Tuesday, June 29, 2010

Friday, June 25, 2010

Violence Expert Visits Her Dark Past

6/25/10. A review of Jessica's Stern's "DENIAL. A Memoir of Terror." Stern is one of the world's experts on violence and evil. Her book attempts to explain why she is driven to study terrorism and put herself in danger travelling around the world.


The Openness Elixir

6/25/10. A review of two books that urge us to open markets and minds.


Monday, June 21, 2010

"The Temperamental Thread. How genes, culture, time and luck make us who we are"


Anybody who could tell us how genes, culture, time and luck make us who we are gets my attention ---- especially when the author is one of the world’s most distinguished psychologists with a resilient nature and more than fifty years of experience.

Jerome Kagan outlines in clear, concise prose the causes and consequences of the varieties of temperaments across the life-span, drawing on many disciplines. He takes us on an intellectual ride exploring contributions from neuroscience and what we know about brain circuits and temperament, how experience alters the genetic expressions of temperament across the life-span, and the importance of neuroplasticity.

Kagan describes his book:

"This book summarizes what many scientists have learned about a small number of human temperaments, especially the forms they assume during infancy, their derivatives in later childhood, their possible biological origins, the experiences that shape each set of biases into various personality types or symptoms of mental illness, and their contribution to the psychological differences between males and females and ethnic groups."

The book has the following seven chapters:

1. What Are Human Temperaments?

2. Reacting to the Unexpected

3. Experience and Inference

4. Temperament and Gender

5. Temperament and Ethnicity

6. Temperament and Mental Illness

7. What Have We Learned?

Kagan compares personality to “a gray tapestry woven from very thin black and white threads --- the former representing temperaments and the latter life experiences.” He weaves this tapestry together with subtle, often surprising research findings about the joint shaping of biology and experience to shed light on human nature, culture and experience.

As an example of how temperamental threads shape our understanding of mental illness (see Chapter 6), Kagan draws from the seminal work of psychiatrist Paul McHugh. In his influential “Perspectives of Psychiatry” (1), McHugh states that mental disorders are life under altered circumstances. These circumstances are grouped in families of disorders, stemming from breakdowns in the mind’s design that indicate brain disease, or expressions of the mind’s design that lead to behavioral misdirections (e.g. alcoholism) or emotional responses to distressful life encounters (e.g. adjustment disorders) (2).
Kagan infuses his knowledge of temperament to elaborate on McHugh’s four families of psychological disorders which have their origins in (1) brain disease (e.g. autism, dementia, schizophrenia, delirium); (2) temperamental biases for anxiety and depression (e.g. phobias, PTSD, panic disorder, obsessive-compulsive disorder, depression); (3) temperamental biases that make it difficult to regulate impulsive behavior (e.g. ADHD, conduct disorder); or (4) distressful life encounters (e.g. grief, adjustment disorders, trauma).

These four families of disorders are a modest suggestion to improve psychiatry's Diagnostic and Statistical Manual. This approach to classification takes small steps to classify psychiatric disorders by what underlies them --- families of disorders that share a causal, generative nature which may lead to research developing etiological principals.

Whenever I think about temperament and human nature, I am reminded of W. Somerset Maugham’s, “The Summing Up,” a thoroughly satisfying memoir of a lived life. Maugham spent five years in medical school steeped in the human condition before becoming a successful author. In “The Summing Up,” written at age sixty-four years, Maugham sets down his ideas about art, literature, living the famous life, and what he learned from years of reading philosophers. He concludes “The Summing Up”:

"The beauty of life…is nothing but this, that each should act in conformity with his nature and his business."

Whatever your nature, I urge you to make it your business to read Professor Kagan’s, "The Temperamental Thread."


(1) McHugh, Paul R., and Slavney, Phillip R. The Perspectives of Psychiatry.Second Edition. Baltimore: The Johns Hopkins University Press, 1998.

(2) McHugh, Paul R. “Psychiatry at Stalemate.” In Dan Gordon (Editor). Cerebrum 2010. New York: Dana Press, 2010.

(3) Maugham. W. Somerset. The Summing Up. New York: Penguin Books, 1938. This quote is from Fray Luis de Leon.

Wednesday, June 2, 2010

"Families with a Missing Piece"

6/2/10. Jeffrey Zaslow, writer for the Wall Street Journal, writes about the new look about how a parent's early death can reverberate decades later.


Sympathy Deformed

6/2/10. Prison psychiatrist Theodore Dalrymple examines how some forms of compassion hurt the poor.


Seeking an Objective Test for Attention-Deficit/ Hyperactivity Disorder

6/2/10. Until there is a biological marker for ADHD --- , there will be no convincing some skeptics that ADHD exists and that medication helps many people cope with the chronic and pervasive symptoms of distractibility, restlessness, and self-control. Those with ADHD have significant problems filtering out external distractions and "putting the brakes" on their behaviors.

ADHD is not the only psychiatric disorder without a biological marker. In fact, etiology unknown with no biological marker is true for all psychiatric disorders.

Tests for ADHD often claim to take the subjectivity out of the diagnostic process.

These so-called objective tests are no substitute for clinical experience and sound judgment.