11/17/14. Psychologist Martin E.P. Seligman traces the roots of learned helplessness, to resilience to optimism. All of us face failures and disappointments --- to learn how to triumph over trauma is essential.
Dr. Richard A. Friedman offers interesting ideas about ADHD, but none of these ideas are new or hold-up to close examination.
Dr. Friedman tells us that "people with ADHD are actually hard-wired for novelty - seeking --- a trait that had, until relatively recently, a distinct evolutionary advantage." This makes sense as far as it goes.
And it doesn't go that far. That people with extremes on personality traits are hard-wired is not a new finding. In fact, all personality traits are hard-wired - that is, have about a 50% contribution from genetics.
That we should put children, adolescents, and adults in environments that recognize their need for novelty-seeking makes sense --- a utopian sense, given the normal demands on adults in a civilized society. Those people diagnosed with ADHD who benefit from seeking out more stimulating settings should be helped to so --- but seeking these settings has limits. Those who recognize these limits make the best adjustments.
No doubt some adults have more freedom to seek out these more stimulating settings than do children and adolescents. And, yes, longitudinal studies have long found that some people outgrow ADHD.
Yet the search for novelty is one way to construe the symptoms of ADHD. Many people who fit this diagnosis have chronic and pervasive problems with distractibility, restlessness, and self-control which significantly disrupts their everyday life --- sometimes leading to depression, harshly negative self-esteem and self-doubts, anxieties, multiples marriages, loss of jobs, substance abuse, and suicide. These people benefit from medication and the healing of psychological therapy. To call this a search for novelty is a stretch of a sometimes useful concept.
Dr. Friedman's article reminds me of the last sentence of Somerset Maugham's book, "The Summing Up," that he wrote at age 69 years, telling us about his wide-range of life experiences and the many philosophies he has studied.
Maugham writes, "The beauty of life is nothing but this, that each should act in conformity with his nature and his business." True for those with ADHD ---- and everybody else.
For those lucky enough to match their nature and business --- they many not need medication for ADHD. But for the rest --- they need all the help they can get.
7/22/14. No easy answers. Many wrong answers applied too often.
In the 1960's, we celebrated deinstitutionalization ("the myth of mental illness"), created the homeless population, protected patients' rights to be severely mentally ill, made sure nobody forced them to take their medications, and watched while the mentally ill wrecked their lives and left their families heartbroken.
Imagine two guys looking up at a big sign that says STOP
AND THINK. One fellow says to the other:“Sorta makes you STOP AND THINK.”The reaction of these two fellows is exactly
what the cartoons in TheNew Yorker Magazine make youdo –
cartoons that are better described as life drawings requiring you to think
about life’s predicaments and ambiguities, facing the dangers and excitements
of being alive.
Mankoff, cartoon editor for The New
Yorker (TNY), has written a memoir
about his life in cartoons. The topics of TNY cartoons draw on humor from sex,
love, death, parenting, marriage, family, cruelty, fear, jealousy, envy, hate,
identity, character, conscience, desire, mourning and more --- the same topics
that psychologists are up to their ears in.
Mankoff left psychology graduate school to seek his fortune
in drawing cartoons. He started selling cartoons in 1977, and started working
for TNY in 1980. He says he knows all about rejection, being booted out of
psychology graduate school, and submitting thousands of cartoons to TNY before
getting his first cartoon published.
became the cartoon editor in 1997, about 20 years after selling his first
cartoon. As editor of the magazine, he evaluates more than 500 cartoons every
week, selecting about 10 - 15 for each magazine issue
Mankoff is most famous for creating the cartoon bank, and
for the following best-selling cartoon:
An executive is at his desk,
on the phone, and looking at his calendar says, “No, Thursday’s out. How about
never?” Is never good for you?”
title of his memoir is taken from what might be the most popular cartoon in the
history of TNY. Mankoff remembers how he got the idea for this cartoon. He was
trying to get on the phone with a friend who he wanted to see. That friend kept
saying, “Can we meet this time? Could we do it that time?” And finally Mankoff
says to his so-called friend, “How about never? Is never good for you?”
Mankoff traces this snotty retort back to his Queens and
Bronx New York Jewish background. The Chapter 1 title is:“I’m Not Arguing, I’m Jewish.” During
childhood, whenever he complained to his
mother he was bored, she told him to bang his head against the wall, Mankoff
quips. She taught him boredom was a luxury.
He describes his never-boring cartoon editor job as
evaluating humor, a much different process from enjoying humor. He gives an
example of a cartoon with 10 possible captions --- and this is the format of
the cartoon caption contest that runs every week in TNY. The readers submit
captions to a cartoon on the page, and the winners of the caption contest are
printed. His editing job consists of picking cartoons with the best captions.
To evaluate cartoons, Mankoff reports that he is faced with
the paradox of choice, which automatically brings the interference of the
judgment process, short-circuiting the laugh response. So instead of laughing
at the cartoon, he has to judge it.
In analyzing humor, Mankoff comments about what comics call
“the magic of three.” He says you need a sequence for surprise to make a
is an example of a cartoon with the element of triplets in humor --- a one,
two, and then boom.
A woman is saying, “I
started my vegetarianism for moral reasons, then for health concerns, and now
it’s just to annoy people.”
cartoons in TNY, show the very widespread humor taking place in New York, the
circus of the world. Humor makes fun of what’s in the public mind.
Here are two examples of cartoons about same-sex marriage:
A couple is looking at TV,
and the guy is saying, “Gays and lesbians are getting married. Haven’t they
A couple is in bed, and the
guy is saying to the woman, “What’s your opinion of some-sex marriage?”
Mankoff appreciates humor that is benign, not speaking
truth to power, but humor directed back at the people who are reading the
He describes a theory of humor he calls, “Just the Right
Amount of Wrong.” He says this view emphasizes that humor is different in
different contexts. He says that the mother’s milk of humor is anything that’s
embarrassing, guilt- or anxiety-filled. Mankoff has learned that humor comes in
almost endless varieties:humor based on
reality, observational humor, silliness, and playful incongruity or absurdity.
An example of an absurd cartoon is:
It’s a cowboy at a desk. The
person sitting in front of him is a cow, and he’s reading his resume. And the
cowboy is saying, “Very impressive. I’d like to find 5,000 more like you.”
One cartoon, apparently not for everybody’s taste, shows a
rodent in a cage, and then another picture of a rodent who hung himself. The
caption is: “Discouraging data on the antidepressant.” Mankoff tells about
readers who send in letters saying they don’t like cartoons where animals
suffer. Mankoff’s response:“We use
anesthetic ink.” A wise-guy he is.
Some people are hypersensitive to humor, and some people
have little or no humor. I make it a rule never to use humor with people I
don’t like ---- it is hard to keep my unconscious slips from showing.
Mankoff notes there have been many cartoons in TNY about
the Grim Reaper because humor is an important way we cope with death, anxiety,
suffering and illness.
An example of Grim Reaper humor:
The Grim Reaper is taking
away her husband, and the wife is at the apartment door, and she is saying,
“Relax, Harry. Change is good.”
Cartoons about marriage are another staple of TNY cartoons.
Mankoff mentions he is happily married to his third wife. He says humor is indispensable
in our attempts to understand our partners and for our partners to understand
He cites a cartoon on marriage:
A man is talking to a woman
in the living room and he says, “Believe me, Janet, I consider you an important
part of our marriage.
Mankoff focuses on
the links between creativity and humor. He mentions Arthur Koestler’s book,
“The Act of Creation,” (1) in which he connects humor, science and art.
without a sense of humor is life without any sense of proportion or
Where laughter stops,
so does common sense.
As William James noted, “Common sense and a sense of humor are the same
thing, moving at different speeds. A sense of humor is just common sense,
Koestler, Arthur. “The Act of Creation.”New York:Macmillan, 1964.
..."Trigger warnings logically follow from the recent history of American academic life. This is a history in which demographic diversity has triumphed over intellectual standards and the display of virtue over the search for truth."...
One Pope, in the Dark Ages, decreed that all Jews had to leave Rome. The Jews did not want to leave, and so the Pope challenged them to a disputation to prove that they could remain. No one, however, wanted the responsibility... until the synagogue janitor, Moishe, volunteered.
As there was nobody else who wanted to go, Moishe was given the task. But because he knew only Hebrew, a silent debate was agreed. The day of the debate came, and they went to St. Peter's Square to sort out the decision. First the Pope waved his hand around his head. Moishe pointed firmly at the ground.
The Pope, in some surprise, held up three fingers. In response, Moishe gave him the middle finger.
The crowd started to complain, but the Pope thoughtfully waved them to be quiet. He took out a bottle of wine and a wafer, holding them up. Moishe took out an apple, and held it up.
The Pope, to the people’s surprise, said, "I concede. This man is too good. The Jews can stay."
Later, the Pope was asked what the debate had meant. He explained, "First, I showed him the Heavens, to show that God is everywhere. He pointed at the ground to signify that God is right here with us. I showed him three fingers, for the Trinity. He reminded me that there is One God common to both our religions. I showed him wine and a wafer, for God's forgiveness. With an apple, he showed me original sin. The man was a master of silent debate."
In the Jewish corner, Moishe had the same question put to him, and answered, "It was all nonsense, really. First, he told me that this whole town would be free of Jews. I told him, Go to Hell! We’re staying right here! Then, he told me we had three days to get out. I told him just what I thought of that proposal." An older woman asked, "But what about the part at the end?" "That?" said Moishe with a shrug, "Well, I saw him take out his lunch, so I took out mine."
difference between men and women is that, if a woman has to choose between
catching a fly ball and saving an infant's life, she will choose to save the
infant's life without even considering if there are men on base."
cigar is as great a comfort to a man as a good cry to a woman."
sex-war thoughtlessness is the weapon of the male,
of the female."
women belong to different species,
communication between them is a science still in its infancy."
men think. Sex, work --
and those are reversible, depending on age -- sex, work,
food, sports, and lastly, begrudgingly, relationships. And here's how
women think. Relationships,
relationships, relationships, work, sex,
shopping, weight, food."
motivated and empowered when they feel needed....
motivated and empowered when they feel cherished."
symptom of true love is a young man is timidity,
in a young
speak because they wish to speak, whereas
a man speaks
only when driven to speech by something outside himself -- like, for
instance, he can't find any clean socks."
falls in love through his eyes, a woman through her imagination,
and then they
both speak of it as an affair of 'the heart'."
might be able to fake orgasms.
But men can
fake whole relationships."
hate waiting while their wives shop for clothes and trinkets;
how women hate
waiting, often for much of their lives, while their
husbands shop for fame and glory."
face is his autobiography. A woman's face
is her work of fiction."
Review:Hinshaw, Stephen P., and Scheffler,
Richard M. The ADHD Explosion. Myths,Medication, Money, and Today’s Push for
Performance.New York:Oxford University Press, 2014.
Myths about ADHD persist. Too many
people continue to believe it’s a cop out, an unvalidated condition related to
society’s penchant for overmedicalizing defiance or a convenient label intended
to cover over social problems. These myths destroy any hope of providing
systematic educational, behavioral, and medical care for the youth, families,
and adults who desperately need help. Medications are still viewed suspiciously
for behavioral and psychiatric conditions, a position unfortunately fostered by
the ease of getting an ADHD diagnosis and securing pills for performance
enhancement in too many quarters of society – and by overreliance on medication
as the only treatment worth pursuing. To deal with ADHD better than we do now,
we must alter our attitudes as well as our educational and healthcare practices (Hinshaw & Scheffler, page 168).
This book, written by Stephen P.
Hinshaw, Ph.D., Professor of Psychology at the University of California,
Berkeley, and Richard M. Scheffler, Ph.D., Distinguished Professor of Health
Economics and Public Policy in the School of Public Health and the Goldman
School of Public Policy at the University of California, Berkeley, could not
have come at better time.
For the past two years, the media
--- the New York Times, the Wall Street Journal --- have been awash with
articles attacking the validity of ADHD, and slamming the medication treatment
for this serious psychiatric disorder. The following are some headlines of these
Gone Wrong.” Sroufe, L. Alan. The New
York Times, January 28, 2012.
Rise of the Good-Grade Pill.”Schwarz,
Alan. The New York Times, June 9,
“Drowned in a Stream of Prescriptions.” Schwarz,
Alan. The New York Times, February 2,
Nation of Kids on Speed.” Cohen, Pieter. Rasmussen, Nicholas. The Wall Street Journal, June 16, 2013.
Now these exposes about ADHD are
nothing new. Some of these reports are critically examined in “The ADHD
Explosion,” with some surprising results.
Scientologists, where their founder L. Ron Hubbard
lectures us about the between-lives period, when thetans are transported to
Venus to have their memories erased, have waged a 40 year war against Ritalin –
and against psychology and psychiatry, along with sympathetic mental health
clinicians through the Citizens Commission on Human Rights, a Los-Angeles based
nonprofit organization formed by the church in 1969 to investigate mental
health abuses. Scientologists have used their considerable fortune to sue drug
companies and the American Academy of Child and Adolescent Psychiatry, among
others. When Scientologists announce their legal challenges to protect
children, the media shines a bright light on these efforts. When all the
lawsuits are dropped because of no merit, not a word their dismissals reach the
Hinshaw and Scheffler’s book has
four fundamental messages:
ridiculed, ADHD represents a genuine medical condition that robs people of
major life chances. Its economic consequences are huge, totaling hundreds of
billions of dollars annually in terms of special education services, juvenile
justice and substance abuse costs, plus low work productivity and employment
lapses in adults.
Only diligent and
thorough assessment can distinguish ADHD from other mental health conditions,
chaotic home environments, or the aftereffects of maltreatment. Yet, ADHD is
too often diagnosed in extremely cursory fashion. This lack of careful
evaluation, fueling both overdiagnosis and underdiagnosis contributes to a
are effective in reducing the condition’s core symptoms, at least in the short
run, but the most genuine gains are achieved by combining medication with
4. Rates of ADHD and
medication treatment vary dramatically across states (and, for treatment,
across the world), related to family and cultural values, health care systems,
medical portrayals and advertisements, and, in particular, variations in school
policies linked to demands for achievement and performance.
The authors list ten major goals for
improving the science and practice related to ADHD in the future. Each of these
goals roughly corresponds to a chapter in the book:
that ADHD is recognized as both biological and cultural and contextual in
that ADHD be diagnosed carefully by professionals who know their business.
that ADHD be treated by clinicians (and paraprofessionals) who are versed in
realistic national quotas for stimulants, balancing the need for prescriptions
for legitimate cases of ADHD with the reality of ever-greater diversion of the
medications for neuro-enhancement or pleasure.
educational practices to promote more individualized approaches.
partnered systems of cure, and coordinated payment mechanisms, across insurers,
schools, and employers.
a different set of media images about ADHD, emphasizing the reality of daily
struggles and triumphs.
information exchange across scientists and clinicians internationally.
to recognize that ADHD exists well beyond white, middle-class boys, revealing
itself across gender, race and ethnicity, and the age span.
(10)Recognize that fostering human potential,
reducing stigma and enhancing economic productivity
go hand in hand.
This book provides a corrective
emotional and cognitive experience through an even-handed discussion about the
controversies surrounding ADHD. The authors make clear what is known about
ADHD, and distill the complexities about the personal and social costs of people
who suffer with the chronic and pervasive problems of ADHD.
Going Clear. Scientology, Hollywood, and
the Prison of Belief. New York:Alfred A. Knopf, 2013.