Today, I want to consider if the American Psychological Association’s participation in the mental disorder labelling practices promoted by the the American Psychiatric Association is due to something other than science and promoting human welfare?
The American Psychological Association’s Emphasis on Science and Human Welfare
First of all, I should note that I am a member of the American Psychological Association, and have been so for over forty years. Nevertheless, there is one particular aspect of the association that is deeply troubling to me.
Its very first sentence of the home page of its website states that it is “the leading scientific and professional organization representing psychology in the United States.” Shortly after this, it mentions, as well, that it has a mission to “promote human welfare.”
Keeping the profession as scientific as possible and promoting human welfare is something I very much support. Moreover, there are some things the association has been doing over the years that are consistent with these values, and therefore I have continued my membership. However, it greatly frustrates me that most psychologists providing mental health services are required to “diagnose” a person seeking mental health services with an approach supported and promulgated by the psychiatrist’s organization. This so called diagnosis then must be placed on the patient/client insurance form.
As part of the psychological organization’s strong interest in science, pretty much anyone entering its approved doctoral psychology program is required to study the ideas of Thomas Kuhn’s thesis on The Structure of Scientific Revolutions. Such revolutions, we learned, come about after a period of time when a field presupposes a conceptual and instrumental framework accepted without question. Then, more and more, members of the community begin to see a buildup of anomalies in the framework until a “crisis” which can no longer be resolved within the pre-established framework.
It just so happens that the psychiatrist’s stigmatizing diagnostic system, which is described in its Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5), has huge anomalies that have been recognized for years, and despite this, psychologists continue to utilize it without taking substantive steps to create a more scientific alternative. Let’s take a quick look at these anomalies. Afterwards, we’ll look at the benefits to psychologists that may be motivating it to continue to go along with the DSM-5 approach despite its major scientific weaknesses.
The Scientific Shortcomings of the DSM-5
Science demands objective definitions, but the DSM-5 approach relies on the completely subjective definition of a mental disorder. Its definition of a mental disorder is, in large part, and I quote, “a syndrome characterized by a clinically significant disturbance in an individual.” Now, I ask you, what can be more subjective than this?
The process described in the DSM-5 for assessing the subjective notions of “disturbance” in the individual is left to the clinician who decides if these are “clinically significant.” Thus, it provides clinicians an opportunity to include anything that benefits their set of values.
Now we all know that many clinicians have a financial interest in deciding whether or not their clients have a clinically significant condition. When they judge that their clients’ conditions are significant, they indicate this on the third party intake forms and this allows them to continue to see these clients and to get paid for additional visits. On the other hand, clinicians who work in an underfunded community government clinic that is being swamped by those seeking to access mental health services might apply a more stringent standard for what constitutes a mental disorder. Thus, the DSM-5 approach to the definition of a mental disorder obviously leaves room for enormous bias by clinicians, rather than anything that looks objective and free from bias.
All psychologists are taught that if a hypothetical construct, such as a mental disorder, is to have any validity, it must first demonstrate that it can be reliably identified. Upon reading the DSM-5, we find that there is no documentation that people, whether they are clinicians or not, can reliably distinguish between those who have mental disorders and those who do not have mental disorders. Thus, the lack of this documentation is analogous to a classification system of birds that has no documentation that people can reliably distinguish birds from non-birds.
With regards to reliably distinguishing between the different types of mental disorders, some field trials did look at this. Keep in mind that the DSM-5 defines over 300 different mental disorders. Approximately 270 of them were not tested at all for reliability but are nevertheless included in the DSM-5. The field trials tried to look at the reliability for thirty-one “disorders” included in the DSM-5, probably selected because these were ones that its developers thought would be most likely to make the DSM-5 look as good as possible. The results indicate that eight disorders had to be dropped altogether from the analysis because the researchers were unable to get enough data to support any analysis at all. Three others had reliability estimates that, according to the authors, fell in the “unacceptable range.” Six others had reliability estimates that fell in the “questionable range.” The remaining fourteen mental disorders had, according to the authors, “good to very good” reliability, despite the fact that there are no generally accepted standards for what counts as reliable enough against which the DSM-5 criteria can be judged. Among the “disorders” that were found to have very low reliability were “major depressive disorder” and “generalized anxiety disorder,” two of the most common “diagnoses.”
As I already mentioned, a classification system for a hypothetical construct must first demonstrate it is reliable. Then we look at the “validity” of the system. Upon examining the validity of the DSM, Thomas Insel, a recent NIMH director, stated:
The weakness [of the DSM] is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half-century, as we have understood that symptoms alone rarely indicate the best choice of treatment.
In addition to the DSM’s shortcomings with regards to its classification system’s reliability and validity, there are also serious shortcomings with regards to its claim of being a diagnostic system. A diagnostic system speaks to etiology, that is, the cause, set of causes, or manner of causation of a disease or condition. But the DSM-5 specifically states that it is not designed to identify the cause of the various “disorders” it classifies. Then why use the term “diagnosis” rather than the more scientifically defensible term, “classification?” As we will see, this gets us back to our larger question, why does the psychologist organization accept the use of the DSM-5 given its problematic record of reliability and validity, as well as its use of the word “diagnosis” in a misleading, imprecise manner?
Why Does the American Psychological Association Continue to Go Along with the Use of the DSM-5?
In answering this question, in the interest of fairness to the psychologist organization, it is crucial to point out that it has not, to my knowledge, interfered with discussions about this issue. In fact, it has even, on occasion, supported these discussions. For example, in 2002, it published a book titled, Rethinking the DSM: A Psychological Perspective. There we find well researched critiques of the DSM approach, and some preliminary alternatives proposed. 
Moreover, symposium proposals on this issue are oftentimes accepted for presentations at its national convention. (See HERE for a description of one well thought out research based alternative that was presented at its 2016 and 2017 conventions and was later published in a peer reviewed journal).
But despite these publications, discussions, and proposals, nothing has been done by the association to bring anything of substance to fruition. It certainly has the resources to commission the development of a far more scientific approach, but it has never done so. How come? Here’s one theory.
A well recognized usefulness of the DSM-5 is that by using its medical sounding terms to refer to all of the experiences that this approach classifies as “mental disorders” it legitimizes in the minds of many the prescribing of drugs for these experiences.
There is an enormous amount of money being made from this approach because it takes less than a penny to manufacture each pill, and yet each pill can be sold for hundreds of times that amount. This is a rather unique business situation. Typically, if a company can sell its products or services for a 10 percent profit it is doing super well. Compared to such companies, the pharmaceutical companies are Jonathan Swift’s Brobdingnag Giants. With so much money being generated from this enterprise, the drug companies have managed to make it clear to powerful groups that what benefits the drug companies also benefits them. Examples are, major media outlets gain enormous revenues from drug company advertisements, and political campaigns get substantial support from industry lobby groups. Whenever a university wants to build a new building, often a pharmaceutical company offers financial support, and a number of professorship positions would not exist without its support.
Now keep in mind that the psychiatric association membership consists largely of psychiatrists who make their living by prescribing these drugs. Moreover, there are several reports indicating that the majority of the major players who developed the DSM-5 were on the payroll of the pharmaceutical industry. So, it makes sense to theorize that the psychiatric organization may very well be influenced by all of this wealth. But what about the psychological association?
Psychologists have a division called “Psychopharmacology and Substance Abuse” which depends, to a large extent, on grants provided by drug companies. Many psychologists get referrals from psychiatrists. More and more psychologists are getting the right to prescribe psychiatric drugs. And, as I already mentioned, the drug companies have powerful lobbyists working to influence government decisions about mental health practices.
Because of these influencing factors, the American Psychological Association, it appears to me, has turned a blind eye to its stated mission to be scientific and a promoter of human welfare.
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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence. To begin at the very first post you can click HERE.
Welcome to From Insults to Respect. Today’s topic, addiction. When we see we have become addicted to something and find we are having difficulty breaking the habit, we may begin to lose some self respect. And sometimes our actions related to our addictions lead to others losing respect for us. So, it makes sense that we spend a little time giving this topic some thought.
Regular readers of this blog know that from time to time I like to enrich some ideas about a subject with some relevant thoughts that Bob Dylan has shared on his 
Today’s show is all about smoking. We’re not here to encourage it or to glorify it. You’re smart enough to look up all the facts. What we’re going to do over the next hour, is to give a looking and a listen to what happens when the tobacco plant collides with popular culture. As Oscar Wilde once said, “A cigarette is the perfect type of a perfect pleasure; it is exquisite and it leaves one unsatisfied. What more can one want?” We’ll be examining tobacco in all of its forms, from plant, to ash, with stops at cigars, cigarette, snuff, and chewing tobacco. So sit back, smoke em if you got em, and enjoy the next 60 minutes as we blow a few musical smoke rings your way.
Now I’m a fellow with a heart of gold
One of the problems when you smoke is when you’re not smoking, you can have one of those nicotine fits. Here’s how nicotine fits work. Nicotine is physically addictive; it alters your brain functions. Every nerve in your brain’s nervous system has these very tiny neurotransmitters. Nicotine works on some of them, tricking your body that it needs more of these receptors. When you started smoking, your body started responding to the nicotine, and started growing these extra receptors. Over the years, your body has gotten used to these extra receptors, and needs the nicotine to feed them. When you stop smoking, your body thinks your body’s transmitters have been shut off. Your body seeks equilibrium. That’s what the craving for nicotine comes from. When you have a craving for nicotine, the only thing that will help you, is another cigarette. 
Your body does so, according to this theory, because at first the nicotine leads to your receptors firing more frequently than usual. This leads to feeling more alert, which some of us experience as rather pleasant. But your body recognizes that if you were to keep firing those receptors at the pace that occurs when you first started smoking, certain functions in your body will end up exhausted. Thus, your body starts to reduce the number of these receptors. In the scientific literature, this process is called “down regulation” or “tolerance.”
However, shortly after you pause from smoking even for a few minutes, you end up not having enough of these receptors to do what they were originally designed to do. It is this shortage of receptors that occurs when there is not enough nicotine in your system to keep your receptors firing at a rate that would typically occur if you were not addicted to the drug that leads to the uncomfortable, sluggish, stressful feelings that lead to a craving for the next cigarette. When you light up, you feel relief because now the reduced amount of receptors are sufficient to carry out your major life functions in a less distressed manner.
Theoretically, this same process is largely the reason why people become addicted to other substances, such as alcohol, caffeine, illegal drugs, and even the drugs that psychiatrists prescribe, such as the so called antianxiety drugs (anxiolytics), antidepressants, and ADHD stimulants such as Ritalin. They all have the potential of creating for addicted people the illusion that they are functioning better than they did before they started consuming the addictive drug.
Dim lights, thick smoke, and loud loud music
We’re going to start off with George Zimmerman and the Thrills doing “Ain’t Got No Money to Pay for this Drink.”
“Just give me a drink,” says Mr. Birnam with exquisite anguish.
Well you thought I’d be waitin’ up when you came home last night
Beer is, it’s not just a drink to me, it represents something, it reminds me of being in college and high school, and discovering getting drunk, and having a sixteen pack in the trunk of my friend, Tommy’s car, drinking it hot out of the can in a parking lot in Las Vegas. Something about beer equals good times to me. 
I love java, sweet and hot
Now when I get up in the morning
Well, there you have it, a little Bob Dylan meditation on the nature of addiction. As I listened to his shows, it came vividly clear to me that many people reach a point at which they decide that they want to get off the merry-go-round of their addiction. When this occurs, what is the best way to go about doing this?
The following year, Dr Szasz published a best selling book by the same name. Some loved it while others writhed in anger. One reviewer, for example, gave it five stars out of five, and wrote:
Here is my curse on you, Thomas: May you suffer ten minutes of acute clinical depression. Ten minutes in that “over-heated room”, that “bell-jar”, that “bed of nails” which we sufferers know oh too well.
I was initially puzzled about the anger that appears to come from many who genuinely believe, and demand others believe as well, that without any doubt mental illness is an illness like any other illness. My puzzlement stemmed from my experience that oftentimes when someone proposes a different way to describe something, it doesn’t create great uproars. The proposal is either met with feelings that the new way to describe something is either helpful, or not.
William James, in his book, Pragmatism, tells us the following story. 
This human witness tries to get sight of the squirrel by moving rapidly round the tree, but no matter how fast he goes, the squirrel moves as fast in the opposite direction, and always keeps the tree between himself and the man, so that never a glimpse of him is caught. (p. 43)
“Which party is right,” I said, “depends on what you practically mean by ‘going round’ the squirrel. If you mean passing from north of him to the east, then to the south, then to the west, and then to the north again, obviously the man does go round him, for he occupies these successive positions. But if on the contrary you mean being first in front of him, then on the right of him, then behind him, then on his left, and finally in front again, it is quite obvious that the man fails to go round him, for by the compensating movement the squirrel makes, he keeps his belly turned towards the man all the time, and his back turned away. (p. 44)
Once the process of comparing and contrasting two or more descriptive approaches gets underway, it can lead to an understanding of just how vague some of the descriptions were, and they can be abandoned for more precise descriptions. Of course, the new description may also be so terribly vague as well, and nothing positive occurs. In such cases, a little time was wasted, and people get on with their lives without furious reactions.
Let me begin here by asking you to note that in the squirrel anecdote, those who discussed whether or not the squirrel went around the tree were not going to lose their job, money, freedom, or any other highly significant valued thing depending on who ended up being proved correct. Once everyone declared their positions, each might have had a little sense of prestige that might be derived if they could convince others that they came up with the most respected answer. But for people who like to discuss issues, learning from the discussion is typically the most important reward for them, and they can well handle their emotions that come from having taken a position that ends up being faulty.
The facts are that there are numerous examples of people who could have easily been classified as having a mental illness who come to a state of enormous improvement either through a religious experience, a philosophy such as Buddhism, a delightful romantic love, an exciting new job, a support group such as AA, counseling, etc., You don’t see diabetes being “cured” by changes in relationships, work settings, religious beliefs, and thinking patterns. The fear of those invested in pharmaceutical company profits and the prescribing of their pills leads to great resistance to any descriptive changes that are not in line with the illness approach.
The second consequence that I think people fear is that people who now have access to mental health services might lose them if people stop thinking that the patterns now viewed as real illnesses are really not illnesses. Dr. Szasz’s “problems in living” alternative and my “mental health concerns” approach, they fear, will trivialize these experiences.
Some argue that if everyone could go to a mental health professional merely to have their concerns addressed, then the system would soon be overloaded with clients, and insurance policy costs would soar. Because insurance companies only cover people with more serious conditions known as mental disorders, so the argument goes, this limits the number of people who can get to see a mental health professional. However, I believe that third-party-payer executives would readily come to understand, with a little explaining, that mental health service providers now using the current mental illness approach do not turn anyone away who has mental health insurance coverage and comes to their office expressing what my approach refers to as a mental health concern. Professionals are in the business of increasing their clients. The current relevant definitions are so vague that with little imagination, anyone can be “diagnosed” as having 
Similarly, people who seriously hurt others while drinking alcohol or in some furious fit might be blamed for their actions. Thinking that they have an illness, somehow makes them blameless.
This process involves learning that there is a dramatic difference between taking some responsibility for what has occurred and blaming oneself for what has occurred. Blame suggest that you should be punished for your actions. Taking some responsibility for your actions allows one to realize that there may indeed be some very strong conditions that are out of your control regardless of whether or not you have an illness. Blaming yourself for these is not helpful, but allowing yourself to experience deeply the dissatisfied feelings about whatever control you do have can spur you to make valued changes.
Okay, so those are the three feared consequences that I have come to believe ignite anger whenever there is a discussion about conceptualizing the set of concerns now called mental illnesses. In my view, “mental health concerns” are a more apt way to conceptualize these concerns than “illnesses.” However, I fully support that for those who prefer the illness approach, that they be free to access services using that model. At the same time, I believe that ending the monopoly of the illness approach could very well stir up some valuable competition that will improve services for all.
Between 1931 and 1933, Albert Einstein engaged Sigmund Freud in a discussion that addressed the question, “Is there any way of delivering mankind from the menace of war?” Their exchange was subsequently published as a pamphlet that is available for free on line by clicking 
Do you not share the feeling that a change could be brought about by a free association of men whose previous work and achievements offer a guarantee of their ability and integrity? Such a group of international scope, whose members would have to keep contact with each other through constant interchange of opinions, might gain a significant and wholesome moral influence on the solution of political problems if its own attitudes, backed by the signatures of its concurring members, were made public through the press. 
Such an association would, of course, suffer from all the defects that have so often led to degeneration in learned societies; the danger that such a degeneration may develop is, unfortunately, ever present in view of the imperfections of human nature. However, and despite those dangers, should we not make at least an attempt to form such an association in spite of all dangers? It seems to me nothing less than an imperative duty!
As one immune from nationalist bias, I personally see a simple way of dealing with the superficial (i.e., administrative) aspect of the problem: the setting up, by international consent, of a legislative and judicial body to settle every conflict arising between nations. Each nation would undertake to abide by the orders issued by this legislative body, to invoke its decision in every dispute, to accept its judgments unreservedly and to carry out every measure the tribunal deems necessary for the execution of its decrees…. Thus I am led to my first axiom: The quest of international security involves the unconditional surrender by every nation, in a certain measure, of its liberty of action–its sovereignty that is to say–and it is clear beyond all doubt that no other road can lead to such security….
The craving for power which characterizes the governing class in every nation is hostile to any limitation of the national sovereignty. This political power hunger is often supported by the activities of another group, whose aspirations are on purely mercenary, economic lines. I have especially in mind that small but determined group, active in every nation, composed of individuals who, indifferent to social considerations and restraints, regard warfare, the manufacture and sale of arms, simply as an occasion to advance their personal interests and enlarge their personal authority….
But then he notes that he realizes that Einstein is not so much interested in a lot of theorizing, but rather, in concrete steps that may be taken to promote lasting world peace. The answer, he says, perhaps lies in trying to figure out why he, Einstein, and some others developed into human beings who are so much less likely than others to heed the drums of war. Perhaps if we understand this, we can create the conditions for others to reach a similar level of development. Thus, Freud wrote,
Because every man has a right over his own life and war destroys lives that were full of promise; it forces the individual into situations that shame his manhood, obliging him to murder fellow men, against his will; it ravages material amenities, the fruits of human toil, and much besides. Moreover, wars, as now conducted, afford no scope for acts of heroism according to the old ideals and, given the high perfection of modern arms, war today would mean the sheer extermination of one of the combatants, if not of both. This is so true, so obvious, that we can but wonder why the conduct of war is not banned by general consent…. 
The psychic changes which accompany this process of cultural change are striking, and not to be gainsaid. They consist in the progressive rejection of instinctive ends and a scaling down of instinctive reactions. Sensations which delighted our forefathers have become neutral or unbearable to us; and, if our ethical and aesthetic ideals have undergone a change, the causes of this are ultimately organic. On the psychological side two of the most important phenomena of culture are, firstly, a strengthening of the intellect, which tends to master our instinctive life, and, secondly, an introversion of the aggressive impulse, with all its consequent benefits and perils. 
Now war runs most emphatically counter to the psychic disposition imposed on us by the growth of culture; we are therefore bound to resent war, to find it utterly intolerable. With pacifists like us it is not merely an intellectual and affective revulsion, but a constitutional intolerance, an idiosyncrasy in its most drastic form. And it would seem that the aesthetic ignominies of warfare play almost as large a part in this repugnance as war’s atrocities.
But actually solid research evidence, brilliantly summarized by Steven Pinker in his book, The Better Angels of Our Nature: Why Violence has Declined, indicates that over the course of human history we have been finding less and less violent ways to resolve our differences.
Those who point the way toward alternatives to violent interactions, can, in time, perhaps way too slowly than we would like, effect change. As Pinker says in the conclusion of his book, “the data we have seen in this book show it is a goal on which progress can be made–progress that is halting and incomplete, but unmistakable nonetheless.” It is my sincere hope that Einstein’s and Freud’s efforts so many years ago will serve as an enduring inspiration to all of us to keep up the struggle toward bringing about a more peaceful world.
Do you not share the feeling that a change could be brought about by a free association of men whose previous work and achievements offer a guarantee of their ability and integrity? Such a group of international scope, whose members would have to keep contact with each other through constant interchange of opinions, might gain a significant and wholesome moral influence on the solution of political problems if its own attitudes, backed by the signatures of its concurring members, were made public through the press. 
Such an association would, of course, suffer from all the defects that have so often led to degeneration in learned societies; the danger that such a degeneration may develop is, unfortunately, ever present in view of the imperfections of human nature. However, and despite those dangers, should we not make at least an attempt to form such an association in spite of all dangers? It seems to me nothing less than an imperative duty!
As one immune from nationalist bias, I personally see a simple way of dealing with the superficial (i.e., administrative) aspect of the problem: the setting up, by international consent, of a legislative and judicial body to settle every conflict arising between nations. Each nation would undertake to abide by the orders issued by this legislative body, to invoke its decision in every dispute, to accept its judgments unreservedly and to carry out every measure the tribunal deems necessary for the execution of its decrees…. Thus I am led to my first axiom: The quest of international security involves the unconditional surrender by every nation, in a certain measure, of its liberty of action–its sovereignty that is to say–and it is clear beyond all doubt that no other road can lead to such security….
The craving for power which characterizes the governing class in every nation is hostile to any limitation of the national sovereignty. This political power hunger is often supported by the activities of another group, whose aspirations are on purely mercenary, economic lines. I have especially in mind that small but determined group, active in every nation, composed of individuals who, indifferent to social considerations and restraints, regard warfare, the manufacture and sale of arms, simply as an occasion to advance their personal interests and enlarge their personal authority….
But then he notes that he realizes that Einstein is not so much interested in a lot of theorizing, but rather, in concrete steps that may be taken to promote lasting world peace. The answer, he says, perhaps lies in trying to figure out why he, Einstein, and some others developed into human beings who are so much less likely than others to heed the drums of war. Perhaps if we understand this, we can create the conditions for others to reach a similar level of development. Thus, Freud wrote,
Because every man has a right over his own life and war destroys lives that were full of promise; it forces the individual into situations that shame his manhood, obliging him to murder fellow men, against his will; it ravages material amenities, the fruits of human toil, and much besides. Moreover, wars, as now conducted, afford no scope for acts of heroism according to the old ideals and, given the high perfection of modern arms, war today would mean the sheer extermination of one of the combatants, if not of both. This is so true, so obvious, that we can but wonder why the conduct of war is not banned by general consent…. 
The psychic changes which accompany this process of cultural change are striking, and not to be gainsaid. They consist in the progressive rejection of instinctive ends and a scaling down of instinctive reactions. Sensations which delighted our forefathers have become neutral or unbearable to us; and, if our ethical and aesthetic ideals have undergone a change, the causes of this are ultimately organic. On the psychological side two of the most important phenomena of culture are, firstly, a strengthening of the intellect, which tends to master our instinctive life, and, secondly, an introversion of the aggressive impulse, with all its consequent benefits and perils. 
Now war runs most emphatically counter to the psychic disposition imposed on us by the growth of culture; we are therefore bound to resent war, to find it utterly intolerable. With pacifists like us it is not merely an intellectual and affective revulsion, but a constitutional intolerance, an idiosyncrasy in its most drastic form. And it would seem that the aesthetic ignominies of warfare play almost as large a part in this repugnance as war’s atrocities.
But actually solid research evidence, brilliantly summarized by Steven Pinker in his book, The Better Angels of Our Nature: Why Violence has Declined, indicates that over the course of human history we have been finding less and less violent ways to resolve our differences. Human beings who take the time to make vivid the negatives of war, rather than glorifying it, do make a difference. 
Those who point the way toward alternatives to violent interactions, can, in time, perhaps way too slowly than we would like, effect change. As Pinker says in the conclusion of his book, “the data we have seen in this book show it is a goal on which progress can be made–progress that is halting and incomplete, but unmistakable nonetheless.” It is my sincere hope that Einstein’s and Freud’s efforts so many years ago will serve as an enduring inspiration to all of us to keep up the struggle toward bringing about a more peaceful world.
Although remaining serious throughout a conflict has some merit, many people like to interject a little humor. Such a style raises some important considerations that we will explore in today’s “From Insults to Respect” post. We’ll go about exploring these considerations by first taking another look at the original parable, and then I’ll present it again, but with some humor thrown in. After discussing the different approaches illustrated in the two versions of the parable, we’ll discuss a few more examples of people using humor in conflict situations. 
As Abraham Lincoln once said, ‘Better to remain silent and be thought a fool than to speak out and remove all doubt.'” Then Kate provides a delightful smile. She notices a hint of a smile come to Mr. Nelson’s face. She then says, “I will be ready to move this discussion forward within a week, Sir.” She then looks into Mr. Nelson’s eyes and says gently, “Please give me a little time.” 
The anger that Mr. Nelson is experiencing has, in a sense, placed him on a train barreling in one direction, toward punishing Kate for what has occurred. When Kate presents the Lincoln quote and uses it to provide her an opportunity to provide a pleasant smile, it begins to slow the train down, then brings it to a halt, and then gives Mr. Nelson an opportunity to get off. Once off the anger train, he has an opportunity to look around at some other paths he could take besides the path the train had been taking him. Said another way, in contrast to being close minded, he becomes more open minded.
At the time this example took place, Kennedy was a young senator running for president. It had recently become clear that he was rising in the polls, and the outcome was beginning to look more and more favorable for him. Senator Kennedy, to promote his candidacy, decided to invite leading opinion writers from the press to discuss the issues of the day.
Then a huge smile spreads across Senator Kennedy’s face, and all of those present break out laughing, including Fred.
Much better is to make the joke teller the butt of the joke. Second, there are times when humor might be in the form of satire that counters the other party’s position. When this is done, it’s a great idea to say some kind things about the person who holds the other party’s position.
For example, Lincoln got a tremendous laugh from the audience when, during the famous Lincoln-Douglas Debates, he said that Judge Douglas’s arguments were “as thin as the homeopathic soup that was made by boiling the shadow of a pigeon that had starved to death.” At another point, after Judge Douglas made the case that slavery wasn’t all that bad, Lincoln cracked up the audience when he replied, “Whenever I hear anyone arguing for slavery, I feel a strong impulse to see it tried on him personally.”
From time to time, I like to enrich some ideas that I introduced in earlier posts with some relevant thoughts that Bob Dylan has shared on his 
Are the drugs used to treat ADHD as safe and effective as the pharmaceutical industry claim? Are many of the students now classified as having ADHD really more aptly construed as having an “attention priority difference?” Are many of those who are classified really just the youngest students in their class? Are there safer ways than drugs to deal with the challenges that are associated with the behavior patterns that lead to an ADHD classification? These are some of the questions that I addressed in my earlier posts. Let’s see what Bob has to say about this.
What a day for a daydream
“Back when I was going to school you would see kids daydreaming and sometimes not paying attention, running around or acting impulsively. I always thought that was being a kid. Nowadays, everybody’s got Attention Deficit/Hyperactivity disorder–ADHD. They say it’s hyperactivity, impulsivity, and all sorts of other things. I’m sure there are kids with real problems. But quite often people just didn’t want to pay attention. I see parents not wanting to spend time with their kids, and for them, not paying attention or being bored or acting impulsively is the kid’s problem. I don’t think so. Spend time with your kids. You might find that they don’t have ADHD, they have other needs, a need to see their parents. I’ll tell ya something, I didn’t pay a lot of attention, and I was known to daydream in class and things turned out pretty good for me. I’ll be the first to agree with you that sometime medication is necessary. But maybe we are too often in a hurry to treat things chemically and not look at what the real problem is. Sometimes there is not even a problem there, at least one that couldn’t be solved with a little bit of patience, attention, care, and love.
Mr. Kramer is a professional photographer, who got a sweet deal when he was hired to follow Bob around for a little over a year to take pictures of him at home, going around different places, and before and during performances. Here’s a little of what he observed.
“he would grab at moments that were available, often writing in a small black looseleaf notebook, in which he probably wrote new material or kept ideas. He would interrupt something in order to glimpse a TV screen to see another performer. I’ve seen him use ten minutes working out melodies on a backstage piano while someone was out locating the key to his dressing room.” (p. 36)
“No matter how scatter-brained the type of a man’s successive fields of consciousness may be, if he really cares for a subject, he will return to it incessantly from his incessant wanderings, and first and last do more with it, and get more results from it, than another person whose attention may be more continuous during a given interval, but whose passion for the subject is of a more languid and less permanent sort.
In typical American classrooms, a subject is brought up by teachers at a given time and for a specific period of time. Those in the class who have the ability to switch their attention to what the teacher brings up at a given time and then stay focussed throughout the scheduled time, are often more highly valued by teachers then those students who are less skilled at this. Teachers often refer to the Special Education Department those children who are not following along in lockstep with their schedule and they urge parents to take these children to doctors to get prescriptions for drugs. Like Bob, I’m not comfortable with this.
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Trying to get the kids off your hands by sticking them in front of a TV or computer game terminal may be a pretty enticing thing to do. If that doesn’t work, it is oh, so easy to just give them some pills.
When I say, “take the responsibility” I don’t mean to imply that parents should blame themselves. Blame suggests that parents should seek to punish themselves whenever their approach at discipline doesn’t work well. Punishing themselves in such situations only makes a challenging situation worse.
What I mean by taking responsibility is that we recognize within ourselves that we are dissatisfied with where things are at. We observe in a nonjudgmental manner how this goes along with some physical sensations in our body–perhaps a tightening in our chest, and tension around the forehead. Perhaps we might observe ourselves making some nasty comments about ourselves because of old habits. Although we observe these nasty comments, we don’t accept them as correct, just habitual statements learned oh, so many years ago. But as we observe all of this, from time to time we consider the attitude that these sensations that we are experiencing have the potential of spurring us to make some improvement in our own actions.
I never heard back from Richard, and so I put the gay issue aside believing it wasn’t necessary to take it on directly because it is only a small minority who could relate to this. According to a 2015 Gallop poll, less than 4 percent of the adult population identify themselves as gay. It seemed to me that my blog posts should focus on issues with which the vast majority of people could identify. Moreover, the many suggestions that I do provide in my posts to deal with insults in a general way could easily be applied by someone who is called gay in a disrespectful manner.
I responded with an email directly to the writer of this email, offering some suggestions. Then, after a little more thought, I decided that the issues raised earlier by Richard from Colorado and the writer of the email I recently received actually do impact a majority of people. Moreover, even if it didn’t, taking a little time to directly address a concern that a minority are dealing with is a decent thing to do. And so, in this light, I offer the following meditation on this topic.
A pianist, Liberace, played a pretty impressive number, and then, as he was being interviewed by the show’s host, my mom turned to me and said, “He’s a faygala, but I like him anyway.”
The fact that my mom still liked Liberace despite his being gay was not all that unusual. With his unique blend of piano prowess and over-the-top showmanship, Liberace was one of the most loved performers of the 20th century. For several years he had his own TV show, with an estimated 35 million mostly female viewers. He sold millions of records and was one of the highest paid performers in Las Vegas.
I happened to be talking to a friend of mine that we’ll call for today Nick. As we discussed some stuff, at one point he told me that a guy who was a mutual friend of ours was insulted by someone. As soon as I heard about it, I immediately called the insulter “a dirty faggot.”
“Hmmm,” I said. And then, after giving this some thought, I replied, “I see what you mean. I’ll try to stop using those types of words. It’s an old habit, so if you catch me slipping up some time, feel free to call me on it.”
If you hear someone using terms for gay people in an insulting manner, consider having a similar conversation that Nick had with me. Perhaps it might motivate you to do so if you keep in mind that someday you might find out that your own child might turn out to be gay, and if you had remained silent all those years before you became aware of this, how would you end up feeling?
In my earlier blog posts, I also reviewed research studies that indicate that almost immediately after taking these types of drugs, many children will complete more academic work and get more of the items correct. Parents also tend to report behavioral improvements. But these effects begin to wane. According to the best available evidence, by a little over a year, any perceived improvement, when objectively measured, had completely disappeared. The available studies indicate no lasting benefits for those who use them in terms of academic achievement, social outcomes, and high school graduation rates. In the end, thousands of dollars have been spent and the drug treated children, having suffered the various side-effects and been subjected to serious risks are no better off than children who had similar behavior challenges but did not take any of the ADHD drugs.
“Researchers in Taiwan looked at data from 378,881 children ages 4 to 17 and found that students born in August, the cut-off month for school entry in that country, were more likely to be given diagnoses of A.D.H.D. than students born in September. The children born in September would have missed the previous year’s cut-off date for school entry, and thus had nearly a full extra year to mature before entering school.”
On March 13, 2016, 
In my opinion, I did not have a medical illness. Out on the streets of Brooklyn, I was as healthy as a horse as I got into handball, basketball, and stickball games for hours and hours during my free time. Nevertheless, I am certain that if my parents had taken me to a doctor in this modern world of ours, I very likely would have been given an ADHD label and placed on one of the ADHD drugs.