he took advantage of me.
We know today of girls who are ‘seduced’ but rarely do we talk about boys who are subjected to the same kinds of trauma and manipulation.
Seduction is distinct from manipulation in the underlying ‘love’ and ‘empathy’ that the seducer and seducee experiences.  In contrast the ’user’ lacks the capacity to consider truly the other persons desires or feelings. With projection I ‘dominate’ your inner world with my ‘desires’ and ‘feelings’. I over ride the possibility of your distinctness and difference.  The user and taker simply considers the other an object, like a mattress, for they can’t conceive other others having feelings and depth beyond their own shallow narcissism.
I may indeed be so psychotic, so narcissistically injured, that I truly believe that Angelina Jolie is even now just waiting for my phone call.
I have treated some ‘celebrity’ stalkers and have been ’stalked on several occasions’ by psychotic people whose depth of inner inferiority is such that they project onto others that they ‘desire’ them.  Because they falsely believe that if those people did want to have sex with them, then their self image would improve. It’s quite likely that I’d feel good if Angelina Jolie or Rita Hayworth or Nicole Kidman or Taylor Swift wanted me.  I’d feel pretty powerful too if Cassius Clay or Wayne Gretzky or Mohammed Ali  wanted to fight with me.
The key here is to understand that ‘projection’ comes out of inferiority.
A beautiful young woman actually once did try to have sex with me, at least it certainly appeared that way, when she was trying to sell me a house.  The house was rather dilapidated and not what I wanted but the saleswoman seemed so desperate and seductive that she seemed willing to throw her body into the mix to get the sale.  I don’t think the saleswoman for the Taj Mahul would be trying to the ’sweeten’ the deal with me with sex.  The Taj Mahal tends to sell itself.
The trouble with projection is that it’s tied in with another aspect of psychological development, merger.  When we are infants, we are indeed ‘merged’ with our mothers.  As a fetus  in the womb  we are de facto ‘one’, a mother child unit,  linked by the umbilical cord.  As we grow we ’separate’.  The one becomes two yet there is this desire to overcome the ‘isolation’ of existence.  Each of us has ‘boundaries’ about us. Not really boundaries but membranes for sure.
I personally don’t like this term boundaries because as  biological beings we are surrounded by membranes not boundaries ‘per se’.  Boundaries comes out of the political and social schools of thought rather than the biological. Membranes have forms of active and passive transfer and are always interconnected with their environments and their neighbours.  They are  dynamic and flows and exchanges as compared to boundaries which bring to mind the fixed, rigid static and 19th century thinking.  
Psychotic projection is about one individual wanting to become ‘one’ with another to overcome their ’sense of separateness’.  Unfortunately or fortunately the merger (sex or aggression) doesn’t solve the problem for the individual.  So they quickly move on like parasites when the host has become immune to their type of drama.
It’s been said alcoholics and addicts don’t want relationships but rather ’take hostages’.
The users and manipulators don’t really care deeply what you want because they are obsessed with their own desires and feelings.  If they are sexually aroused then ‘you made them that way’ because they ‘don’t own’ their own feelings and desires. There is nothing more immature and antiquated than a man who said “I had to rape you because you were wearing a mini skirt”.  Clearly such a deeply inferior individual or rather an individual with such deep sense of inferiority lacks personal self control and sees the environment and others as controlling them.
Melanie Klein an early child psychoanalytic theorist described the ’splitting’ we see with the projective as being the inability of the child to acknowledge that the mother has a ‘good breast’ and a “bad breast’ rather than her being ’the good breast” or “the bad breast”.  To the ‘egomaniac with and inferiority complex” ( a common description of narcissists or alcoholics or addicts) others are only good when they are serving the individuals needs. That they have a life independent of being a breast is inconceivable to the baby at an earlier developmental stage, the narcissist who has not developed empathy because of early childhood trauma, or the narcissitically regressed due to later trauma or simply the alcoholic or addict.  Alcohol and drugs of addiction cause developmental and emotional regression and retardation.
The thing about ‘projective’ individuals is that they make already complicated matters such as sexual relationships more messy.  For an adult person to have sex and share bodily fluids with another they must join membranously with another.  In the old days of boundary talk and ‘every man is a castle’ we’d say we had to ‘let down the drawbridge and drain the moat to ‘let the other person in’.  The trouble with that boundary metaphor is that indeed we are more like mollusks or amoebas in sex and the experience is fundamentally that of ‘merger’.  In the physical act of orgasm we ‘lose ourselves’ and ‘become one’.  The problem then becomes ‘separation’.
With the individual with an ‘inferiority complex’ they want to remain stuck on. They can go on to be the love addict.  Alternatively the narcissist having had their ‘sexual addiction’  “fix” just wants to move on to the next ‘host’.  Half people like narcissists are like vampires and mosquitos, they are parasitic in their relationships.  They ‘attach’ and don’t let go, not gently  as ‘loyal’ people but rather with the grip of death of ‘needy’ people.  Alternativelty  they are so superficial that they just  bash about one to the next like a pig in in a fine parlour.
Historically in ‘courtship’ and ‘community’ relationships ‘grew’ and ‘climaxed’.  My gay patient said of the alcoholic gay bar “scene” “we shook dicks before we shook hands’ and there wasn’t time ‘to learn or remember names”.  The ‘alcoholic gay bar scene’ is no longer limited to the ‘gay’ population. It’s the metaphor of any ‘night club’ or ‘alcoholic mixing scene’.  Theorists in the LGBT community described the alcoholism and lack of relationship with only raw sex and exploitative encounters as being related to the shame and hidden ‘illegal’ “illicit” nature of the sexual contacts prior to legalization of homosexuality. That ‘illicit’ nature of the sexual encounter between strangers has spilt over into the general population following ‘AIDS’ which resulted in the feeling of ‘extreme risk taking’.  When two people were attracted to each other even superficially in the gay bar coupled with copious alcohol they ‘merged’.  This was thought because they were running from their own ’shamefulness’ to be with another in ‘validating’ experience. (See the classic text Velvet Rage) .  The same holds true today with all stranger sexual encounter in the ‘bar scene’ because the dangers are explicit and there’s such ‘alienation’ in the general consumer culture.
Enough on the ‘description’ of the phenomena.  What to do about it?  Of course the 70’s gave us ‘I” statements but really, the language changes but the insanity prevails. That’s the fundamental problem of political correctness.  We change the names of things so Auschwitz,  the Nazi extermination gas chamber, was called  the “Solution”.  The word ‘abortion’ is acceptable but ‘murder’ is distasteful.  Fuck is distasteful, but ‘make love’ is acceptable.  The South African Army didn’t ‘kill’ the blacks, they ‘culled them’.
Language is important but the politically correct normally are content to ‘relabel’ gas chambers because changing the sign on things is cheap and gives the ‘appearance’ of change. Indeed they commonly call this ‘real change’ when it’s usually just more of the same with a different ‘spin’.
Obviously avoiding drugs and alcohol all together is perhaps the healthiest ways adults can avoid poor judgement in relationships.  Drugs and alcohol caused the sense of ‘false’ merger’ and are commonly associated with projection and exploitation.
But projection occurs all around us.  People ‘speak’ for others. Politicians are an especially bad lot for claiming to speak for the ‘people’ when they are as often promoting their agenda.
“Do you want to make love with me” said the prince to the princess.
“Do you want a fight?” said the princess to the prince.
At the extremes of sex and aggression we can see ‘our part in’ the relationships but this is true at all levels between.  
“You want pizza tonight?"
“No, why would you think that?"
“You always want pizza on friday night."
“But that was then, this is now, I think I want Chinese tonight."
Don’t ‘ASSUME”  Assume makes an ASS out of U and Me.
More importantly don’t get ‘angry’ or ‘lustful’ or emotionally charged at the knee jerk level in relationships in general.  Go slow.
“You want pizza tonight?"
“No, why would you think that?"
“What about Chinese?"
Now all of this said, there are indeed a whole group of people who are sexually and physically different than the mainstream.  They believe that by having sex first they avoid all the nuisance of relationship. They like to start by fighting with another person physically and getting to know them that way. I remember as an adolescent making best friends with a guy I fought with.  We’d bashed each other with our fists and feet till we came to a draw and later just began to hang out as friends. We had music in common and felt that after that fight we were somehow bonded.  A lot of military folk are that way. Ex prostitutes have told me that they liked to get the ‘sex out of the way’ so they could find out if they liked a person.
I mention this because the whole issue of merger and projection then becomes part of the ‘risk taking’ ‘fast living’ ‘carpe diem’ life style of these individuals.  As a psychiatrist I don’t approve or disapprove. I have problems when people get hurt and people who are using drugs and alcohol are likely to get hurt.  Also we see young people getting taken advantage of by older more sophisticated people. When I worked in the theatre and television the old lecherous men and women were for ever literally taking advantage of the young and naive with false promises and gross manipulation.
In retrospect I think of “Hannibal the Cannibal” saying ‘You really want me to eat your brain."
And Monty Python answering, “Not really, I was just looking for my lost parrot”.
I have written about this “projection”, ‘classic defence’, so that people can be more aware of when they are doing it but most importantly when others are doing it.  You can’t counter projection by saying “You’re projecting” because it’s either something the other person is doing unconsciously and will deny or the other person is a manipulator and will deny as well. However if you are aware of this you can recognize it.
You can say, “is this really what I want.'
You can then say to yourself, “I drove my rolls royce to the 7-11. I want some peanuts.  I didn’t want to have sex right there with the rather plain girl buying nachos beside me..  I didn’t want to share my life with her and half my assets. I think that might have been her desire."
The troll said to the princess, “You want to have sex with me."
The princess responded, “Maybe not. Give me some time to get back to you.  Let me think about that.  I’ll call you. No you give me your phone number.”

Social Housing and Nimbyism

The Neighbour began violently banging on the walls at 6 am. I was quietly dressing to catch a cross country flight.  The banging went on for 10 minutes and was so forceful as to cause the pictures to fall off the wall.  My friend, who I was staying over with said,
“That’s the neighbour, she’s always banging on the walls and ceiling.  Everyone has complained.  I’ve even complained to the super.  Nothing is done."
Suddenly the banging is on the door.  My friend opens her door.  She is tired and in her housecoat. The neighbour is wide eyed, crazy, yelling.
“Stop banging on my walls,” she shouts.  My friend holds up her arm to stop the young woman from barging into her suite.  She backs up screaming ‘Don’t touch me. Don’t touch me.”  Every action, every statement is an sophisticated attack. She, the aggressor, is positioning herself as the victim.  “You bang on my walls every morning at 8:30.” It’s 6 am I’ve been getting ready quietly so as not to disturb my friend.  She usually leaves for work before 8:30.  But that isn’t the point, is it.  This is a distraction.  She’s attacking here and now.
My psychiatrist mind has flipped into gear because of the danger she presents. She’s either psychotic or a sophisticated borderline sociopath.  She’s sweating profusely. That could be from the banging or she may be in withdrawal.  Her irritability could be heroin withdrawal but such paranoid projection is more common with marijuana psychosis, crystal meth or heroin psychosis. My crystal meth patients become like this.
Of course she doesn’t look like the stereotype of the mentally ill or addicted. She’s well groomed, maybe 40’s, plain but not unnattractive.  My friend says she has a job.  The rent for suites here is standard Vancouver , well over a thousand. It’s a nice neighbourhood but no neighbourhood is safe from drugs or even sociopaths.
The whole idea of ’social housing’ has the drug addicted and ex convicts increasingly housed in nice communities because such orderly civilized environments ameliorate the insanity and violence of these populations. It’s like the distribution of difficult children in normal classrooms. The normal students provide structure for the ill mannered.  The alternative is the ghetto. The Vancouver Downtown Eastside is a breeding grounds for crime, violence, drug addiction and insanity.
Government agencies, civil and human rights associations, ex convict advocacy activists, mental health agencies, families of the ex convicts and the mentally ill, all serve to get their individual concerns cared for in the best of districts. At the other end of the spectrum the rich and privileged don’t accept ‘social housing’.  They have gated communities. They are protected by their wealth.  The middle class can no longer afford the same so increasingly they’ve turned to Nimbyism.  Not In My Back Yard.
The whole idea of ’social housing’ developed 50 years ago.  That was the height of community movements, middle class values, law and order. The police and authorities in general were widely supported by the citizens.  So many of the adults had returned from World War II.  They had seen up close what ‘chaos’ was like.  They’d seen or heard about the concentration camps. The Jewish doctors, gay composers, ethnic minorities and anyone different had been gassed.  The Soviets had raped everyone in their ‘liberation" especially teen age girls and boys.  After the long nightmare, everyone wanted peace and order.
It’s 2015.  The police have no authority.  My police friend left the force when she said “I set out to be a crime fighter.  I was reduced to being a ‘crime recorder’.  Police are simply not allowed to do anything. When they catch criminals red handed  rich lawyers  get privileged judges to let their clients off on a ‘technicality’. “  Justice is a revolving door.
I treat victims of physical sexual violence. They’ve lost limbs. They have nightmares for years.  They’re still in treatment for the horrifying consequences of their assaults when the criminals are being released back into the community.  They’re terrified. Some of my patients are the victimizers. They’re terrifying.
Increasingly the judges, once the admired back bone of society are being exposed by the rapacious media.  Everywhere the media exposes to the masses the one bad apple and demands an enquiry into the whole barrels. There’s no money for front line resources so police and mental health care givers are forever forced to cut corners or ignore all the while million dollar enquiries make everyone rich writing up more plans and protocols that no budget has resources to address.. Media logic goes like this.   One northern judge in British Columbia was caught for pedophlia so all judges are pedophiles. The former head of the Supreme Court of Canada was a slurring alcoholic so all judges are drunks and alcoholics.  The judges increasingly are throwing the police under the bus, more concerned apparently with popularity than justice.    Everyone in authority knows there will be no one to protect them in retirement.  When the police learned that the proposed new gun laws for disarm police on retirement suddenly the police were no longer en mass in favour of highly restrictive gun laws.  All those in the know want to be living in a gated community. Private security firms prosper like never before.
The industry of housing as “mental health and addiction’ treatment simply  takes the money from true treatment, psychiatrists, physicians,  nurses, psychologists, addictionists, counsellors, standardized scientific therapies and certified treatment facilities and certified recovery houses with treatment components. They give the money instead to ’slum landlords’. These smart businessmen raise the ‘rent’ on their unliveable facilities because they’re overnight called ’social housing.  When the tenants destroy them the landlords give the repair bills to the health care system.  When the facilities are repaired to a liveable state they rent them out at high priced Vancouver prices to ‘normal’ people who now will live in these improved bed bug and cockroach free apartment complexes. The money designated for addiction has paid for the upgrades.
Meanwhile with ‘social housing’ the violent, the insane and the drug addicted are distributed through communities. They’re ’somebody’ else’s problem”.
Psychiatrist used to be able to ‘committ’ for treatment the mentally ill who were violently insane and destructive in the community. Yet today the government has closed down all the asylum and mental health beds with the result that there are simply no resources. The ‘bar’ for admission to a psychiatric facility is raised so high that even psychotic schizophrenics who publicly chop off the heads of their neighbours are quickly discharged  free in the community.  The assumption is that these patients are taking medications that will stop them from being violent. The trouble is that there are so few resources that when patients stop taking medications its often months or another violent episode before anyone notices that they are no longer getting their monthly injections or following up with the treatment team.  The sex offenders from the criminal system are similarly placed in the community with marvellous ‘parole’ and ‘probation’ idealized recommendations.  These pretty documents no doubt make judges feel good about their ‘intent’. The trouble is with no jails and no community staff and castrated  police and a thoroughly unnaccountable destructive deceitful media and vigilantte Facebook justice, there’s no follow through in fact.
When I said to the crazy lady, “You were the one hammering on the wall. We both heard you and you need to leave.”  She shouted spitting in my face, “Shut the fuck up you fucking old man.”  I backed away.
I am old. I’m in my 60’s.  My friend is in her 50’s.  She’s focused her life on health care administration and raising children. She has no training in dealing with criminals or psychotics or violent young women who know all the angles and claim they’re the victim. They have a monopoly of victimship and can bring massive beaurocratic  governmental to bear on kindly innocent people like my friend, the sweet older quiet lady, who has never harmed anyone.  Everyone she has ever met will speak to her good manners and respect for others and loving nature. This woman likely has a rap sheet a mile long. Yet the courts and agencies no longer respect individual histories. Everyone is equal before the law.  Character doesn’t count in the courts. In the street Vigillante justice runs on how many people you know and how many hits you can get on Facebook by taking a video out of context.  Just be sure to sound politically correct.
I work in the mental health and addiction field.  People like her don’t ‘just happen’.  She had all the ‘lingo’ rehearsed.  The best defence is an offence.  She was like Hitler where claimed his destructive tank blitzkriegs were ‘defence.’  Politically correctness is all in the language. Get the right marketing jingo and everyone will believe you should pick up the lump end by the clean end and that this clean end exists and is apparent to all.  The neighbour went from loud to catastrophic. She’s a ticking bomb, a social terrorist. Now’s she’s hammering on walls and ceilings and doors. What will she do next.  My  friend admits that everyone in the building is afraid of her.  She certainly frightened me.
I’ve always been afraid of drug addicts. I know the neuroscience of drug addiction. I’ve watched my little cockapoo dog growl defensively, whenever anyone delirious on marijuana, crack or crystal meth approaches. Animals sense the unpredictability of people who are emotionally anaethetized  bubble boys and girls. These people are able to inflict all manner of emotional and physical trauma without feeling anything in return because they’re drugged.  They’re also always the ‘victim’. Right.
Theres’ a tug of war between the rich with ‘gated communities’ and the new ‘bunker houses’. These two or more story bunker houses were all the rage in medieval towns. Then a family home had to stand against the riots that plagued the city.   Few if any small windows on the lower floor with the big windows on the second or third floor. Reinforced doors.  That’s what the rich have begun to demand.
Barricaded private complexes are a response to the increasing decline of law and order. The public structures are all but collapsing into increasing chaos and brute force rule.  If my friend hadn’t put up her hand to stop this woman pushing her way forward she might well have barged in. Bullies take advantage when they see weakness.     This neighbour would have phoned the police  too and claimed she’d been assaulted if it was one on one. The first come first serve justice system gives the edge to the complainant.  Criminals and frequent fliers know the system.  Everyone knows in Canada that ‘false allegations’ are standard but that there’s never any consequence.  As one judge asked about slander said, “everyone lies in court, it’s my job to assess whose lying more.”
Everyone doesn’t lie and no judge can do what lie detector tests and countless psychological scientific studies have proved.  But what we do know in psychopaths can act better than the innocent. The innocent are no longer the victims.  Everyone is the new ‘victim’.  "Nobody is right when everyone is wrong."  The criminals all know the system and rule because frankly there is no other authority.
“Shut the fuck up you fucking old man!”
There is lawlessness here and now.  The question is when will the media do it’s job and report that.  Will parliaments and congress make the pendulum swing back to the centre. Will judges be supported in making the tough decisions.  Will the rich want to face the ‘peasants’ again.  Have they so quickly forgotten what saying ‘give them cake’ caused.  Do the corporate czars really think they can protect themselves from the Lennins of this world.  The middle classes, the truthful,  the educated, the professionals, the artisans, the engineers, the businessmen, all those whose represent the meritocracy, will they be protected because they don’t do well in chaos. The Pol Pot killed the doctors and university teachers first then killed half the country later throwing a once thriving country into the dark ages.
Hitlers first act was to make the Brown Shirts. The brown shirts became his personal army. They were made up of pedophiles, drug addticts, criminally insane and sociopaths, bullies.
A day doesn’t go by when I don’t hear of a person being brutalized by their neighbours.  The real fear of investing a million dollars in a Vancouver property is not the predicted tsunami and earthquakes but more importantly the very reall possibility of the dangerous or just offensive neighbour.  I know of dozens and dozens of such cases.
Personally I’ve lived the last few years in what is essentially a gated community.  After hearing so often of such complaints I witnessed first hand what is perhaps best called ‘evil’.  When the psychotic is powerful there is little language to capture the depth of insanity one must face.
I feel sorry for my friend.  I get to leave.  Her sleep has been disturbed many nights.  My day began with a threatening confrontation which my friend says is routine, If she’s not banging on her door she’s banging on the woman above her, the man beside her, shouting in the halls or threatening people coming through the vestibule with her.  She’s clearly way out of control and has been for a very long time.  No one is a bout to control her soon because frankly the system will punish the good rather than engage with this evil.  The system lacks the mechanism, resolve or even the intelligence to address it.  It’s not an individual.  It’s a disease.
If it’s not in your neighbourhood.  It’s coming.  It is coming to your neighbourhood.  

Marijuana and Youth

Marijuana and Youth

-Dr Shimi Kang

This was a lecture at the Canadian Society of Addiction Medicine Conference in Vancouver Sept. 26, 2013.  Dr. Shimi Kang is on staff at UBC Women’s Hospital and with the Department of Addiction Psychiatry UBC.  She is a truly brilliant speaker, and astute clinician whose presentation was one of the best I ‘ve ever head on a subject I’m very familiar with.  I have copied my rough notes here though would strongly recommend for anyone who ever has the opportunity to hear her, to take advantage of this, as she is one of the very best speakers for combining scientific and academic information with clinical experience.  I apologize for the notes that really don't do justice to this splendid presentation. However I believe that by uploading these notes it will perhaps help someone find the right direction to look.  Dr. Kang has a book coming out as well and it certainly will be worth looking for and reading.  

Learning objectives

• incidence in youth
• risk factors

Are you a tiger, dolphin or jellyfish?

When we look at therapists we see

• distinct results 
• engagement
• success

Average doctor patient 

-70% doctor

Listening more is good

Non judgemental

I give information to adolescents all the time but in the end I always tell them it’s your 

Empathy is the biggest thing for success

Standing in their shoes and walking in their shoes

Saying “i can tell marijuana serves in your life but....”

3 qualities

genuineness --I don’t say anything I don’t believe in with adolescence -

empathy 

kindness

Tiger therapist - I am the authority, I’ve recommendations

Jellyfish therapist - going with flow, very kind and empathic and rapport but they don’t use this for any goal - we all know these - patients say I saw this counsellor three yeas and she was very nice - but when I ask her did your substance change - and she says no

We don’t want to be tiger or jellyfish

We want to be a dolphin - highly intelligent, collaborative - working with young people, collaborative - playful, going side by side - creative - great communicators - adaptable - not a tiger pushing and not a jellyfish - 

Favourite teacher

Attributes and Affect

nonjudgemental

Challenge patient

Even if they’re forced to come to us - we allign them to move forward - everyone wants to move forward in their life

Marijuana

• life magazine -1950 on cover

• time magazine - 2013 - still on cover

50 years later same questions being asked, big topic

15 -24 -3x risk

average age 15

in BC its lower age of starting 

Michael Phelps - “What a Dope?”  I always use him as comorbidity - 13 times Olympic goald medal winner with cannabis pipe

When I started psychiatry years ago and we asked do you drugs - now I ask specifically - marijuana use - if you ask drugs -they don’t answer - it’s pervasive

THC content and potency

-it’s increased over 30 years

NIDA  Marijuana Abuse (2010)

Saw father of adolescent and he said he didn’t think his son’s smoking marijuana is a problem because he used marijuana every day through law school - however his son was 16 and the potency was greater than a man at 23.  As we’re seeing younger and younger we’re seeing greater problems  - we shouldn’t call it the same drug - we don’t call heroin - poppy - even though marijuana is very different drug we call it the same drug - what you son is using is a very differrent drug than what it was in the 60’s.  

the more potent for THC the less neuroprotective drug in the cannabinoid.

Also I said that the life style was different - different situations from the 60’s - the son wasn’t sleeping and had had head injuries from hockey and 

Brain impact from marijuana

• Marijuana Effects 
• CBR - Cannabinoid receptors - naturally in the brain - high densities are found in areas that influence pleasure, memory, thinking, concentration, movement, coordination and sensory and time
• NIDA Marijuana ABuse 2010

THC stimulates CBR - overstimulation - disruption of natural or endogenous cannabinoids - ‘marijuana - ‘high’

They say I’m not depressed and not anxious - but I tell them they are ‘high’ and that they wouldn’t be anxious or depressed with being drunk but they’d recognise that they were ‘drunk’.

High - heightened perception, altered perception of time and increased appetite

disrupts co ordination 

-psychosis - 

effects on general health - heart rate speeds up

when they say they feel anxious without pot - I ask how long since they were off marijuana for 2 weeks - there is a withdrawal phase - so I explain the withdrawal and cycle and explain that we really don’t know until we have a period of time to see

Medical marijuana - scientists confirmed cannabis plants contain active ingredients with therapeutic potential for relieving pain, controlling nausea, stimulating appetite and decreasing ocular pressure

NIDA 2010

Heath Canada grants accept to marijuana for medical use to those who are suffering from grave and debilitating illnesses

-documentary WEED 

-young people saw this and come with the argument and there was real disconnect in this documentary, what it was saying and who it was saying about

Csnnabis and Schizophrenia

• Longitudinal studes in 5 countries strong evidence of causal link
• researchers established drug abuse lead to double rate in adolescents in hospitalization for sx
• metal analysis McLaren et al 2010 causal link

--temporal link can not be connected

Prodromal patients

• genetic marker - at risk
• Haroun t al 2006
• Kristensen & 2006

Pre-existing vulnerability

• family history of psychosis
• have you had hallucinations using pot - risk - not everyone who experiences psychosis when they use coke or pot - then ask how long after you used did the psychosis - if longer days or weeks - then it sounds like your brain is having trouble recovering from the hit you gave it
• head injury - I use analogy of head injury - mohammed alli - boxer dementia - his condition didn’t come from a single knockout - culmination of multiple hits - everytime we experience psychosis when high - this works
• Stefanis et al 2004 
• Downside of High-CBC Documentary

I tell young people to look at this documentary on You Tube

Marijuana, Memory, Amotivation

-amotivational syndrome is real - we see it all the time - 28 year old guy playing video games in parents basement

associations with marijuana use and depression, anxiety, suicidal thoughts, among adolescences and personality disturbances

• told parents to be hypocrites- be parent not the friend - don’t get caught in that - don’t tell them you smoked pot - 

Cannabis and MVA

• clear evidence that cannabis like alcohohl impairs psychomotor skills required for safe driving
• moderate doses cannabise impaires automated tasks but leave complex function
• drives at increased risk of crashin
• lower reaction

Should marijuana be legalized? 

WHO _ Biggest public health disaster of all time was the legalization of tobacco - director general

When alcohol prohibition was in the states - all health indicators improved though in a different system - crime went up but from health basis - much improved

Cons to Legalization

• cannabis use is harmful to adolescents especially with early or frequent use

• Implications
• marijuania more prevalent among patients with psychaitric disorders

increase schizophrenia and chronic psychosis

One tool - cycle of drug use - 1 abstience - experimentation - recreation use - habitual use - abuse - dependence 

I show this to adolescents 

When I ask adolescents where they are they are usually not that far off telling me where they are in the cycle - then I ask ‘wouldn’t it be great if you could go back ‘ then show them how especially to the very resistant

In psychiatry we say you shouldn’t self disclose but I find that self disclosure helps and I saw myself doing this when I was a mother that I was self disclosing so I developped a different view .  But if I’m working with a person and I’m not using a ‘recovery’ model I can say that I’m not talking about  but rather I’m talking about coping methods so I don’t only have to speak from experience and be helpful

Asked re harm reduction and marijuana - don’t see any benefit for ‘smoked’ marijuana - 

Discussion of other agents - sativex, cesamet and newer pharmaceuticals that are superior to ‘medical marijuana’ and recommendation that doctors specify that there is no ‘medical’ benefit to ‘smoked’ so indicated only for use as ‘tea’.

Kandinsky-Clerambault Syndrome: Differences in understanding a mental automatism syndrome

These are my rough notes from the Lecture. The presenter was remarkable, to say the least, understated, historical, and clinically astute. He made a very strong case for a syndrome, still relevant today, which seems to have been lost in the era of 'categorization' and "reductionism". In the end I couldn't help but wonder who to believe, Spitzer, or a number of psychiatrists as well as that great observer of human nature, William Shakespeare?(whose quotations animated the lecture) Sunday, Dec. 2, 2012

First Interdisciplinary Congress “Psychiatry and Related Sciences” Chairs; W. Gaebel (Germany) M. Mavreas (Greece)

 P.V Morozov (Russia) MD PHD Dr.SCi Professor, Department of Psychiatry, Faculty of Advanced Medical Studies, Moscow
Kandinsky-Clerambault Syndrome: Differences in understanding a mental automatism syndrome

Set of interrelated symptons - pseudohallucinations, delusions of persecutions, First dx aftr Epstein in 1927 Spitzer - should be removed DSM4 - pseudohallucinatios Kaplan Sadock - consider it erotomania but not
Kandisky was psychiatrist and patient pseudohallucinations - as opposed to real hallucinations F.W. Hagen 1868 - “pseudohallucinatios “ auditory Baillarger - internal intellectual voices No a variety of sensory but belongs to thought
Kandisky described ‘internal ear’, ‘internal vision’ -pseudohallucination - when patient saw or listened to something in their mind as opposed to externally Kallbaum 1886 Kandinsky Pseudohallucinations of hearing vision “internal talk’ “pseudohallucinations in torrents - influx that is oniric (oneriod) in nature, the fabulousnes and tension of a plot with a patients active participation”
 This has been reported in epileptics as well. Brain imaging studies show that there are different areas of the brain involved in the experience of ‘pseudohallucinations’ as opposed to ‘hallucinations’

 Dr. Morozov shared this presentation as it is important in Russia and France but less well addressed by the DSM. He encouraged us to consider this as still an important distinction.

 (I commented that it was something we saw in addiction commonly and that interestingly it responded to treatment with antipsychotics suggesting an underlying brain disorder. )

North Vancouver Island Weekend for a Friend

My friend is 81 yo.  He was falsely accused of domestic violence. His 81 yo wife has developed psychotic dementia.  She's begun to attack him. The police arrested him however when she phoned them and spitefully falsely accused him.
He's crippled with a pace maker and diabetes. He was hurt with the bullying and  hand cuffing and jailed for a day.
He's a hunter. We've been hunting together for a quarter century.  I know his son well and his daughter. He is one of the most caring and generous men I've ever known. He has dozens of grandchildren, was always a hard worker and served his community and church for years. His home was invaded,  his privacy violated.
All his guns were removed from their locked storage.  He's never been anything but a responsible gun owner. I know his concern and respect for gun safety from dozens of hunting trips with him.  He was jailed. He is crippled, frail, having had heart attacks, cancer, heart disease and diabetes.  A young Rambo cop obviously had unresolved father issues.
Thankfully, older RCMP officers intervened who knew him as I did. They saved him from further physical abuse. His son, a lawyer friend and his church minister all came to his aid.  His wife was hospitalized. She's been doctor shopping,  not taking her medications and increasingly bizarre.  She's now in a psychiatric ward.  She's still calling him daily to take her back.  We know he wants to, out of duty and love,  but we tell him he can't.  "You're not the only ones who are telling me that,"he says. We're glad  as I can see this almost killed him.
Laura and I decided we'd come over to the Island to provide moral support.  He's a great man and it's terrible that at 81 years of age he's been brutalized,  his home invaded, his property confiscated, his reputation maligned, and all because of a false accusation by a tragically disturbed person whose principal caregiver was the person she turned on. Canada isn't the country it was or could still be.

It was a lovely trip up the island. We took the Horseshoe Bay ferry enjoying the ride across Georgia Strait.  I love Nanaimo since I've begun sailing my 40 foot Folkes sailboat over there and enjoying the town as it's meant to be enjoyed, from the sea inward.  This day we just drove through as I've done too many times before.
I'd lived in Parksville for several years.  I still miss the property I developed there and the work I did, the life of country living and the friends.  I can't go by the place without feeling immensely guilty not stopping to see the friends I have there who are simply some of the worlds' finest of people.
I drove the coastal highway reminiscing all the way about coming first to the island as a doctor in Courtenay and Campbell River before moving later to Parksville.  I was just driving through these places steeped in wonderful memories of decades back, youth, foolishness and women more beautiful that the spring flowers beginning to blossom on the island.  I remembered my dog Shinto too.  Gilbert is a great companion today and he and Shinto would have been the best of pals if they'd had a chance to know each other.
Passing the turn off to Mount Washington I told Laura how much fun the mountain was, so much more laid back than Whistler,  how much we enjoyed skiing powder there and how I'd love to ski there again.
Then there were the roads I took to the interior to go fishing sometimes, hunting other times.  My mouth watered passing the oyster beds I once knew. Then there were the anchorages I'd found along the coast where I'd spent nights using my dinghy to go ashore.
We called my friend and visitted his place. It was awful to see having known the tidiness and care he'd once had for his cabin. Now there was the chaos of an obviously sick person, nowhere to move and no ability to clean. I could tell my friend was sad I saw what he'd been living with.
He sang her praises, told us of her achievements, but hinted at the stress of the last few months,  He's a proud man and it was obvious he felt so sad he couldn't care for her any more.  This person he loved and admired had become someone else.  I told him he has to protect himself.  He's too old and frail to withstand more attacks physically or socially.
We had dinner at Salmon Point Restaurant. I remember eating there with someone glamorous decades back when as a young doctor I'd brought dates to just this place because of the view, the service, the fine food. It was like it hadn't changed except now early in the evening families with children dominated.  I couldn't help seeing how my friend had aged, my own grey hair and added girth coming to mind as well.  We listened as he told stories I'd heard a dozen times, tales of hunting, stories of family, shared memories of struggling through snows and climbing hills to get to places in the dark where we'd wait for game together.  It was a lovely evening.
Then Laura and I were leaving him back at his cabin, driving in my Ford F350 truck on to Discovery Inn.  I've stayed there often and love the rooms. Tonight our suite had a hot tub as well. Gilbert was welcome and Laura was pleased.
Tomorrow we'll go to church with my friend before heading home.  His son will come by on Monday to help clean up her stuff. Then he get get a cleaner in.

It's sad to think these things are common.  The Gun Registry for hunting rifles is being scrapped even now. It will go with all it's politically inspired hatred for men, hunters, outdoorsmen, our grandparents, farmers, trappers,  the explorers and settlers who made Canada the country it is.  The tragedies of aging won't be coupled with further humiliation and insensitivity.  Maybe then a man could care for his dementing wife without fear for his life, but not now.  Sadly not now.

Marijuana Debate - Canadian Society of Addiction Medicine 2011

Addiction Medicine Specialist, Dr. Paul Sobey refereed the marijuana debate between Canadian family physician and marijuana researcher Dr. Mark Ware and Prof. Jag Khalsa.from the National Institute of Drug Abuse.  Good humored laid back Indo American Prof Khalsa should have been the pro marijuana debater if steretypes were true. Dr. Mark Ware in comparison was such a clean cut and measured speaker by comparison. They were both extremely learned and the debate and discussion was one of the best I've heard.
Dr. Sobey did a masterful job of asking questions comparing efficacy of prescription pharmaceutical cannabinoid products, such as cesamet and nabilone,  with smoked marijuana products. Specifically Dr. Ware's research showed that smoked marijuana to date was superior in treatment of neuropathic pain associated with HIV.  Clearly there was benefit from cannabinoids for treatment of spasticity, nausea associated with chemotherapy, neuropathic pain and improving appetite in HIV patient. Other than rare examples the benefit of marijuana or cannabiniods over alternatives was negligible but physicians were generally glad to have as many alternatives as possible in their tool boxes.  . To date there had been no abuse of pharmaceutical cannabinoids noted by Dr. Ware's recent research or Dr. Khalsa's investigation.  There was a lot of 'off label' use of cannabiniods in areas where research had already excluded the benefit.  Such an example was migraines whereas there was need for more research in it's use in multiple sclerosis.
There was clear evidence agreed on by both that 'smoked marijuana' was associated with Chronic Lung Disease. Further there was overwhelming evidence that it caused psychosis and had profoundly negative mental health consequences for many.  The cost/benefit was significantly altered when the drug was now associated with causing or contributing to the development of schizophrenia in adolescents.  Further it was clearly associated with accidents, specifically motor vehicle accidents and fatalities.
Both researchers said that marijuana should not be used by adolescents.  Brain development continues rapidly to age 25 and Dr. Ware was very specific in making clear that he wanted to see more research and perhaps more use of smoked marijuana in chronically medically ill patients of older age. He was very upset that adolescents were quoting him saying it didn't appear to be associated with causing throat cancer as a justification for their using it recreationally.
Both researchers felt there was a strong need for more study of marijuana.  Prof. Khalsa was very pointed in saying that NIDA had not been against marijuana and that there were countless studies done on cannabinoids in the US. The position of NIDA was specifically against 'smoking' as there was no evidence that smoking of any kind was anything but harmful.
Dr. Ware made the telling comment that when the government introduced so called 'medical marijuana' with some 22,000 now smoking marijuana after 5 years in Canada there was no solid research component as part of this politically powered federal legislation.  Obviously any good marijuania program especially one government funded should incorporate an ongoing research component. The University of California was doing just this in the US.
With typical good humor Prof Khalsa responded to Dr. Ware's cry for more research money for the study of smoking marijuana saying that much medical research is done by private funding. There was certainly financially invested interests in the marijuana debate who had not been willing to date to back up their claims of the benefits of marijuana with research funding.  The marijuana industry certainly was making a killing but not as open to research as Dr. Ware was proposing especially in light of increasing evidence of the long term negative consequences for some and the real dangers for children, adolescents and pregnant women.
Dr. Ware's excellent scientific knowledge and reasoned  approach were a pleasant change to the usual paranoid marijuana devotee who bludgeons the medical doctor with phrases like 'organic' and 'herbal'  insisting penicillin is dangerous and marijuana is life's cure.  I
ndeed listening to both these learned men in an excellent discussion was a breath of fresh air given how smokey the discussion has been in past years.
Despite this being Vancouver, and the discussion immensely entertaining, no one lit up a joint during or after the debate.

Evil, Suffering, and Death: Developing a Framework of Hope in an Age of Nihilism, Pierre Gilbert PHD

At the Christian Medical and Dental Society Annual Meeting in Winnipeg I attended Pierre Gilbert's lecture, Evil, Suffering, and Death: Developing a Framework of Hope in an Age of Nihilism.  Part of Pierre's presentation was addressing the issue of 'exerocism' and 'demon possession'.  Many of the doctors and psychiatrists in CMDS and EMAS had worked as missionaries in countries where 'demons' were very much apart of the cultures of indigenous people.  Witchcraft and evil and magic were part of the 'medicine' of the local people of Haiti where CMDS doctors responded recently to the Haitian crisis.  As worldviews and as understanding of disease process it is important as practitioners to be able to separate what is useful from what is not.  In my own work with addiction I know that many of my patients perceive their addictions as 'demon drink' for instance and certainly the crack addicts eventually beginning to experience visual hallucinations and 'shadows' which they relate to as 'demons' or 'ghosts'.  Gabor Mate's book about addiction was titled "Hungry Ghosts" as that descriptions comes out of the experience of the addict themselves.
Pierre Gilbert began by saying that in western culture there really is not that much 'room' for demons and yet he is aware of increasing numbers of ministers and individuals seeking a faith based 'cure' to their experience of 'possession'.  He described a number of anecdotes which turned out to be classic psychiatric illness which had been misunderstood.   He felt that the reason for the confusion lay with the increasing confusion of postmodernism.
What follows are the rough notes I took of a part of his lecture:  I've just begun reading his book Demons, Lies and Shadows: A Plea for a Return to Text and Reason (Winnipeg, Manitoba, Kindred Productions, 2008).  As promised it goes further than the lecture and elucidates so many points time demanded he just touch on. A fascinating philosophical and theological read.
I found Pierre's observation about philosophers and social scientists amusing for he said,  to paraphrase that 'unlike other fields of study philosophers have the greatest tendency to get together and talk to each other in their own room without consideration of others or the world at large."   Because they're only speaking with themselves they often come to the most extraordinary conclusions which then become fashionable untill after a while everyone realizes they don't work. Then they get a new idea and that becomes the new fashion.

Postmodern

• I’m not particularly fond of this expression - I start to itch -it’s wholefully inadequate - reductionist

Jean - Francois Lyotard - pioneered the use of this expression.  Wrote a book.  Intellectuals were all over this like rottweillers on poodle

Jawues Ellul was ignored - said social scientists could hide themselves in room and tell each other stories - warned against this - despite his warnings - intellectuals began to characterize western society as ‘postmodernity’.  Collectivity began to do this

Alvin Plantinga’s definition

1. rejection of notion of objectivity (classical foundationalism)
2. rejection of the notion of absolute truth
3. rejection of meta narrative
4. Rejection of Judeo Christian  moral God
5. Exultation of the self and moral autonomy
6. And they lived happily everafter????

We should be Happy

Post modernists say we have it all. We should be happy.

We have a ‘unified field theory’

(They don’t sound or look well. They don’t seem happy)

‘WE ARE NOT WELL!”

1. There is no absolute truth ?  (A contradiction in terms)
2. No evil in the world?
3. No absolute moral code? (There is plenty of moralism in our media)
4. Postmodern where it doesn’t matter - okay in spheres that don’t seem critical to us in religion and sexuality
5. Modern where it matters - ‘who needs a post modern engineer?  (who wants a post modern doctor?  who wants a postmodern bank account)
6. No metanarative?  - What about materialism? Evolution, secularism, pluralism, new age spiritualism.
7. Self confidence of post modern society is illusion and delusion

Cognitive dissonnance is structural and fabric - can’t go on for long at risk of society and individuals.  We are deeply sick.”that only a deeply sick society can consider such phenomena as abortion, divorce...sexual promiscuity, substance addiction, and teenage suicide as unavoidable”  Society is depressed - Tony Anatrella “Non a la societe depressive (1997)

Age of Confusion - post modernism is a Rejection of Christianity.

• it’s is an expression of man’s (C. L. Lewis ‘s) “bent” towards Pantheism
• Rejection of Christianity

It is rebellion against Christianity and Return to Pantheism

I call postmodernism a SENSUAL PAGANISM

• no kids - largest self genocide in history of the world
• no to personal responsibility
• No community
• No personal and no moral God
• Nihilism - like to feel good about their nihilism - hence a jargon and philosophy that is so confusing
• Doesn’t explain Love, doesn’t explain good

The Mystery of the problem of good

Pascal’s The God Shaped Hole inside ourself

Western civilization is dying - most obvious sign is we are unwilling to reproduce.  In US million birth per year.  Canada 100,000.  Russia more abortions than live births.

“No nation or group of people can believe that death is the end of it all and survive. Societyes that procoaim deatth as the abolute and cannot survive. They commit suicide In fact industrial societes that carry this kind of idology have a reproduction co efficent near zero - pierre chaunu

We live in society that worships present, doesn’t view the past and doesn’t project into the future. ‘Living without being anchored in past and no meaningful view of the future”

When crisis strikes it creates profound sense of difficulties

An absolute present plus Existential Crisis = Hopelessness

Victor Frankl  - what man needs above all need a purpose to live

human needs hope

real hope is impossible where the present fills our entire horizon and there is no future.

How do we fight this cloud of hopelessness

Fighting Hopelessness

1. The Importance of Hope

• fight cynicism
• value of life
• “cloud of hope”

Roadmap to Hope

1. Hear of the drums of relativism - our society constantly beats drum of relativism and that christianity is a cultural artifact - if we fail to see the ‘virus’ it will erode our life
2. How do we gain knowledge about God?

Experience versus Revelation

Mother Theresa versus Hitler versus at top of empire state building - without warning I push them off - both hit ground same time - what can we learn from god from this experiment - in right and jsut universe - mother theresa should slow down and Hitler should accelerate. That’s not the way things work.

God is a God of law

God pays no attention to human piety

God is inflexible.

this is what Job concludes

In Judeo Christian experience we are not to develop our idea of God only from experience but from scripture as well

Faith is to act and live on the basis of what we know is true despite what we experience

How do we develop this kind of confidence? We develop it from history

C.S. Lewis - either Jesus was a raving lunatic or else he was precisely what he said. There is no middle way - (Problem of Evil)

The help of the Holy Spirit

Back to the Demons

A: Why is it so confusing?

-a hypothesis

• a limited database (in my book I studied  genesis 1-3, corinthians and mark and developped foundation I would use in real world with people who seemed demon possessed.
• They exist
• What is the nature and extent

Gospel of Mark

• Satan = Nuissance
• Demons are empty shadows

First Corinthians

• audience - belief in magic
• a piece of meat is a peice of meat and doesn’t carry magic

A: James 5 - Major Illness - sober approach to this

B: An Interview

• fellowship with demon?  - have they sought fellowship with demons
• signs of mental illness? If it looks like mental illness consult

C: Prayer -

• 1. Casting out of demons - pray with oil and cast out demons - based on the data the assumption I have is that the demon has gone.
• 2. Prayer of healing

D:  Two possibilites

-Demons dissipate - Restoration

Symptons remain - consultation with psychiatrist

E: Two typical cases - given antipsychotic drugs - symptons dissappearance - unless demons are allergic to antipsychotics it must be mental illness

F: Difficult cases -

Questioning our Identity

If we don’t go back to classical age of Christianity we can’t have hope

Of all the people on the planet we are the ones who should be most hopeful.

I've included this here because part of the 'predjudice' promoted in the 'anti Christian' movement is that Christians are somehow 'stupid' and that they really 'don't think'.  In contrast I 've found at the CMDS that Christian doctors are the most thoughtful.  Certainly the history of medicine and science shows that Christians were at the forefront of science in the same way that Einstein was not an aetheist.  Even today neuroscientist Mario de Beuregaard in Spiritual Brain discusses the findings of sciences as they apply to human behaviour and constrasts the 'truth' of science with the confusion of 'pseudosciences' which often 'misuse' information  for political gains.  Maybe it's because I work with dope smokers but I so often encounter this everything goes sloppy mindedness in that realm whereas at CMDS I hear real 'clarity of thought'.