The Disappearance of the Unconscious (Sorry, Siggie)


The original concept of the unconscious involved a part of the mind hidden from conscious or verbal awareness but which contained all the primitive, childish drives and wishes.  It was able to influence our behavior without our verbal awareness.  Our irrational and animalistic impulses remained comfortably apart from our image of our own character.  Over time the concept took on even more potency to run our lives.

Nowadays, as we watch television, read the papers and books, and watch movies, we see behavior that seems quite primitive even to us.  To the people of Freud's day, in the first half of the 20th century, it would seem animalistic, shocking and outrageous.  We watch it with some amusement and interest. They would have left the room and had bad dreams.

If we had an 'unconscious', what would we bother to bury in it?  We don't bury those impulses anymore.  We are not shamed by them. Actually, we seem to enjoy them at least vicariously. So what has happened?  The unconscious seems to have largely disappeared.
Yet it still appears in peculiar and unique circumstances.  People with rigid and limited self-images or self-concepts find themselves behaving in ways that surprise them (though not those who know them well).  People who are very naive, uneducated or "innocent" seem also to fall prey to "unconscious" impulses.  People from cultures who have a very narrow and limited range of acceptable behaviors or strong religious prohibitions also seem to have problems with their unconscious.

It seems that the "unconscious" is not so much universal as it is a function of denial and repression in certain personality types.   Those behaviors and impulses that are "forbidden" or have been shamed strongly are relegated to the non-verbal sections of the brain.  I imagine this process as being like that of a child shamed by a parent for displaying aggressive or sexual impulses, whose shame strikes at his very self-concept and sense of self-worth.  The child does not want to verbally acknowledge those impulses or admit to them in any way.  However, this does not mean that the impulses will not be acted upon.  It means that the child can express the primitive and instinctual behavior without having to acknowledge that they are a part of his actual self.

So we develop an "unconscious" in situations or circumstances in which an important and emotionally strong impulse is shamed and denied.  Since less and less seems to fall in this category, the unconscious seems to be relegated to those limited circumstance described previously.  No shame or denial equals no unconscious.  We may choose, however, to limit our awareness in order to preserve our "proper" sense of self.

Addiction as privilege

Technically, addiction is the result of your body becoming dependent on pleasure-producing substances to the degree that discontinuing the substance causes profound physiological disturbance.  We could stretch the definition beyond usability by attempting to shoe-horn substances like water or food.  What is meant is quite clear, however.

People attempt to widen the definition of addiction to include behaviors, such as gambling or sexual activity.  As a psychotherapist it is useful to ask the purpose of such a re-definition.  The answers seem clear. There is an implication of reduced power to control one's behavior due to some sort of physical dependency.  "Sex addicts", for example, don't simply enjoy sex, they "must" have it or some sort of withdrawal and physiological disturbance must result. Consequently they are not somehow as responsible for controlling their behavior as the rest of us non-addicts.  The same reasoning applies to "gambling addiction" or "food addiction".
Thus defining oneself as an addict of some kind implies a lesser responsibility and blame for the behaviors involved.  If one simply "can't" (not "won't) control their behavior, they can't be blamed.  They want to consider themselves "ill", not morally culpable.  They should get a free pass  for their behavior, no matter how damaging it may be to themselves or others.

Our innate responses to stimuli fall along a normal curve, with the majority in the mid-range, and with extremes at the tail end of the curve.  We respond to sudden noises with a wide range of reaction, from nearly placid disinterest to sudden leaps and shouts.  One has only to watch the reaction of new-born infants behind the viewing glass to flash photographs to observe this range, and it is clearly innate.  But just because our response lies toward one of the extremes does not imply an "illness" or disorder of some kind.  People who have relatively extreme reactions learn to moderate them.  We do not allow people to have a free pass to hurt someone just because they are more easily angry or frightened than others.  The law makes no exceptions, nor should it.

The Income Tax Lottery!

I have what may be a way to solve our debt problems once and for all!

We all have to pay the income tax and we all have to wade through the instructions or hire an expert to lead us by the hand.  And we all know that there are many people who avoid paying taxes by staying under the radar, or who have such clever tax dodges that they get away with paying a minimal amount. Various proposals have been made to deal with this issue, from national sales taxes to flat taxes to...

But what if we turned our income tax day into a national lottery, with a hundred million-dollar prizes, and for each $5.00 (or some such small amount) paid into the IRS for income taxes we would get a ticket for the lottery.   Prizes could range from small to large, or a lifetime exemption from income taxes or...  The more you pay in, the more chances you have, and the prizes would themselves be tax free.  Perhaps people could buy additional tickets, but only if they had paid their income tax already.

You could give extra tickets for early filing, or for whatever reason you want to encourage.   Would you find such a system appealing?  

No Help For Self-Inflicted Injury, Part 2

The number of people injured or killed in automobiles as a result of the usage of cell-phones to text while driving is increasing.  We all know that there is a much greater likelihood of having an accident while driving when we are distracted.  According to the Daily Oklahoman today, the chances of having an accident while texting are 23 times greater.

The Highway Patrol and the local police agree that making texting while driving illegal is not a practical solution to the problem, as it is almost impossible to detect the presence of that kind of distraction prior to an accident.  Why arrest when you can't prove in court that the driver was actually texting while driving?

I would be in favor of allowing texting while driving if the drivers killed only themselves.  Why not eliminate the dummards from the gene pool, and earlier/younger better than later?  But they kill people who aren't doing anything stupid and who deserve to be protected from the criminally stupid.  So the following solution suggests itself:  Why not excuse insurance companies from paying for damages caused by texting while driving?  Perhaps the victims of the accident could still be covered, but certainly the texting driver at fault should not be covered.  And perhaps criminal penalties could also be involved if the law were written properly.

By the same line of reasoning,  insurance should not pay a drunken driver for causing an accident.  It's important to add that the victims of the accident who were not the cause should not be penalized financially. 

The principle idea remains the same in this small series of blogs:  People who knowingly and willfully assume a risk should be financially and personally responsible for the outcome of the risky behavior.  It's impractical to assume that police can stop all irresponsible behavior before it has a tragic result.  But we can make the self-injurious pay their own bills, and perhaps that will discourage at least those few who can count.

A good way to start would be to contact your insurance agent and tell him/her:  "I don't want to pay extra for people who take unnecessary risks, like driving and texting or drinking.  Please contact the company and tell them I'm looking for insurance that doesn't reward deliberately reckless behavior."  You could also contact the Insurance Commissioner in your home state and share the problem with him/her.

No Solution To Mass Murders

Listening to a debate on radio re various gun laws.  A trenchant comment by one of the debaters:  "Considering all the gun laws before Congress now, it should be noted that not one of those laws, if enacted, would have prevented ANY of the mass murders of the last 40 years or so". 

Not one limitation due to "mental illness", however defined, would have stopped any of them either.  There was no apparent mental illness in the mass murderers, unless you consider mild or moderate depression, and that would include almost everyone in the US.  The mass murderers were not psychotic.  They had not lost touch with reality.  They were not mentally incompetent.  They simply made wicked choices, and it should be obvious to anyone that the concept of "free will" must include the capacity to make wrong choices or the concept is meaningless.

It is notable that, with the exception of terrorist attacks (such as in Oklahoma City), the killers expected to die, and were in fact without any hope.  So threats and punishments would never be effective; you can't threaten someone who is already hopeless.  Prohibition of guns has not been effective, any more than the prohibition of alcohol was in the '20s.  In Sandy Hook the murderer stole guns from a family member.  Fertilizer was the weapon of choice in Oklahoma City.  There simply is no way to limit weapons.  We will always have our bare hands.

I think we have to face the fact that this problem is not solvable.  Whatever we decide to do will not limit the possibility of mass murders.  We can lose our civil liberties in the attempt, but we will not be able to stop killers, even with the most stringent of laws.  How much are we willing to surrender our civil liberties to gain an illusion of safety, which will be lost on the very next mass murder?

Facebook and tribal chatter

It doesn't take long for us older members of the human race to get terminally bored with Facebook.  Facebook is a storehouse for the relentlessly and shamelessly trivial.  The level of intellectual content could hardly be lower.  Hours on end (literally) sending pictures of uninteresting activities by people who can only be thought interesting by close friends and families...  and talking about recipes and where you ate lunch and what you had to eat and the funny thing your son said and a really nice picture of your cat or of yourself and where you might meet to find a mate (temporary or permanent) and ... and...  So why do the younger primates (and you know who you are) find it so endlessly fascinating? 

Back when our ancestors lived in trees (and I'm old enough to almost remember that) I imagine the level of chatter between treetops in the evening covered much of the same subject matter.  A lot of it was about the same things talked about on Facebook now.  We told each other about food and good water and interesting potential sexual partners.  An important element of every message was simply "Here I am!  Don't forget about me!  I'm in the pack!"  It was probably an expression of our need to keep our tribal bonds intact and strong.  We talked because we needed to feel contact and to know we belonged.  Facebook is just another expression of the endless urge to "connect" constantly with our tribe.

So now I'm in the same tribal position as the "silverback".  Too old to win mating battles and bored with the endless mindless chatter of "Here I am!  Look at me!", no longer interested in dominating our tribe or expanding our boundaries, I wander off into the jungle looking for more interesting things to do.  All that talk was once interesting, but now I'd rather go look for an unusual rock or maybe even a mountain. And I'll just sit there and enjoy the silence.

"Mental Illness" and Gun Ownership Laws

After a local man who had been identified as being "mentally ill" (through various previous contacts with the police) had obtained several guns and used them to kill his mother, the newspapers and legislature began discussing the importance of prohibiting "mentally ill" people from getting guns.

The first problem is that all people with "mental illness" are lumped together as unfit for gun ownership.  Does this mean that people who are being treated for an anxiety disorder can't buy guns to protect themselves?  If you've ever had a depression and gotten treatment, are you prohibited from gun ownership?  Exactly what do we mean by "mental illness" and which illnesses render us unfit?

The second issue is that the Federal database used to screen people for suitability to own a gun has to have that data available for all gun sellers.  Where do they get their data?  Are psychiatrists and psychologists going to be required to report any patient to the state or Feds in case they might want a gun?  How much is going to be reported?  Who will have access to these mental health records?

We have always treated medical records as private, and mental health records as especially private and privileged.  We did not want to discourage people from seeking mental health treatment by threatening to make their private problems public.  Where we have not taken such precautions we have created a disaster.  Consider the military situation as regards depression and other  mental illnesses.  When a pilot sees a military psychiatrist, he effectively ends his career.  He will not advance in rank; he will not fly military aircraft; he will not likely be promoted. So he elects to go untreated.  And often this scenario ends with suicide.

In past years I saw military officers in my private practice, which they chose rather than see a paid-for military psychiatrist or psychologist.  Still, they were very concerned about the risk they ran of being "outed" as a "mentally ill person", and in addition they felt it necessary to lie about their treatment status on annual medical evaluation forms.

I think we can consider limiting weapons to people whose judgment is seriously impaired enough to require the state to act as parental supervisor.  Clearly some forms of mental illness are not consistent with gun ownership or flying military airplanes.  But the vast majority of such disorders are consistent with gun ownership.  We can't and shouldn't put all mental illnesses in the same stereotypical bag. 

Since our Constitution guarantees all citizens to have the right to keep and bear arms, are we going to decide that people with a "mental illness" do not have the same rights as other citizens? Are we going to change the Constitution?  How are we going to protect privacy and encourage people to seek needed help, and at the same time protect ourselves against gun owners whose judgment is critically impaired?  The appropriate criterion might be an appraisal of the prospective purchaser's judgment, not of their psychiatric diagnosis.  Perhaps some form of formal mental status procedure evaluating basic judgement, carried out by a mental health professional, resulting in a pass/fail finding, would protect people's right to medical privacy while at the same time not lumping all mental health issues into the single category "mental illness". 

Obesity, depression and recovery

Obese people can be seen as belonging to two separate groups.  "Group 1" is characterized by having a generally satisfactory life, with interests and hobbies (other than food) and reasonably good relationships.  "Group 2" people are usually depressed and/or unhappy, with few or no sources of pleasure other than food. 

Group I people are frequently successful with rigorous diet and exercise programs.  While they may relapse into overeating, they do lose weight at least while they continue the program.  They are able to make a rapid change in their eating and exercise habits, frequently picking a particular date to start and then following through.  Their lives have plenty of good things in them that don't depend on eating.  They frequently have trouble seeing why other obese people have such difficulty losing weight. 

Group 2 people are almost never successful with rapid weight-change programs.  Because they are already depressed or unhappy, they are easily overwhelmed by the amount of change they see as necessary.  They think "I just can't do all that", while envisioning major changes in exercise and food intake.  They have little other sources of pleasure, so that giving up the one and sometimes only pleasure they have, eating, leaves them contemplating a life with nothing rewarding or good in it.  They can't seem to get started.  They don't understand how others can succeed at such a difficult task, which further convinces them of their own inadequacy.

For Group 2 people to succeed, they have to make small behavioral changes, not the large ones they feel overwhelmed by.  They can't deal with losing "a hundred pounds".   They can't accept "no more desserts" or "walking three miles".  They may pick a starting date, but they either don't do it or they give up almost immediately, feeling helpless and intimidated by the task.  Their failures increase their low self-esteem and their depression.

In helping depressed patients overcome their depression, we use what I call the "2-Plate Rule".  This rule applies to all overwhelming tasks, which for depressed people includes almost everything.  The rule states that if washing 2 dishes in the sink is too much to do, change the size of the task by a half. Wash 1 plate.  If that's overwhelming, plan to wash a saucer.  It is crucial that the size of the task be reduced until it can be accomplished, and it doesn't really matter how small the task is as long as it can be done.  My patients are instructed to stop when they have completed the task, and not to treat their success as some kind of trick so they can be urged to do more.  Depressed people need more successes, not more failures.

Group 2 patients need to be assisted in reducing the initial tasks involved in beginning to lose weight until the initial task is something doable.  For instance, the patient may be instructed to pick a task involving exercise or involving diet (not both) and break it down into smaller "chunks".  An exercise "chunk" might involve walking to the end of the driveway and back on the first day, and staying with that chunk for a week (or some specific short length of time).  If they are successful with that task, they might decide that walking to the end of the block is possible.  At the first failure, they are to recognize that they gave themselves too much to accomplish, and that they need to choose a smaller task. 

A diet "chunk" might be to decide to have a smaller dessert, such as a half-piece of cake or pie. Or it might be to decide to not have anything to eat after midnight.  The patient is instructed to stay with their success for at least a week.   Later in their program they can shorten the length of time between changes, as long as they find the task something they can accomplish.  If they have a problem carrying out their task in their time frame, apply the 2-Plate Rule.