Philosophical Thriller

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When Martin (Channing Tatum), the husband of Emily Taylor (Rooney Mara), is released from prison after serving five years for insider trading, her troubles should all be over. Her handsome husband has come home, ready to start rebuilding his life with her. Instead, they are just beginning. She just can't seem to shake the depression and sadness. First she drives herself head-on into a brick wall. Then she nearly steps off a platform into the path of a subway train. She feels inexplicably sad and cries all the time. Her psychiatrist Dr. Banks (Jude Law) prescribes traditional antidepressants, but they don't seem to help. Then he prescribes a newly developed antidepressant that picks her right up. She laughs again. Her libido returns. But there are side effects. She sleepwalks. And she kills her husband.

True depression — not an occasional bout of the blues — is a serious problem. It has been described clinically as "the inability to imagine a future," and poetically as "a poisonous fog bank rolling in at 3 pm." Clinical depression is often caused by the brain's inability to release or absorb essential hormones or communicate effectively with itself. In these cases, psychotropic drugs can offer relief. As Dr. Banks tells Emily, "It doesn't make you someone you aren't; it just makes it easier for you to be who you are." As the parent of an epileptic daughter whose grand mal seizures are completely controlled by medication, I am grateful for pharmaceutical companies that have worked diligently to develop better and more effective drugs.

But psychotropic drugs can also have severe side effects, including erratic and even violent behavior. Public massacres in recent months have brought the discussion of these drugs to the forefront, but it is difficult to know whether the drugs themselves cause the violent urges, or whether the violent urges already existed within the troubled mind of these young men who planned the massacres. Michael Jackson's doctor was convicted of administering drugs that his client requested — demanded! — but those drugs ended up killing him. Who is culpable in these cases?

Director Steven Soderbergh examines these issues in his fine film Side Effects, which opened this week. We watch Emily as she struggles with sadness and suicidal desires. Her psychiatrists Dr. Banks and Dr. Seibert (Catherine Zeta-Jones) attend conferences where new drugs are introduced and promoted. Banks attends a lunch meeting where he is offered a lucrative deal for recruiting his patients to participate in experimental trials of a new drug.

The first half of the film seems almost like an anti-pharmaceutical Public Service Announcement sponsored by Scientology. In one scene, several doctors are interviewed on "Good Morning America," allowing the screenwriters to ask — and answer — several probing questions. One of the cops investigating Martin's death threatens Dr. Banks to make him comply with the prosecutor's office, saying, "Either she's a murderer, or she's a victim of her medical treatment. Which do you want it to be?" After all, Dr. Banks had already been told about Emily's sleepwalking. Shouldn't he have taken her off the drug?

Under these circumstances, "Did she do it?" and "Is she guilty?" become two very different questions. Can she be guilty if she was completely unconscious of the act? But a man is dead. If she isn't guilty, who is? Since most people are able to use these drugs without adverse effects, should the doctor be held accountable when a patient does have a bad reaction? Is she not guilty by reason of insanity, or a victim of circumstance and her own biology?

The first half of the film presents the audience with these philosophical questions. But don't be put off by the PSA sensibility. The second half of the film turns into a taut and engaging murder thriller as Dr. Banks tries to salvage his career by answering these questions. In the end, the film is as tense and exciting as it is philosophically engaging. Great performances and a fascinating denouement make this a film well worth seeing.


Editor's Note: Review of "Side Effects," directed by Steven Soderbergh. Endgame Entertainment, 2013, 106 minutes.



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The Pains of Proflish

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A student taking an advanced degree at a world-renowned institution sent me a news item about a math professor at Michigan State University who (allegedly, always allegedly) took off his clothes in the middle of class and ran around naked, shouting things like, “There is no f*cking God!”

No, I’m not going to claim those words as an invitation to comment on the linguistic habits of scientific atheists. To paraphrase Richard Nixon, I could do that, but it would be wrong. But I’m not sure how wrong it would be to take it as a commentary on the linguistic habits of college professors (of the which I am one). It seems to me that during the past 30 years we’ve done a lot of running around naked, intellectually speaking, and what has been revealed has not been impressive.

I can’t say I was surprised by the news my fellow Watcher sent me. What did surprise me was the reported reactions of the professor’s class. (No, I didn’t mean “were the reported reactions”; I meant was; the number of the verb follows that of the subject, which is what, and which is singular.) “We were literally scared for our lives,” one student said. “The police took about 15 minutes to get here, and during this time he continued walking around screaming.” The complaint was echoed by another student: "It took them more than 15 minutes to arrive. It could have turned into something very bad if he had a weapon on him. It was pretty infuriating to have to wait that long." And that second student wasn’t even in the professor’s presence; the professor was out in the hall, by that time, and the student was in a classroom.

The fact that the troubled pedagogue was naked didn’t seem to have allayed these young people’s fears. And as for the 15 minutes: I’m no fan of the police, but look at your watch and picture yourself getting a call, leaving your office, traveling across one of the nation’s largest college campuses, locating the place where an incident is taking place, clambering upstairs, and confronting some nut who’s running around naked . . . Now look at your watch again. Think you could make it in 15 minutes? Think that somebody has a right to complain bitterly at this complete abdication of police responsibility? Think that you and I and a bunch of fit young college kids concerned with a naked, middle-aged man possess a right to have cops show up in less than 15 minutes?

I think I’d rather take off my clothes and run around like a maniac than to utter the complaints of those college students.

But if you’re thinking just about words, and not about guts, the worst part of this report is the eight words that say, “The professor’s name has not yet been released.” Not released by whom? And why not? Everybody on the scene knew who he was. Their reactions were reported at length. A blurry picture of his apprehension was included in the news report. So why not his name?

During the past 30 years we professors have done a lot of running around naked, intellectually speaking, and what has been revealed has not been impressive.

Pity? Perhaps. But this pity, this verbal delicacy and restraint, is by no means evenly distributed. If Joe Blow from Kokomo has a fight with his girlfriend, gets a little drunk, drives down the street, and gets nailed by a passing cop, no one will withhold his name from publicity — or his mugshot either, in some jurisdictions.

The day after the scary incident, anonymous students identified the professor as a certain John McCarthy. The day after that, the really loony thing happened. An article about the affair appeared in the MSU student newspaper. You can tell MSU standards of journalism by contemplating the following sentence, which is about the weekly meeting of the “steering committee” of the university’s president: “At the Steering Committee meeting Tuesday, the conversation turned to mathematics professor John McCarthy, which students said he had a mental breakdown during a class Monday.”

“Which students said he had a mental breakdown . . .” OMG — now we know what kind of grammar MSU is teaching.

Well, let’s see what intellectual level MSU’s president is operating on. For other people, the serious issue introduced by the professor’s actions might be, “Did MSU know that at least one of its senior professors might be crazy? Does MSU have any way of discovering how many of its senior professors actually are crazy?” But that was not the issue that President Anna K. Simon wished to discuss. For her, we learn, “an incident Monday brings in to [sic] question the impact and role of social media.”

Huh? As far as I can make out from Simon’s murky remarks, murkily reported, the problem is information control: “’The complication of social media, with everyone with a camera and a cell phone, is one that we continue to struggle with in terms of information because the event would not, under (normal) circumstances, trigger one set of alerts,’ Simon said. ‘There’s also the need for more crisp communication about what the outcome was. Whether that would have controlled some of the rumors, tweets and other things, I’m not quite sure.’”

Did Michigan State know that at least one of its senior professors might be crazy? Does Michigan State have any way of discovering how many of its senior professors actually are crazy?

Let’s look at this in another way. Suppose you’re concerned about the quality of some public institution. You want to find out whether there’s any quality control. You learn that a teacher, policeman, bureaucrat, or other publicly employed personality, may have done something egregiously stupid and wrong, and perhaps illegal, while exercising his or her official duties. She’s said to have told her students to vote for Obama. He’s said to have beaten a homeless person for “resisting” some “order.” She’s accused of making a “questionable” transfer of city funds. He allegedly takes off his clothes in front of his students and runs around screaming.

You’d like more facts. But how long do you have to spend just trying to confirm this person’s name? A week? A month? Three months? Forever? Unless there’s a miracle, the information control artists will keep you from knowing what it is until virtually everyone has forgotten the episode — and then the data will be stored in a closed file, no longer accessible to the public. In the meantime, you will be informed that personnel regulations do not allow release of that information, or, pending possible legal action, the city cannot comment on this case, or some other nonsense that never applies to a normal person in a normal job (or didn’t, until the “standards” of “public service” bureaucracies spread into big private companies). And, to top it off, some CEO will entertain the media by looking at her navel and meditating about how tough the times are, what with all these cameras and phones and computers around, ready to convey the truth to anyone online . . .

So what do you think? What are we supposed to say about that? What are we able to say, since if we do comment we can always be told that we do not have all the facts?

The chair of John McCarthy’s department presumably has all the facts. These facts lead him to be concerned “about the way some people made jokes about the incident. An incident like this often teaches us who we are and what we represent. I hope we can all use what transpired after this incident to reflect on our values and our role as members of an institution that strives to be among the best of the world.”

Gosh, don’t you feel guilty? Your making jokes about a figure of authority at an institution that strives to be among the best of the world has hurt the feelings of an institution that strives to be among the best of the world. Or something.

But to continue with college professors, which I can easily do, considering that I am one, have you been following the curious case of Professor Amy Bishop? She’s the one who was recently convicted of killing three of her colleagues and wounding three others at a meeting of the Biology Department at the University of Alabama, Huntsville. That happened in 2010, and there were plenty of witnesses, because she didn’t manage to kill them all, but it took two and a half years to convict her. I don’t know why, except that it may have something to do with the cultural and verbal universe in which she lived.

Perhaps the EEOC is still trying to find out whether the woman who wasted her brother and killed or did her best to kill six of her colleagues is in “unstable mental health.”

In 1986, in Massachusetts, where’s she’s from, she killed her brother Seth with a shotgun, then went to a local auto dealership and tried to commandeer a car so she could escape. Apparently because of her family’s ties to the local power structure, she wasn’t even questioned about the shooting for 11 days. Then it was called an “accident.” Eight years later, she was implicated in an attempt to pipe bomb an academic supervisor in Boston. He had suggested she was “mentally unstable.” Four months after the attempted bombing, investigators finally showed up at her house. She was uncooperative, and the investigation was inconclusive. It went away. Seven years later, she was arrested after assaulting a woman in a fight over a high chair at an International House of Pancakes in Peabody, MA. She was sentenced to probation and an anger management class (which she probably didn’t take). In the restaurant, she had yelled, “Don’t you know who I am? I’m Amy Bishop!”

Now she gets to the University of Alabama, Huntsville, where she is known as “difficult” by “some.” A good piece of reporting tells the story. Bishop didn’t publish very much; she listed her children as first and second authors on one of her publications; a student filed a grievance against her; she was detested by almost everyone.

Then, as our reporter says — and this is the cream of the jest:

In September 2009 Bishop filed a complaint with the Federal Equal Employment Opportunity Commission. Someone on her departmental tenure committee had called her "crazy" in her tenure review, and would not retract the statement when an administrator gave him a chance to back down. The anonymous professor maintained that Bishop's unstable mental health was apparent on their first meeting.

The EEOC is still looking into that complaint.

I have been unable to learn whether the federal agency is still looking into it. Perhaps it is still trying to find out whether the woman who wasted her brother and killed or did her best to kill six of her colleagues is in “unstable mental health,” or, in plain terms, insane, bonkers, off her rocker, completely gone, in the zone, out of her skull, a desperate lunatic, and otherwise, well, crazy, or if she is, whether anyone should have said it.

A Martian appears in your kitchen and tells you that the folks back on the slopes of Olympus Mons have been following the Amy Bishop story on their nightly news. He wants to know what is so weird and touchy about that word crazy. He wants to know how somebody who uses it in its clearest and most self-evident application could possibly be investigated by a government of 300 million people (which presumably ought to have other things on its mind), because the word might have been discriminatory against the woman who killed four people. What words would you use to explain this?

Maybe you wouldn’t be able to find them, but we professors would — or at least keep anyone else from doing so.

On October 2, I was watching a CNN segment about why more security wasn’t provided to our diplomatic installation in Benghazi, when it was obvious that the place might be in danger from fanatic Muslims. The interviewer asked a professor — or someone who talked so much like a professor that he should immediately be given tenure — what he thought about all the warnings that came in, and apparently were not adequately heeded. Well, he said, “you have to parse the different kinds of violence that were taking place.”

That was his response.

What would you have to do to interpret that for your Martian friend?

I suppose you would start by noting that the key word was “parse.” In normal English, “parse” means to identify the grammatical functions of the words in a sentence. But in Proflish, the professor tongue, which is the status language of planet earth, the language to which all other languages aspire, “parse” means anything you want it to mean. In this case, it appears to mean something like “look at.”

Well, says the Martian, why can’t he just say “look at”?

That’s sort of a puzzler, but I can think of two, related reasons. One, he would be understood immediately, and that is not the goal of anyone speaking Proflish. Two, he would reveal the fact that he is saying nothing. Suppose I do look at or inspect various kinds of violence. Suppose I go further, and distinguish one kind of violence from another. So what? That isn’t enough. I haven’t really said anything. But a word like parse will keep everyone, or at least the interviewer, impressed with me. And that’s the point of talking, see? Ya see?

Yes, says the Martian. I’m parsing it all.


Editor's Note: Word Watch will comment on the presidential and vice presidential debates after the disease has run its course.



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The Dangers of Diagnosis

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“Nearly 1 in 5 Americans had mental illness in 2009.” This recent CNBC online headline captured my attention.

The brief article that followed was based on a report by the Substance Abuse and Mental Health Services Administration, a federal agency (oas.samhsa.gov). The article repeats highlights from the agency’s report entitled “Results from the 2009 National Survey on Drug Use and Health: Mental Health Findings,” available in PDF form.

The article states that an estimated 45 million US residents had a mental illness, and 11 million had a serious mental illness, and that these numbers reflect increasing depression among the unemployed.

The article’s intention — to create alarm — is loosely veiled. If people do not have access to interventionist and preventive treatment, any number of woes can follow: “disability, substance abuse, suicide, lost productivity and family discord.” Lost employment equals lost health insurance equals a lack of access to treatment equals a crisis. The insinuation is that government should step in to close the treatment gap.

Finding this article was fortuitous. Only days before I had read an article in Skeptic magazine about the “foibles of the Diagnostic and Statistical Manual V” — the diagnostic guide for mental health practitioners. (For details, see “Prognosis Negative” in Skeptic, volume 15, number 3 [2010], by John Sorboro, himself a licensed, practicing psychiatrist.)

The state of the psychiatric arts today, complicated by increased government control over our nation’s healthcare industry, should alarm all citizens, not just libertarians.

According to Dr. Sorboro, the upcoming version of the DSM will have a marked increase in diagnosable psychiatric disorders, which may include “compulsive shopping” and “Post Traumatic Embitterment Disorder.” But the problem with the DSM has to do with the validity of what it says.

To rectify the unscientific nature of prior versions of the work, the third version was intended to “increase reliability by standardizing definitions.” Still, critics maintained that “the rhetoric of science — rather than scientific data — was used by the developers of the DSM-III to promote their goal, and science did not support [their] claims.” In 1994, the DSM-IV was published, listing 297 disorders. The latest revision is set to increase that list. Yet according to Dr. Sorboro, almost “every major psychiatric construct is seen as being of questionable validity by a vocal group within the field itself[,] or outside it.”

Psychiatric disorders are supposed to be pathological constructs, as Parkinson’s disease is a pathological construct. For a construct to be valid, Sorboro states, it must differentiate itself from other pathological constructs and provide a theoretical framework for prediction and specific intervention. He likens psychiatric pathological constructs to the construct for fibromyalgia — “a loose collection of non-specific complaints.” Fibromyalgia lacks an underlying, identifiable pathology. So do psychiatric constructs.

Critiques of the DSM include claims that it’s a collection of “the moral objections of a group within power [who] desire to medically pathologize another group for self serving purposes,” and that it is “a-theoretical and purely descriptive.” Evidence in support of the former critique is that homosexuality was not entirely removed from the DSM’s list of mental disorders until the latter half of the 1980s!

A diagnosis based on the DSM is not a divination of pathology. The DSM is tautological. It describes. It does not explain. Thus, diagnosis is subjective, not objective. Sorboro uses bipolar disorders to illustrate. Bipolar I disorder appeared in the DSM-III in 1980, followed by Bipolar II Disorder, Bipolar Disorder NOS (not otherwise specified — that’s worrisome), and cyclothymia. There has been a correlative rise in the diagnoses of such disorders — one statistic that Sorboro cites is a 4000% increase in bipolar disorder diagnoses in children during the past decade, despite the fact that mental health practitioners know “hardly anything more of real scientific significance about bipolar disorder than we did in 1980.”

Soboro states that medical disease classification evolves in a messy and inconsistent way, “and often has to do with politics and not just compelling scientific fact. It’s just much worse in psychiatry.” For example, contributors to the DSM-V include “health care consumers”; and as Sorboro says, no other branch of medicine would ask consumers for advice in defining pathology. Moreover, the American Psychiatric Association taskforce handling this revision is conspicuously closed and non-transparent — task force members must sign confidentiality agreements and cannot keep written notes of their meetings.

Hmm.

I have been skeptical of the DSM since I first read it. I was a judicial clerk, and my judge kept a copy of the DSM-IV on one of his bookshelves. He used it for reference during sentencing hearings and when he presided over mental health hearings. During lulls in my clerkship tasks, I read several large chunks of the DSM-IV. My initial thoughts were: there certainly are some people with severe mental problems, but this is bullshit. Symptoms of the indicated mental “conditions” were so encompassing that anyone and everyone could be classified as having some type of mental disorder.

My best friend from high school is a psychiatrist, and after reading the DSM-IV, I asked her about it. She said that it gives a practitioner guidelines for diagnoses. But don’t guidelines have to guide? I asked. Isn't a diagnostic process that has no conceptual limits wholly subjective? The flu is marked by symptoms that make it the flu and not a common cold or pneumonia. But even a brief reading of the DSM shows that mental illnesses are not marked by unique symptoms. Why? My friend had a few forgettable justifications, but no answers.

Homosexuality was not entirely removed from the DSM’s list of mental disorders until the latter half of the 1980s!

Many Liberty readers are familiar with libertarian criticisms of the mental health industry. But the state of the psychiatric arts today, complicated by increased government control over our nation’s healthcare industry, should alarm all citizens, not just libertarians. Psychiatric abuse by states against citizens is well documented; psychiatric imprisonment for dissidents in the Soviet Union is just one example.

The dangers are clear. In the legal realm, when a criminal statute is overbroad, behavior otherwise constitutionally protected is criminalized, subjecting more citizens to state control. Overdiagnosis of overinclusive mental disorders will subject more citizens to treatment — which, under Obamacare, means subjection to more government control. This should be enough to give anyone an anxiety disorder. Considering the political nature of mental “disease” classification, I wonder if a disorder marked by “irrational fear” of a “benevolent government” might be among the disorders included in the new DSM.




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