Saturday, June 12, 2010
Friday, June 11, 2010
Simplify, Simplify
I will ponder color and design over the weekend, but here I must recommend a recent David Brooks column stoutly defending the liberal arts in education. Eschewing grand but airy pronouncements (of the kind frequently found on this blog), Brooks argued that the study of history, literature, and other domains creakily termed "the humanities" gives unique insight into "The Big Shaggy," his term for the deeply complex and wayward aspects of human nature that escape systematizing theories, whether biological, political, or otherwise ideological ("The Big Shaggy" isn't the term I would have chosen, but Brooks is writing for the New York Times, while I'm writing here).
His column nicely encapsulated what I've stood for in life and fought for in my years of clinical work, that is, resistance to the dumbing-down of human experience that is often found in diagnostic systems and, well, simple-minded approaches to minds that, rightly considered, are infinitely complicated. And yet I found myself contrasting that truth with a recent Jon Stewart routine in which he showed multiple clips of Barack Obama, with respect to situations like the gulf oil spill, health care, and the economy, pronouncing again and again to reporters, "It's complicated." Stewart followed this up with appalled exasperation: "Well simplify it!"
This usefully reminds me that human beings, while capable of appreciating complexity (to varying degrees) are alike in needing, especially in times of crisis, forceful and dramatic metaphors that are, yes, simple. So when I am tempted to disdain such words as "depression" or, even worse, "chemical imbalance," that seem to obscure a wealth of nuance with a kind of advertising slogan, I need to remember that such terms help to orient people. While a minority of folks--those who seek out psychoanalysts and English doctorates--may revel in boundless complication, most people are not wired that way. That is not to say that they're stupid or simple-minded; they merely crave contrast and direction. Leadership, whether political or clinical, is about providing these things; by breaking things down into basics, it risks dumbing-down, but the alternative risk is endless equivocation.
It seems to me that the art of medicine, like the art of life, is steering a path between over-simplification and over-complication, making use of metaphors without becoming trapped by them. Indeed, isn't language itself a kind of over-simplification inasmuch as it reduces, to paraphrase William James, the blooming, buzzing confusion of experience to a finite number of limited words? We can only grasp reality by making a narrative out of it, a narrative that necessarily distorts the stuff of experience. Just as we charge Barack Obama with constructing a narrative of the gulf oil spill that usefully but modestly apportions responsibility and possible avenues of action, we would charge a psychiatrist with drawing up a diagnostic and therapeutic narrative that is respectful of its own limitations. Whenever one tells oneself, "It's complicated," one should inwardly reply, "Simplify, simplify," and vice versa.
His column nicely encapsulated what I've stood for in life and fought for in my years of clinical work, that is, resistance to the dumbing-down of human experience that is often found in diagnostic systems and, well, simple-minded approaches to minds that, rightly considered, are infinitely complicated. And yet I found myself contrasting that truth with a recent Jon Stewart routine in which he showed multiple clips of Barack Obama, with respect to situations like the gulf oil spill, health care, and the economy, pronouncing again and again to reporters, "It's complicated." Stewart followed this up with appalled exasperation: "Well simplify it!"
This usefully reminds me that human beings, while capable of appreciating complexity (to varying degrees) are alike in needing, especially in times of crisis, forceful and dramatic metaphors that are, yes, simple. So when I am tempted to disdain such words as "depression" or, even worse, "chemical imbalance," that seem to obscure a wealth of nuance with a kind of advertising slogan, I need to remember that such terms help to orient people. While a minority of folks--those who seek out psychoanalysts and English doctorates--may revel in boundless complication, most people are not wired that way. That is not to say that they're stupid or simple-minded; they merely crave contrast and direction. Leadership, whether political or clinical, is about providing these things; by breaking things down into basics, it risks dumbing-down, but the alternative risk is endless equivocation.
It seems to me that the art of medicine, like the art of life, is steering a path between over-simplification and over-complication, making use of metaphors without becoming trapped by them. Indeed, isn't language itself a kind of over-simplification inasmuch as it reduces, to paraphrase William James, the blooming, buzzing confusion of experience to a finite number of limited words? We can only grasp reality by making a narrative out of it, a narrative that necessarily distorts the stuff of experience. Just as we charge Barack Obama with constructing a narrative of the gulf oil spill that usefully but modestly apportions responsibility and possible avenues of action, we would charge a psychiatrist with drawing up a diagnostic and therapeutic narrative that is respectful of its own limitations. Whenever one tells oneself, "It's complicated," one should inwardly reply, "Simplify, simplify," and vice versa.
Wednesday, June 9, 2010
Happy 100?
I haven't indulged in blogging about blogging for a long time, but I will allow myself this now that Blue to Blue has inched its way to 100 posts over 11 months. However, while I have retained a few core readers (thank you!), overall the readership as reflected in both hits and comments has been smaller than in my first blog Ars Psychiatrica. Reasons?
1. I haven't been as prolific, either in frequency or ambition of posts; it has simply been a more desultory blog overall. For various reasons I haven't devoted the time and energy that I often did last year. However, some Blue to Blue posts have been, I think, every bit as decent as many in the parent blog.
2. While I would hope that most people would visit this sort of blog primarily for textual content, the cool pictures and quotes that often adorned my previous blog have generally been lacking here. All else being equal, people like pictures.
3. Considering style further, I think that the title Ars Psychiatrica, while a bit pedantic, also usefully named the blog's niche in a way that the more inscrutable "Blue to Blue" does not. Also, the midnight blue template, while appealing to me at first, has grown a bit oppressive (or maybe I'm just bored with it).
4. I haven't been as active in reading and commenting on other blogs as I used to be, which affects readership.
5. As Facebook, Twitter, etc. have continued to grow and offer further distractions, maybe fewer people take time for blogs than used to be the case. (?)
6. As compared to its predecessor blog, probably fewer posts here have offered anything like mainstream commentary on psychiatry (again, the niche is less defined).
7. Perhaps the Novalis brand, so to speak, has grown a bit stale. Just as some claim that writers tend to write the same book over and over again, one does tend to revisit the same issues, although hopefully in a spiral more than a circular fashion (theme with variations).
8. In any event, I find myself at another cusp of choosing whether to give up blogging altogether or, on the contrary, to shift gears again and approach things from a different angle. As compared to the past year, I am in a position to devote more attention to writing if desired. I have even considered returning to Ars Psychiatrica (2.0 perhaps), declaring Blue to Blue a finally unsatisfactory detour. Or perhaps I will undertake something else altogether.
1. I haven't been as prolific, either in frequency or ambition of posts; it has simply been a more desultory blog overall. For various reasons I haven't devoted the time and energy that I often did last year. However, some Blue to Blue posts have been, I think, every bit as decent as many in the parent blog.
2. While I would hope that most people would visit this sort of blog primarily for textual content, the cool pictures and quotes that often adorned my previous blog have generally been lacking here. All else being equal, people like pictures.
3. Considering style further, I think that the title Ars Psychiatrica, while a bit pedantic, also usefully named the blog's niche in a way that the more inscrutable "Blue to Blue" does not. Also, the midnight blue template, while appealing to me at first, has grown a bit oppressive (or maybe I'm just bored with it).
4. I haven't been as active in reading and commenting on other blogs as I used to be, which affects readership.
5. As Facebook, Twitter, etc. have continued to grow and offer further distractions, maybe fewer people take time for blogs than used to be the case. (?)
6. As compared to its predecessor blog, probably fewer posts here have offered anything like mainstream commentary on psychiatry (again, the niche is less defined).
7. Perhaps the Novalis brand, so to speak, has grown a bit stale. Just as some claim that writers tend to write the same book over and over again, one does tend to revisit the same issues, although hopefully in a spiral more than a circular fashion (theme with variations).
8. In any event, I find myself at another cusp of choosing whether to give up blogging altogether or, on the contrary, to shift gears again and approach things from a different angle. As compared to the past year, I am in a position to devote more attention to writing if desired. I have even considered returning to Ars Psychiatrica (2.0 perhaps), declaring Blue to Blue a finally unsatisfactory detour. Or perhaps I will undertake something else altogether.
Monday, June 7, 2010
On the Perpetuation of Species
Spanning the gamut of online wisdom, advice columnist Carolyn Hax and philosopher Peter Singer weigh in on the advisability of adding to the sum total of humanity. I've long been curious about the ways in which people choose (when they do have a choice, which they usually do) whether or not to have children.
Hax, responding to a letter-writer who asks if her anxiety disorder may be too severe for her to attempt parenthood, replies, in effect, that wanting to be a parent is no justification for becoming one. She advises the inquirer to consider, in light of her own knowledge of what it is to be a child, whether she would want herself as a parent. How drastically different human history would be if this were a precept that were followed with any consistency! Isn't the presumption of fitness for parenthood pretty much wired into the human organism? Indeed, it may be only the seriously depressed or demoralized, like the letter-writer in this instance, who even consciously consider the matter (which isn't to say that most people who choose not to have children do so for reasons of pathology).
Singer reminds us that creating a child is, of course, a portentous act of either good or ill. He alludes to recent philosophical writing that argues that, well, life often isn't the unqualified good we take it to be (I envision The Onion article: "Philosophers discover that life isn't worth living."). And all joking aside, one does occasionally encounter lives that are so chock full of misery and degradation that, really, not only the moral universe as a whole, but also the possessors of the lives in question, would seem to have been better without them.
Half tongue-in-cheek, Singer wonders whether it would be reprehensible for the species to decide that we will in fact be the final generation. After all, there is no categorical duty to procreate; we do not hold the childless to be guilty of some existential failure or infraction. We cannot be held to have a responsibility for vague beings of the future who may or may not exist; we have duties toward the living, that is all. And yet...one could argue that the presumption of a future for humanity, even if one does not have biological children oneself, is so deeply ingrained in the human organism that the horror of apocalypse far exceeds one's own demise. The future of humanity is not an obligation, but it is a hope, or perhaps a faith.
If one were to genuinely doubt the chance for a worthwhile life of one's offspring, then one would implicitly have to question one's own as well. I am surprised that Singer didn't mention The Children of Men, the movie a few years back that showed the depression and desperation of a world without reproduction. Arguably the final generation, whenever its grim day may come, whether in years or in millenia, will be the saddest one of all.
Hax, responding to a letter-writer who asks if her anxiety disorder may be too severe for her to attempt parenthood, replies, in effect, that wanting to be a parent is no justification for becoming one. She advises the inquirer to consider, in light of her own knowledge of what it is to be a child, whether she would want herself as a parent. How drastically different human history would be if this were a precept that were followed with any consistency! Isn't the presumption of fitness for parenthood pretty much wired into the human organism? Indeed, it may be only the seriously depressed or demoralized, like the letter-writer in this instance, who even consciously consider the matter (which isn't to say that most people who choose not to have children do so for reasons of pathology).
Singer reminds us that creating a child is, of course, a portentous act of either good or ill. He alludes to recent philosophical writing that argues that, well, life often isn't the unqualified good we take it to be (I envision The Onion article: "Philosophers discover that life isn't worth living."). And all joking aside, one does occasionally encounter lives that are so chock full of misery and degradation that, really, not only the moral universe as a whole, but also the possessors of the lives in question, would seem to have been better without them.
Half tongue-in-cheek, Singer wonders whether it would be reprehensible for the species to decide that we will in fact be the final generation. After all, there is no categorical duty to procreate; we do not hold the childless to be guilty of some existential failure or infraction. We cannot be held to have a responsibility for vague beings of the future who may or may not exist; we have duties toward the living, that is all. And yet...one could argue that the presumption of a future for humanity, even if one does not have biological children oneself, is so deeply ingrained in the human organism that the horror of apocalypse far exceeds one's own demise. The future of humanity is not an obligation, but it is a hope, or perhaps a faith.
If one were to genuinely doubt the chance for a worthwhile life of one's offspring, then one would implicitly have to question one's own as well. I am surprised that Singer didn't mention The Children of Men, the movie a few years back that showed the depression and desperation of a world without reproduction. Arguably the final generation, whenever its grim day may come, whether in years or in millenia, will be the saddest one of all.
Maxim
A nice poem by Carl Dennis (already online at The New Yorker website):
To live each day as if it might be the last
Is an injunction that Marcus Aurelius
Inscribes in his journal to remind himself
That he, too, however privileged, is mortal,
That whatever bounty is destined to reach him
Has reached him already, many times.
But if you take his maxim too literally
And devote your mornings to tinkering with your will,
Your afternoons and evenings to saying farewell
To friends and family, you'll come to regret it.
Soon your lawyer won't fit you into his schedule.
Soon your dear ones will hide in a closet
When they hear your heavy step on the porch.
And then your house will slide into disrepair.
If this is my last day, you'll say to yourself,
Why waste time sealing drafts in the window frames
Or cleaning gutters or patching the driveway?
If you don't want your heirs to curse the day
You first opened Marcus's journals,
Take him simply to mean you should find an hour
Each day to pay a debt or forgive one,
Or write a letter of thanks or apology.
No shame in leaving behind some evidence
You were hoping to live beyond the moment,
No shame in a ticket to a concert seven months off,
Or, better yet, two tickets, as if you were hoping
To meet by then someone who'd love to join you,
Two seats near the front so you catch each note.
A Maxim
To live each day as if it might be the last
Is an injunction that Marcus Aurelius
Inscribes in his journal to remind himself
That he, too, however privileged, is mortal,
That whatever bounty is destined to reach him
Has reached him already, many times.
But if you take his maxim too literally
And devote your mornings to tinkering with your will,
Your afternoons and evenings to saying farewell
To friends and family, you'll come to regret it.
Soon your lawyer won't fit you into his schedule.
Soon your dear ones will hide in a closet
When they hear your heavy step on the porch.
And then your house will slide into disrepair.
If this is my last day, you'll say to yourself,
Why waste time sealing drafts in the window frames
Or cleaning gutters or patching the driveway?
If you don't want your heirs to curse the day
You first opened Marcus's journals,
Take him simply to mean you should find an hour
Each day to pay a debt or forgive one,
Or write a letter of thanks or apology.
No shame in leaving behind some evidence
You were hoping to live beyond the moment,
No shame in a ticket to a concert seven months off,
Or, better yet, two tickets, as if you were hoping
To meet by then someone who'd love to join you,
Two seats near the front so you catch each note.
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