Psychiatric Name Calling: What Do People Say About It?

Post author By Dr. Jeffrey Rubin
Post date May 10, 2015
13 Comments on Psychiatric Name Calling: What Do People Say About It?

In recent weeks, I have been providing a series of blog posts on psychiatric name calling (see here, here, here, and here). In these posts, I have expressed some negative opinions about the Diagnostic and Statistical Manual of Mental Disorders (DSM).

The DSM provides the names for the various mental health concerns that mental health service providers are often required to use if they want to be paid for their services or if they want to have their research published in professional journals.The language of the DSM places its terminology under the umbrella concepts of “mental illness,” “mental disorder,” and “psychopathology.” In my blog series, I have argued that the pathologizing of human experiences in this way does far more harm than good.

As part of my discussions on this topic, I quoted the opinions of some who agreed, and some who disagreed, with my opinions. The quotes that I used were selected from my own personal readings. Therefore, they may not have been characteristic of how a wider range of different people may think and feel about the DSM approach to labeling the various mental health concerns.

A few years ago, two teams of researchers have sought to obtain a broader range of views on this topic by carrying out surveys. Jonathan D. Raskin and Michael C. Gayle surveyed psychologists who regularly use the DSM, and published their findings in the Journal of Humanistic Psychology (DSM-5: Do Psychologists Really Want an Alternative? 2015, pages 1-18). Lois Holzman and her team surveyed people in some New York City communities, and published her findings on the DxSummit.org website (A Report on Community Outreach: Lay Opinions on Emotional Distress and Diagnosis, http://dxsummit.org/archives/2249). Let’s take a look at their findings.

What the Psychologists Had to Say

Here’s a summary of the survey data by Jonathan D. Raskin and Michael C. Gayle:

Only two published studies, both from the early 1980s, have specifically examined psychologist attitudes toward the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current article rectifies this by presenting the results of a recent survey of attitudes toward the DSM-IV-TR and DSM-5. Though the DSM has changed over the years, psychologist attitudes toward it have remained remarkably consistent. Although more than 90% of psychologists report using the DSM, they are dissatisfied with numerous aspects of it and support developing alternatives to it—something that psychologists over 30 years ago supported, as well. The finding that almost all psychologists use the DSM despite serious concerns about it raises ethical issues because professionals are ethically bound to only use instruments in which they are scientifically confident.

In the above summary, the number 5 after the letters DSM, refers to the fact that the DSM has undergone five major revisions. Since the 1980s, there have been three such revisions. Ideally, users of the DSM would see clear improvement for each revision.

When a survey was done in the early 1980s, psychologists were clearly skeptical of the DSM-2. As described by Raskin and Gayle,

More than 40% felt it (a) distorted clinician perceptions of clients, (b) applied medical labels to psychosocial problems, (c) was not reliable and valid, (d) emphasized diagnosis over treatment, (e) obscured individual differences, and (f) overemphasized pathology. Almost 60% were dissatisfied or somewhat dissatisfied with the DSM-2 with only 17% satisfied or somewhat satisfied.

When the DSM-3 came out in 1983, Smith and Kraft carried out an updated survey on this revision of the DSM-2. The findings indicated that psychologists at that time (a) preferred social–interpersonal diagnosis, nondiagnosis, and behavioral analysis over DSM-3—in that order; (b) felt that most conditions in DSM-3 were best seen as nonmedical problems in living; (c) believed too little had been done to develop scientific alternatives to the DSM; and (d) thought that client welfare and integrity would be better served by abandoning the medical model. Eighty-five percent disagreed that mental disorders are a subset of medical disorders.

In the latest survey that was carried out by Raskin and Gayle, 128 anonymous psychologists participated. Among the questions that were asked was, “How satisfied are you with the changes being proposed for DSM-5?” Their answers indicated that they were significantly more negative about it than neutral. The general attitude about the latest version of the DSM were very similar to what was found three decades ago, namely, that a significant number of psychologists are unhappy with the DSM.

What Community Folks Had to Say

In the community outreach survey of lay opinions on emotional distress and diagnosis carried out by Lois Holzman and her colleagues, people were asked questions at two annual NYC street fairs attended by millions of people. Conversations lasted from five to over ten minutes each. In all, 143 people participated in the survey in the first of these two surveys, which occurred in 2013. The second one had 149 people who participated, which occurred in 2014.

In the 2013 survey, the focus was on how psychiatric diagnosis affected kids. Forty percent felt that psychiatric diagnosis was not valuable. For the 60% that felt that psychiatric diagnoses can be valuable, 90% of them had reservations. That is, they said that it was only sometimes helpful, there was a danger of misdiagnosis, there was racism involved in diagnosis, and it leads to stigma and over-medication.

Ten percent were completely against diagnosis under any circumstance, some sharing their experiences pertaining to children. Examples of comments from this group follow:

“Medication makes you act out. My grandson was hyperactive, not ADHD and they wanted to put him on Ritalin – I told them no. Drugs at an early age can lead to hard core drugs later in life.”

“I worked with kids who had wrong diagnosis, and this is prevalent.”

“Kids get told in 1^st grade they’re crazy—then it becomes a self-fulfilling prophecy.”

In the 2014 survey, the researchers:

“tried to go a little deeper and see if we could help people explore the apparent conflict around diagnosis, i.e., its value and its dangers. We also wanted to learn what they thought about the necessity and mandate of diagnosis.

We all know people who have gotten very depressed when they’ve lost a loved one, or children who cannot sit still in school, lots of folks who are angry and demoralized about not finding a job. Do you think any of these people need to get a diagnosis in order to get help with their emotional pain?

(IF THEY SAY YES, ASK THE NEXT 2 QUESTIONS):

Do we need to relate to them as having brain disorders? Or chemical imbalances?

Right now, in most settings, if you want to get help with ANY kind of emotional pain from a mental health professional, they are required to give you a diagnosis. Do you agree with that?

Are there other ways to support people emotionally? What do you think could help them?

Like me, you probably know people in your family, church, or at work who have serious emotional problems, who may have been diagnosed with major depression, bipolar or schizophrenia. Obviously people deserve and need top quality mental health care including access to medication. Do you think that even in these situations a diagnosis can limit the person, label them, and stigmatize them? If so, how?

From our past surveys we have found that people are conflicted about diagnosis and labels. They find it relieving to get a diagnosis and at the same time feel like the diagnosis can stigmatize or label them. Why do you think that so many of us are conflicted about this, feel it can be both helpful and harmful?

Here’s a brief summary of the finding, as described by Dr. Holzman:

Diagnosis Needed: 60% of respondents said no, people did not need a diagnosis to get help with their emotional pain. The majority of the 40% who said diagnosis was needed told us that that was the only way to get to talk to someone.

Only those who said yes, diagnosis was needed (40%), were asked the next two questions.

1a. Biological Basis: 89% of those who said diagnosis was needed said we shouldn’t consider such people as having a brain disorder or chemical imbalance.

1b. Diagnosis Required: 75% of those who said diagnosis was needed did not agree that it should be required.

Other Ways to Support (alternative types of treatment):

Everyone offered an alternative, with most people suggesting more than one. The most frequent responses involved talking to people—therapy, counseling, group therapy being the most common (including, “A center they can go to without getting diagnosed”), followed by family, friends, self-help and support groups.

A wide variety of social activities and life style changes were recommended—volunteering, hobbies, music, dance, writing, meditation, exercise, yoga, diet, prayer and creating community (“Have events that bring people out, like this fair”).

& 4. Concerns about Diagnosis: 90% (including those who thought it was needed) expressed concerns about the stigma of diagnosis, the dangers of misdiagnosis, and/or the over-medication that too often accompanies a diagnosis.

Once you have that label it doesn’t stay at the clinic. You carry it with you for a long time.

People start calling you crazy. It can be a shame for the family.

I had to fight to get counseling for my kid. They just wanted to give him drugs.

Getting a diagnosis limits life experience, you’re treated differently, you feel like an outcast.

It’s helpful to the clinic but not in everyday life.

It’s good to know what’s wrong, but it might make them feel worse about themselves and put them in a box.

It pigeon-holes people and the diagnosis becomes all that I am.

It stagnates them. It keeps them on one path with only one destination.

They think something’s wrong with them.

There is too much use of medication. It is a quick fix to avoid a real understanding.

Against it – children are still growing. Against medication.

So there you have it, some views other than mine about psychiatric name calling. In interpreting these findings, I think it’s important to bear in mind that the views of the people surveyed developed in the context of a multibillion dollar advertisement campaign by the pharmaceutical companies over many years that is designed to convince them that emotional concerns are diagnosable illnesses requiring medication treatment. How might the views of those surveyed been different without this high finance selling of the illness model?

——————————-

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.

Tags DSM, mental disorders, mental illness, psychology

Bob Dylan conflict resolution fools insults Listening skills Name calling

Bob Dylan On Fools

Bob Dylan begins his Theme Time Radio Hour show about fools, with a beautiful instrumental version of “Why Do Fools Fall In Love.” After a few bars of this tune, it continues in the background as Bob begins to speak:

James Thurber

James Thurber once said, “You can fool too many of the people too much of the time,” and for the next hour we’re going to try to do just that. Welcome back to Theme Time Radio Hour. Today we’re going to talk about patsies, stooges, marks, jesters, jokers, buffoons, clowns, tricksters, harlequins, and the village idiots, because in honor of April first, it’s our fools’ program. Everybody plays the fool sometimes, and for the next hour we’re going to play the greatest records about our favorite halfwits, the fools.

Recently, I provided a post on this blog titled, “Bob Dylan on Madness,” as an entertaining way to practice some of the basic principles I regularly discuss. That post was so popular that I thought, Why not do a similar post utilizing Bob’s show on fools? After all, in addition to people at times seeking to insult themselves and others by saying such things as “You’re mad” or “You’re crazy,” they do likewise by saying such things as “You’re a fool” or “You’re a buffoon.” Are there more respectful, helpful ways to deal with situations that give rise to such name calling? I think so. Let’s see if we can have some fun thinking about this issue as we review Bob’s show on fools.

Chain of Fools

After Bob’s brief introduction, he dives right into Aretha Franklin’s emotionally charged song, “Chain of Fools.”

For five long years
I thought you were my man
But I found out
I’m just a link in your chain

You got me where you want me
I ain’t nothin’ but your fool
Ya treated me mean
Oh you treated me cruel

Chain, chain, chain
(Chain, chain, chain)
Chain of fools

Every chain, has got a weak link
I might be weak yeah
But I’ll give you strength

Oh, hey
Chain, chain, chain
(Chain, chain, chain)
Chain of fools

Here we find a woman calling herself a fool because she sees herself attached to a man who treats her cruel. I wonder how I would react to a woman telling me a similar story. I guess I would not rush into giving her any advice, but rather, give her some time to be with her emotional experience while I listened in a caring, empathic manner.

As we discussed in an earlier post titled “To Listen, Or To Criticize,” we often jump too quickly into providing advice. If you would like your listening skills to be respected, it helps to summarize, every few minutes, what is being said in a caring manner, thus reassuring the person talking to you that you are indeed listening and accurately hearing what is going on.

After perhaps fifteen minutes or so of listening and summarizing, I would continue to listen, but I might begin to start asking, as gently as possible, a few clarifying questions. I often use the DIG Conflict Model to come up with my questions. The letters of the word “DIG” would remind me to ask about what she “desires” in this situation, what is “interfering” with her desire, and if she feels she is “guilty” of doing something wrong. I would gently encourage her to be as specific as she could be. A statement like, I’m guilty of being a fool” is way too vague to be helpful in coming up with any practical plan. “I’m guilty of not going out to social events on Friday evenings so I can find a loving relationship with a man who would treat me with respect,” fits better with my image of being specific.

Aretha Franklin’s song continues with these words:

One of these mornings
The chain is gonna break
But up until the day
I’m gonna take all I can take, oh hey

Chain, chain, chain
(Chain, chain, chain)
Chain of fools

We see a glimmer of hope in these words. That weak link in the chain is not completely unbreakable. I think that at some point in my relationship with a woman dealing with this type of concern, I might ask what she thinks she might do if the chain would indeed break. My overall goal at this point in the relationship would be to focus not so much on what is wrong with what is happening in her life, but what she could specifically do to improve her situation.

Further On In the Show

A little later in Bob’s show, he introduces another song:

Hank Snow

Everyone plays the fool sometime. Hank Snow knew that. We talk about Hank an awful lot [on my show], and he was one of the biggest voices in country music from 1951 and 1955. He had a remarkable number of top ten hits. This is from the tail end of that streak, in 1955–“Now And Then There Is A Fool Such As I.”

Here are some of the lyrics:

Pardon me, if I’m sentimental
When we say goodbye.
Don’t be angry with me should I cry.
When you’re gone, yet I’ll dream
A little dream as years go by.

Now and then there’s a fool such as I.

…

And now you say that we are through.
I’m a fool, but I’ll love you dear
Until the day I die.
Now and then there’s a fool such as I.

Like the Aretha Franklin song, this Hank Snow song is about someone in love who is feeling like a fool. As it turns out, almost all of the songs Bob plays over the course of his hour show is about love and someone feeling like a fool. But they differ nevertheless. In the first two songs we find out about two people who are calling themselves fools, but the first one is about a woman who feels she’s a fool for staying connected with a man even though he treats her bad. The second song is about a man who feels foolish for continuing to love a woman even after she said they are through.

In other songs that Dylan plays during his show, a singer is trying to convince her parents that she’s no fool for loving a man that they think is less than ideal. Then there’s one about a man who is trying to convince a woman that she’s a fool for not loving him despite all that he has to offer.

One of the highlights of Bob’s show is a little audio clip of Humphrey Bogart, as Sam Spade, confronting Mary Astor as the femme fatale, Brigid, in the classic film noir, The Maltese Falcon.

Brigid, desperately: You’ve been playing with me, just pretending to trap me like this. You didn’t care at all. You don’t love me.

Spade: I won’t play the sap for you.

Brigid: You know it’s not like that! You can’t say that!

Spade: You haven’t played straight with me for half hour at a stretch since I’ve known you.

Brigid: You know down deep in your heart that in spite of everything I’ve done, I love you.

Spade: I don’t care who loves who, I won’t play the sap for you. You killed Miles and you’re going over for it.

As you can see, even when used in the context of love difficulties, the word, “fool,” or its related terms, are used to refer to quite a variety of different circumstances.

As we leave the love arena, we see that the term is used in even a wider set of circumstances. Thus, Bob tells us about the enormously talented singer, Frankie Lymon, who died way too early with a heroin syringe by his side. As another example, he tells us about a couple of football games:

Every field has its fools, and the biggest mistakes are made on the football field. For example, Roy Unsway Regales played for the University of California, and in the 1929 Rose Bowl Game, he got turned around and ran 65 yards in the wrong direction.

Jim, upon realizing his mistake.

That’s nothing compared to Jim Marshal who played for the Minnesota Vikings. On October 25, 1964 the Vikings were playing against the San Francisco 49ers. Marshal recovered a fumble and ran 66 yards in the wrong direction into his own end zone. He was so excited he threw down the ball in celebration. The ball landed out of bounds, resulting in a safety for the 49ers. Fortunately for him, the Vikings won the game anyway, 27 to 22, and I was there that day. Strange but true.

We All Sometimes Play the Fool

Throughout the show, Bob reminds us repeatedly that everyone plays the fool sometime. He does it in a variety of ways. Thus, before playing the song, “Three Times a Fool,” Bob tells us “It wouldn’t be bad if you were just a fool once a year, but all of us are fools on more than one occasion.”

A little later, he says:

We’re talking about fools of all stripes here on Theme Time Radio Hour. As Jean Brown once said, “Foolproof systems don’t take into account the ingenuity of fools.”

And still a little later, Bob gives us some quotes from Shakespeare and Twain on the subject of fools.

Shakespeare looking a little foolish in his outfit.

Shakespeare spoke quite often about fools. For example, in A Midsummers Night Dream he said, Lord, what fools these mortals be? Twelfth Night gave us the following line, Foolery, Sir, does walk about the orb like the sun. It shines everywhere. And From As You Like it, The more pity that fools may not speak wisely what wise men do foolishly.

Shakespeare, hell of a cat.

…

As Mark Twain says,”The first of April is the day we remember who we are the other 364 days of the year.

And so when people call us a fool, perhaps we may find that the sting of the comment is lessened if we keep in mind that no doubt these name callers have had their share of playing the fool on plenty of occasions. And when, out of old habits, we find ourselves calling either ourselves, or someone else a fool, perhaps a little sympathy with the human condition is in order.

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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.

Tags conflict management, criticism, fools, insults, name calling, negative criticism, respect, types of criticism

conflict resolution learning through stories respect

On Being Respected

How does someone learn how to become a person people respect? Arguably, the best way to develop a deep understanding of this is through stories that depict characters that, as they mature, grow into individuals that have the set of characteristics that people highly respect. In the Cool Steve Stories, a coming-of-age trilogy of a boy growing up in Brooklyn, I have attempted to provide my readers with just this type of story.

A Hero Grows in Brooklyn

The first novel of the trilogy, A Hero Grows in Brooklyn, can be downloaded for free on any e-book reader, iPad, or computer. It is also available as a paperback book.

In the trilogy, the topic of respect initially arises when Steve is only five-years old. His Uncle Ricky has taken him to Yankee Stadium, and Mickey Mantle has just won the first game of a double header with a spectacular catch in center field.

The story continues from here:

“Hey Steve,” says Ricky as he stretches his arms way above his head, “while we wait for them to get ready for the next game let’s take a walk. My legs are getting stiff.”

“Can we go way up there?” Steve asks pointing to the seats high above them.

“Let’s go see,” says Ricky.

In the crowded aisle between the dark green seats, slowly they make their way up to a covered cement walkway with hordes of fans on long lines seeking to buy peanuts, hot dogs, ice cream, beer, and soda. Uncle Ricky looks around to get reoriented.

“Let’s try this way, Steve.”

“Wow, Uncle Ricky, I never seen so many people!”

The crowd thins out along an upwardly sloping tunnel. Soon, they emerge into bright sunlight and Steve finds himself in the upper deck behind home plate. This view provides a bird’s-eye perspective. Looking down from the wall in front of the upper deck’s first row of seats, Steve’s mouth flies open, and he suddenly takes a step back. “I bet a guy could get pretty hurt if he fell from here!” he cries.

“Ya wanna find out,” Ricky responds mischievously. “Here. I’ll give ya a boost,” and as he says this he bends down, interlocks the fingers of his hands together and holds them by Steve’s feet.

Steve feigns anger, throwing some mock punches at his uncle while laughing.

As they begin the journey back to their seats, Steve notices the unique smell of stale beer and Cracker Jacks.

“So, Steve, you getting excited about starting kindergarten in the fall?”

“I hear they got some mean kids there.”

“There are always a few kids trying to earn respect by pushing kids around.”

“Resect? What’s that mean?”

“Not resect, respect.”

“Yeah, re… respect, Uncle Ricky, what’s it mean?”

“Well, if ya like a guy then ya…” Ricky begins to say but then pauses. He was about to say, If you like a guy you respect him. But then he thinks about his older brother Mike, who happens to be Steve’s dad. Ricky realizes that he likes Mike, even loves him, but he doesn’t truly respect him. Then Ricky wonders to himself if you can dislike a guy and still respect him. Hmmm.

“Well?” says Steve.

“I guess I’ll tell ya what my dad used to say about respect. You’re a little young ta understand this yet but anyway, every now and then your nonno, in his heavy Italian accent, would say ta me and your dad when we were young, ‘Ricky, Mike, if ya wanna get respect ya gotta learn how ta use this-uh, wit’ this-uh, and wit’ this-uh,” and as Ricky imitates Steve’s grandfather saying these words he points first to his right arm’s biceps, then to his head, and then to his heart.

The little Yankee Stadium scene that I just described, only begins the process of encouraging people to start thinking about the nature of respect. Why Ricky doesn’t respect Steve’s dad, and how Steve, when he becomes a teenager, manages to become respected are answered by reading the rest of the trilogy. By following over the course of a few months the characters as they deal with specific situations that we can relate to, we find ourselves envisioning how we might handle similar situations. As psychologist Rollo May put it, these types of stories are the fibers with which a person weaves a coherent fabric of identity and meaning.

Other Ways to Learn About Respect

An alternative to stories for learning about respect, is to review a list that some people put together of the characteristics that they believe lead to respect. One such list, for example, is provided by wikiHow’s, titled “How to Be Respected.” Among the items listed is:

Being a Good Role Model

Present yourself well

Set an example for others

Make your own decisions

Don’t be overly materialistic

Don’t procrastinate

Be a cultured person

Keep your language clean and respectable

Exude confidence

Be optimistic

Stick to your word

Excel at something

Admit to your mistakes

Avoid getting overly intoxicated in public

Stick up for yourself when you need to

Respecting Others

Greet people in a proper and friendly manner

Never bully others or take advantage of their weaknesses

Give everyone a chance

Be prepared to see other people’s side of the story

Don’t act like a know-it-all

Be discreet

Each item on this list comes with a few examples along with a picture illustrating the point that is being made. Although I believe that there are some essential characteristics left off the list, and many of the examples are too vague to readily put into practice, the items are worth thinking about.

I think the list can be usefully employed as part of a discussion on this topic, especially if those participating in the discussion are encouraged to tell a little story of their own depicting an incident in which someone they know acted in a way that illustrates the items on the list.

Of course another way to learn the skills that lead to respect is to begin reading this blog, starting with the first post, and systematically going through each succeeding post at your own pace. It’s free, and engaging in discussions can be done by posting comments in the “comment section” that appear at the bottom of each of the posts.

Conclusion

Regardless of how else you choose to learn about respect, the Cool Steve Stories is a great way to supplement your learning. The process has elements of fun, sadness, frustration, excitement and humor.

To end today’s post, let’s take a little look at how five-year old Steve ended his day at Yankee Stadium.

After Steve’s mom, Marie, makes him take a shower, it’s time for both of them to watch the Ed Sullivan Show, a Sunday night tradition of theirs.

“Did it start yet?” asks Steve hurrying into the room wearing his pajamas, still dripping from his shower.

“Not yet,” says Marie as she turns the RCA dial to channel two. “Hmmm. That doesn’t look so good.” She adjusts the rabbit-ear antenna so she can get rid of the shadows that are interfering with the picture quality. “There,” she says, “that’s better. You need anything before the show starts?”

“I’m fine, Mom.”

“Well, in that case, I’ll just come over here and sit by my handsome young man.” Together they settle in on their green sofa to enjoy the night’s variety acts.

Steve likes the juggling act. Not only does the guy get balls flying all around, but he also performs a smooth routine using cigar boxes that dance in the air.

During a commercial, as Marie goes into the kitchen to get something to nibble on, Steve gets two pink rubber balls and a baseball and tries to juggle. As he tosses one ball up and then the second, he observes that he is already too late to catch the first because it is about to hit the floor. He tries again and again.

Marie comes back into the living room with a large bowl. The aroma of fresh buttered popcorn enters Steve’s nostrils. He puts the balls down, goes over to the sofa, snuggles with his mom, and together they munch away on the soft, fluffy treat.

“Steve, what was all that commotion I heard in here while I was making the popcorn?”

“I was trying ta juggle, Mom. It’s kinda hard. I’m gonna practice a little everyday till I get it.”

The show drifts by. Marie recalls the quarrel she had with Mike before he left for the bar. He had promised to defrost the refrigerator today, and it hadn’t gotten done. Oh, if this had been the only unfulfilled promise of Mike’s she would have said nothing, nothing at all. But time and time again!

Aching memory after aching memory drift through her thoughts as Dean Martin croons his way through “That’s Amore.” Then Marie looks over to her son. She sees the golden highlights of his dark brown hair, his beautiful face, his sweet lips, the sparkle in his eyes… and as she gazes at him waves and waves of joy flow through her.

The show comes to an end. Steve begins to yawn. It’s been a long day.

“Come on, Steve, it’s time to go to bed,” says Marie.

When they get to Steve’s bedroom, Marie tucks Steve in with his teddy bear. “I love you, Steve,” she says as she leans over and kisses him on his forehead.

“I love ya too, Mom.”

Snuggling with his teddy bear, Steve closes his eyes. His mind drifts here and there. After a while, he begins to dream of one day becoming the next great Yankee centerfielder.

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Tags A Hero Grows in Brooklyn, learning through stories, Mickey Mantle, respect, respect list, The Cool Steve Stories, Yankee Stadium

Bob Dylan conflict resolution crazy criticism DSM insults madness meditation mental disorders Mental Illness Name calling negative criticism psychiatry psychopathology The Diagnostic and Statistical Manual of Mental Disorders

Bob Dylan on Madness

As some of you may know, Bob Dylan has a show called “Theme Time Radio Hour.” As the title suggests, each episode is centered on a theme. He begins his episode on madness as follows:

“Let me ask you a few questions, friends. Are you disinterested in work or family life? Do you suffer from sleep disruption? Have you had significant changes in appetite? Have you had paranoid thoughts? Thoughts of grandeur or invincibility? Any feelings of persistent anxiety or perhaps panic attacks? Are you hearing voices or seeing people who are not there? Do you have thoughts of dying? Do you exhibit strong or violent anger? Do you have the inability to pursue a normal life, normal activities or normal relationships? Well, I’m no doctor, but perhaps you’re mad as a hatter; crazy as a loon. Have you lost your morals? Are your bats in the belfry? Maybe you’re nutty as a fruitcake? Crazy as a coot? Taxed in the head? Bunkers? Bananas? Deranged? Are you crackers or daffy? Unhinged or loco? Not all there or all around the bend? Maybe you’re cuckoo or buggy or simply non compos mentis? Do you talk to yourself? Do you ever binge out on food? Do you swing suddenly from one mood to another? Do vague acquaintances treat you as though they know you far better than you would expect?

Allan Ginsberg

“Allan Ginsberg once said that he had seen the best minds of his generation destroyed by madness. Now for the next hour we’ll be providing the sound track. We’re going to look at madness, insanity, and craziness.”

Introducing his theme in this way may seem like quite a mouthful for Bob, but he manages to carry it off rather well. There is deep, dungeon-like music in the background, and he varies his voice in a manner that is full of concern and dramatic interest. Besides, if you think Bob’s description of his theme is lengthy, take a gander at the latest American Psychiatric Association’s description of a related topic. In its book titled Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, over 900 pages are consumed describing various “mental disorders.”

The theme of “madness” is relevant to this blog’s theme because when people seek to insult others, we commonly hear words like, “You’re mad,” “You’re crazy,” “You have a mental disorder,” and “You’re mentally ill.” Negative consequences often flow from such name calling. Individuals flinging these efforts to insult often become less respected by those who are their targets. Those who are their targets sometimes end up having less respect for themselves. From here, conflicts can escalate, leading to losing friends, problems at work, and even violence.

Dylan’s First Madness Song

Bob introduces the first song for his show on madness as follows:

“If craziness was a country, this would be the national anthem. Here’s Patsy Cline in a little number written by Willie Nelson–“Crazy.”

Patsy’s beautiful voice, accompanied by gentle piano riffs, drifts into its melancholy words–“I’m crazy, I’m crazy, for being so lonely. I’m crazy, I’m crazy for being so blue.”

The song goes on from here to weave the sad story of a woman calling herself crazy for loving a man whom she knows will soon be leaving her. She feels she’s crazy for worrying when he’ll leave, and crazy for trying, and crazy for crying, and crazy for loving this man.

Here we learn of just one type of experience that falls under the enormous umbrella of madness.

Connecting Madness With Genius

As the song phases out, Bob begins to tell us that according to Aristotle, “No excellent mind is without a tincture of madness,” a position with which Bob heartily agrees. He declares that “There is a thin line between genius and madness.” Defending this, he introduces us to several individuals who had been declared mad by some, and yet achieved at impressive levels in many valued fields. Thus, he tells us about the brilliant writer, Ernest Hemingway:

Earnest Hemingway

“Ernest Hemingway, for example, was convinced that people were out to assassinate him. His wife, Mary, tricked him into a mental hospital by telling him it was to treat his high blood pressure. He got shock therapy and maybe a dozen other treatments. It didn’t help. It left him more paranoid, delusional and depressed. He was afraid that his wife would put him away again, which many people believe is what led him to take his own life with a shotgun in July of ’61.”

Bob then tells us about the great jazz musician, Charlie Mingus:

Charlie Mingus

“Charlie Mingus spent some time away, although he later claimed he only had gone in to get papers declaring he was incompetent to get out of a contract with the gangster, Joey Gallo. Whatever the reason, he spent some time in Bellevue and was diagnosed as a paranoid schizophrenic.”

After this, Bob tells us the story of two more jazz greats–Bud Powell and Charlie Parker. Both at times were troubled by demons.

Then there was a comic writer:

One man that was no stranger to madness was Bill Gates. He was the editor of E. C. Comics. He had a series of horror comics in the ’50s, but then he was targeted by the government who said that his comics were ruining the morals of America’s young people. He was supposed to water down all of his books. He had one humor comic he called “Mad.” He changed it to a magazine so it wouldn’t be subjected to the comics’ code of authority. It became a huge hit and generations of kids got their first lessons on comedy from the usual gang of idiots that he assembled. He never sold advertising in the magazine while he was alive and there were no sacred cows. Bill Gates, madman of free speech.”

Bob soon moves on to the story of a hell of a fine baseball player:

“One guy that was accused of cracking up was Jimmy Piersall. He became a professional baseball player at 18, signing with the Boston Red Sox in ’48. On May 24, 1952, just before the game against the New York Yankees, he got into a fist fight with Yankee infielder, Billy Martin. After that, he scuffled with his teammate, Mickey McDermott. The final straw came when Jimmy Piersall spanked the four-year old son of his teammate, Burnt Stevens during a game in the Red Sox clubhouse. The four-year old had tried to tweek his nose and poured lemonade down his shirt. You can see Jimmy’s position–Boy, you need a spanking. There were a number of incidences like this and he was sent down to the minor leagues. He got into a lot of trouble down in the minor leagues, and spent some time in the West Borough State Hospital. He was diagnosed with manic depression, but he still returned to baseball by the opening of the ’53 season. And get this, he finished ninth in the voting for the MVP award, and the next year he was the Sox’s regular center fielder.”

Feeling That We Are Crazy Is A Common Experience

In addition to describing these individuals who were thought to be mad by some and yet achieved greatness in various valued arenas, Bob provides diverse examples of regular Joes and Jills who displayed behaviors that were viewed as crazy by either themselves or others. These examples touch a chord in the listener because they illustrate experiences that are pretty close to what we have all experienced at different points in our lives.

Thus, the show’s take away lesson, as I see it, is that if you catch yourself calling yourself names such as “crazy” note that many of the most talented people have had similar experiences. Note, as well, that such criticism is too vague to be helpful. Learn to become more aware of these thoughts, to stand back and simply observe them passing through your mind–“Oh, there I go again calling myself mad.’ In time, you will come to a point at which you will formulate some more specific approach to make improvements in your life. The practice of meditation can help you to learn this skill.

If you are tempted to call someone else these types of names, remember that such names are way too vague, encompassing thousands of unusual and usual experiences. For criticism to be truly helpful, it is usually best to craft a statement that avoids name calling and statements about what someone did wrong, and instead provides specific suggestions for what the target of the criticism can do to improve. If you can not come up with such a statement right away, perhaps it would be best to delay the criticism until you have some time for your creative impulses to come up with something better than “You’re a crazy, mentally ill fool!”

Although these are my take away lessons for today’s post, let’s end with how the more poetic Bob Dylan ends his madness show:

“Time flies when you’re talking crazy, and we gotta get out of here. But before we do I want to leave you with the words of the man who is the voice of the barroom, poet of the gutter, and Shakespeare of the alleyway. Here’s a poem by Charles Bukowski called “Some People.”

some people never go crazy.
me, sometimes I’ll lie down behind the couch
for 3 or 4 days.
they’ll find me there.
it’s Cherub, they’ll say, and
they pour wine down my throat
rub my chest
sprinkle me with oils.
then, I’ll rise with a roar,
rant, rage –
curse them and the universe
as I send them scattering over the
lawn.
I’ll feel much better,
sit down to toast and eggs,
hum a little tune,
suddenly become as lovable as a
pink
overfed whale.
some people never go crazy.
what truly horrible lives
they must lead.”

——————————-

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.

Tags Bob Dylan, conflict management, conflict resolution, criticism, insults, intrapersonal conflicts, madness, mental disorders, name calling, respect

anger conflict management conflict resolution criticism insults interpersonal conflicts negative criticism respect Responding to Criticism Uninvited criticism Unsolicited criticism

A Conversation About Unsolicited Criticism

Post author By Dr. Jeffrey Rubin
Post date March 30, 2015
6 Comments on A Conversation About Unsolicited Criticism

A while back, I published on this blog a post titled, “Unsolicited Criticism: Good or Bad?” Regular readers may recall that it begins as follows:

Illustration by Aviva Maltin

“Judy, it’s so nice to see you,” I say as she comes into my office and sits down on my couch.

“I’ve been reading your blog again, Dr Rubin. It’s filled with a bunch of hogwash.”

“Hmmm, it sounds like there are some ideas in it that you don’t care for.”

“I read last night two of your blog posts–Is Criticism Bad and Criticism and Wisdom. What a bunch of nonsense!”

“I’m very interested in your point of view, Judy. Please tell me more specifically about what you disagree with in those posts.”

John Stewart Mill

“Well, you talk about this John Stuart Mill. According to him, if people criticize us, even for holding an opinion we are very sure of, we should thank them for it, open our minds to listen to them, and rejoice. That’s ridiculous! If you don’t have something nice to say to somebody you should keep your stupid mouth shut! And, as far as I’m concerned, unless I give someone permission to criticize me, that person has no right to inflict it upon me!”

The rest of that post provides my response to Judy. As brilliant as that response is, it is my considered opinion that my readers and I benefit from hearing a variety of views on these types of issues. And so, with that in mind, I went about seeking these views by introducing the post to the Facebook groups that I belong to. Thus, I wrote for each group the following:

Some say that unless you are invited to provide criticism, you should keep your mouth shut. How wise is that?

Then I provided the link to my post. It led to quite a few excellent insightful discussions. My favorite happened to appear on the wonderful group, The Brain Cafe. To our good fortune, several of its participants graciously granted permission to use their comments for the current post. These permissions do not mean they are providing a blanket endorsement of this blog or its writers. And, with that, let’s take a look at the discussion that had taken place.

The Brain Cafe Discussion

Brad Esau, prior to reading my blog post wrote: Uninvited “advice” makes me go thermo nuclear. Uninvited criticism is courting death. Perhaps I should read this.

I, Jeffrey Rubin, replied: Please do read it, Brad Esau, and then let me know what you think.

Barry Kort: I suppose the context matters. As a retired academic, I hang out in Internet venues where my fellow academics schmooze with each other and with interested lay people who are arm-chair aficionados of the subjects on the table. In academia, we have a scholarly culture such that we routinely peer-review each other’s work in a collegial and congenial manner. I view this culture as being characterized by an informal tacit social contract that defines a scholarly culture.

There is, on the other hand, the unscientific (or non-scientific) political culture which has its own inscrutable ground rules which admit of some rather dicey and sleazy practices.

What is the lay person to do in these Social Networks? Clearly we find a mix of behavior that spans the spectrum.

I don’t mind conscientious scholarly criticism of the sort one would expect in academia. I’m not fond of the kind of snarky or mean-spirited dismissals that one finds in our ofttimes toxic political culture….

Brad Esau: This seems to be a cultural thing. I’ve noticed Americans (I’m Canadian) seem to have this notion that they have the “right” to speak out about anything at any time. This is much different than most cultures.

I happen to believe a) I – or anyone – absolutely has the right to deny anyone’s “right” to offer “criticism” or “input” and b) through much, much, much hard won experience, I learned that most people’s “criticism” was largely invalid and of poor construct. In other words, they had no idea what they were talking about.

I am very, very open to critique – if it’s from someone whose expertise or experience I trust and they’ve *earned* my trust. Otherwise, I have no time to waste on most people’s hot air.

So while I think your approach is valid for within American culture, it should be limited to that.

E. C.: Well said Brad! (also a “fellow” Canadian). Love your courage for taking this on Jeffrey. And Brad, you make me THINK

Brad Esau: Thanks, E. C. After growing up in polite Canada and spending a decade and a half around Asians (Japanese, Taiwanese and Chinese) where this kind of “right” to openly criticize is unthinkable, I still find this jarring. Most of my online exchanges are with our friends south of the 49th. Just could never get used to their unrestrained forwardness.

And thank you for the compliment.

Barry Kort: What stood out for me in that vignette was that Judy was enacting a practice that she abhorred when the roles were reversed. About the only scenario where that’s kosher is in scripted psychodrama as a theatrical performance.

Brad Esau: Thinking on this further, I think unsolicited criticism is warranted in cases where intervention is needed. Somebody is clearly going about things in ways that will harm their future or… their chances at their goals, and then I think it’s quite correct to voice some well founded constructive criticism….

The thing with most people, they’re not nearly as “smart” or “wise” or “expert” as they believe themselves to be and most of their “criticism” or “advice” is nothing more than egotistical bluster and hot air.

After some time had passed, Brad added: I now just sort of have this iron clad rule for when anyone – and I mean anyone – offers “advice” or “criticism” I ask for or dig into their credentials and poke into what their motivation might be. 98% of people don’t pass those simple tests.

Of course the trick then is to learn to check one’s own premises and to see if whatever criticism or feedback they might have had to offer was warranted.

There are so many variables at work here!

I could fill a city with people crippled by the criticism they received all their lives from their mothers. Hell, maybe a whole continent. I’d have to say raising motherly criticism is invalid.

Judges are different – you purposely go there to be judged. The topic here is *unsolicited* criticism and how to deal with it.

E. C.: No one wants or needs to hear “bad things” about themselves. That is not constructive criticism. What is helpful is solicited advice on how I can improve on something. That is entirely different, and it requires the “advice giver” to have to actively listen to what it is I am asking and what information I am giving as far as what I need advice or help with.

Lyra Alves: I agree that it is highly determined by our cultural background, but we surely can work our way out of having it as “taboo” and adapt to it. I find criticism, from whatever source it comes, from people who know me or not, who have something interesting to say or not, an incredible gift for my personal growth. I trust much more people who are straight forward than those who are over-polite. I also tend to feel that often those who resist to criticism or those who only accept it if it comes from certain “certified” sources may have self-confidence issues, some hidden insecurities to be sorted out. Every chance we receive some criticism is a chance we have to review various concepts we have about ourselves, about what is the best or not. I think it is always a valuable chance to expand our view on the world and increase our ability to empathize.

Susan Clemens: I have a Facebook rule: Your wall; your opinion.
Other than that, constructive criticism can be offered if you have a relationship with the person, if the person is otherwise at risk of injury, or if you are approaching a business from the customer perspective.
“Pat them-poke them-pat them” works best. I have a few friends who welcome criticism and others who can’t stand it. I try to respect them and vice versa.

Brad Esau <irony>

I’ve recently posted a piece critical of America and Americans along with my own well founded views.

Going by the universal angry responses and denial I’ve gotten so far, it seems like the people who enjoy criticizing the most and defend their “right” to do so, are most uncomfortable with criticism of themselves.

</irony>

Jeffrey Rubin: Brad Esau, I’ve noticed the same thing–that many people who hate to be criticized are among the quickest to criticize, and often are the ones who are the nastiest criticizers as well.

E. C.: I wonder, am I the only one who kind of “bristles” at the word “Criticism?” I am all for constructive feedback but for some reason framing it as “criticism” feels far less helpful and like others have said does become more about the person giving it than about the person needing it. Jeffrey Rubin – do you see a difference? If so, why or why not?

Jeffrey Rubin: Hi E. C. I see the difference that you are trying to make, and it is an important and worthwhile distinction to make. I don’t see that that difference has to be made by using the word “feedback” for one and “criticism” for the other. However, if I am in a conversation just with you, I wouldn’t object to an understanding that we would use the words to mean whatever you would like.

That said, people have a variety of conceptions of these two words (criticism and feedback) and therefore typically it is a good idea to use more than just those words to explain what we mean. Defining our terms beforehand is a good strategy.

For future reference, to me and Daniel Webster, criticism is an evaluation. If you have evaluated something, then you have formulated a criticism of it; and if you tell someone your evaluation, you are providing the person criticism or a critique of something. It can be done in a way so that it is designed to be helpful to someone. Sometimes it is expressed in a manner that is designed to punish someone, or to just hurt someone for a variety of reasons, e.g., because of jealousy or because the person is stressed and irritable.

Concluding Comment

Well, I hope you enjoyed this discussion as much as I did. I hate to end it here, for there is so much more to say, but rest assured that there will be more on this emotionally packed conversation in coming weeks. Until then, here’s hoping that kindness accompanies all of the criticisms that come our way.

——————————-

Tags conflict management, dispute management, disrespectful, insults, uninvited criticism, unsolictied criticism

conflict resolution DSM Emotional pain empathy insults mental disorders Mental Illness Name calling psychiatrists psychiatry psychopathology The Diagnostic and Statistical Manual of Mental Disorders William James

From Psychiatric Name Calling to Plain, Humane English

Post author By Dr. Jeffrey Rubin
Post date March 14, 2015
4 Comments on From Psychiatric Name Calling to Plain, Humane English

Many mental health service providers well know that there are serious problems with the jargon that is used in their profession. In a recent post titled “Psychiatric Name Calling: Is It Time To Put A Stop To It?” I outline some of the most glaring ones. In a subsequent post titled “Psychiatric Name Calling: Is There An Alternative?” I describe a plan for professionals who have an interest in eliminating the problems inherent in the current psychiatric pathologizing approach. This plan would allow professionals to replace the old model with one that would be practical, more consistent with principles of science, and far less stigmatizing.

As I have been seeking ways to promote these ideas, it has become more and more apparent that the gears of the mental health service provider professional organizations grind slowly. Until the necessary changes occur, what can the average English speaking person do when faced with terms like mental illness, major depressive disorder, psychosis, schizophrenia, etc.?

Three Principles That Can Be Used When Psychiatric Pathology Terms Are Employed by Others So That The Negative Effects Associated With Their Usage Can Be Reduced

Even people who are not mental health service providers will regularly use psychiatric jargon. Thus, a French writer once wrote:

My sadness was without limit, and having got possession of me, it filled my life from the most indifferent external acts to the most secret thoughts, and corrupted at their source my feelings, my judgment, and my happiness. It was then that I saw that to expect to put a stop to this disorder by my reason and by my will, which were themselves diseased, would be to act like a blind man who should pretend to correct one of his eyes by the aid of the other equally blind one.

In this quote, the French writer, to describe some concerns he had about his sad mood and how it was affecting his feelings, judgments, and happiness, uses the words “disorder” and “disease.” This is the type of language most mental health service providers throw around. What is the writer attempting to convey by their use?

Sometimes when these words will be employed, their context will make it clear what meaning the author intends. In this example, the author does provide some context. He clearly indicates he was much sadder than he wished to be, and he believed he was unable to do anything about it. He also expressed a concern about his feelings, judgments, and happiness, but he was less clear about what he meant by this.

When someone begins to use pathologizing language and we simply don’t know what is intended, we might end up with misleading, simplistic associations. And so, here are three principles that can be used when psychiatric pathology terms are employed so that we can avoid unnecessary confusion.

Each Time Someone Uses A Psychopathologizing Term, Ask The User Of The Term For A More Specific Description Of What Is Meant By It

In the example that I provided above, there was some lack of clarity about what the French writer meant about his judgments. We know that he felt that it was disordered and diseased. That really tells us nothing more than he was dissatisfied with his judgments. To clarify, we could ask for some specific examples of when his judgment proved to him unsatisfactory.

As another example, suppose you hear Alice saying that John Doe is “mentally ill.” If you want to use this first principle, you would ask Alice what, specifically, does “mentally ill” mean to her and what has John done specifically that led to her calling John this name. These questions typically lead to further constructive discussions and ends up clarifying the nature of many fascinating experiences.

When Psychopathologizing Terms Are Employed, Express A Concern That This Terminology Simplistically Devalues An Experience

Terms like “mental disorders,” “mental illness” and “psychosis,” even when used by professionals, implies that there is something wrong with the person being described. However, as I described in my post “Are Mental Illnesses Really Potentially Helpful Tools?” there are numerous examples of the types of experiences that tend to be labelled mental disorders that end up being enormously helpful. Moreover, in cultures that recognize this possibility the outcomes for those people undergoing these challenging experiences are distinctly better.

And so, as you begin to use the first principle, asking for the user of pathologizing terminology for more specifics, if he or she seems to be suggesting that the experience is bad, you might wish to point out this well documented observation. At such times, I often say, “Many people with artistic temperaments have these types of experiences. Such people have given the world some of its most valued achievements.”

Instead Of Using The Concept of “Disease” And “Illness” To Encourage Humane Responding Toward Individuals Undergoing Challenging Experiences, Emphasize Rights, Kindness, And Practical Reasons

In seeking to encourage people who are using pathologizing terminology to be more specific, it is not uncommon to find that one reason they use these terms is that they hope it will encourage people to be more humane toward those who have certain challenging experiences. They usually mean well by this, but this approach has been used for centuries and history documents that despite such efforts, people who are being given these labels have often ended up in some of the most horrible, degrading treatment facilities.

Instead of using the concept of “disease” to encourage humane responding toward individuals undergoing the experiences that get labelled with pathological terms, an alternative is to emphasize human rights, kindness, and practical reasons.

Note that when people in a town are hit with a hurricane, we don’t have to resort to calling them ill to encourage some help. Instead, we have set up laws that entitle people to certain rights from the government when emergencies occur. Moreover, as word gets out about what is occurring to those who are suffering, out of kindness, people make donations or join their hands to provide direct assistance in a variety of ways. And lest we forget, there are practical reasons to lend a hand. By doing so, we model for people just what kindness is all about.

Any of us can find ourselves in an emergency situation. The more we promote acts of kindness, the more likely we may find that others will treat us with kindness if we are ever to find ourselves in a very unfortunate set of circumstances.

Using the Three Principles

William James, in his grand book, The Varieties of Religious Experience, tells us of some people who have mystical experiences that tend to be called “mental disorders.” James begins to use the three principles when he seeks out descriptions of the various mystical experiences that go well beyond the simplistic psychopathological descriptions. He then states that these mystical states have the right to be absolutely authoritative over the individuals to whom they come.

It is vain for rationalism to grumble about this. If the mystical truth that comes to a man proves to be a force that he can live by, what mandate have we of the majority to order him to live in another way? We can throw him into a prison or a madhouse, but we cannot change his mind-we commonly attach it only the more stubbornly to its beliefs.

It mocks our utmost efforts, as a matter of fact, and in point of logic it absolutely escapes our jurisdiction. Our own more “rational” beliefs are based on evidence exactly similar in nature to that which mystics quote for theirs. Our senses, namely, have assured us of certain states of fact; but mystical experiences are as direct perceptions of fact for those who have them as any sensations ever were for us…. The mystic is, in short, invulnerable, and must be left, whether we relish it or not, in undisturbed enjoyment of his creed.

In this quote, we find no plea from James that we should treat mystics humanely because they have a mental disease. Instead, James puts forth “rights” and “pragmatic” considerations. He argues that just like we in the majority would not like to be ordered to live in a particular way, these mystics have the right to live their way. And pragmatically, if we do use heavy-handed approaches to try to change them, such as throwing them in a madhouse, they will become more stubborn in their beliefs.

James proceeds from here to state that mystics have no right to claim that “we ought to accept the deliverance of their peculiar experiences, if we are ourselves outsiders, and feel no private call thereto.” His theme is tolerance for both the majority toward the minority and vice versa.

Returning to pragmatic arguments, James tells us in his chapter on mysticism that some have found that their mystical experiences have led to wonderful fruits that they highly valued. Some, for example, suffered for a great period of time and after their mystical experience felt wondrously free from their pain and found in its place increased energy and happiness.

James well realizes that the fruits from mystical experiences are not always positive, but he asks us, at the very least, to realize that they have the potential to “be indispensable stages in our approach to the final fullness of the truth.” Thus, we see that “rights” and “pragmatic arguments” can be used instead of a disease concept to promote humane, kind responses toward those who have the types of experiences that tend to be called mental disorders.

——————————-

Tags insults, mental disorders, mental health concerns, mental illness, name calling, William James

Bad Mood conflict resolution fear mental disorders Mental Illness psychiatry psychological maturity psychopathology William James wisdom

William James’s Personal Bout with a “Mental Disorder”

Post author By Dr. Jeffrey Rubin
Post date March 8, 2015
5 Comments on William James’s Personal Bout with a “Mental Disorder”

William James, psychologist and philosopher, passed away over a century ago. Nevertheless, his remarkable body of work remains as fresh as fruit plucked from its tree but moments ago.

His views about his personal bout with a challenging experience developed over many years. Today I think it will be instructive if we spent a little time reviewing what he learned.

A Glimpse at James’s Early Views on Mental Disorders

We begin in April of 1867. James is 25-years old. Suddenly, he interrupts his medical education and flees to Europe.

Later, on describing the feelings that led to his departure, James wrote “it was as if something hitherto solid within my breast gave way entirely, and I became a mass of quivering fear. . . . I awoke morning after morning with a horrible dread in the pit of my stomach.”

William and Henry James's Father, with Young Henry on the right — William and Henry James’s Father, with Young Henry on the right

Several years went by and then, gradually, James’s spirits lifted. His father, noticing the difference in him, asked about it, and then relayed the news by letter to another son, Henry, in March, 1873:

He came in here the other afternoon when I was sitting alone, and after walking the floor in an animated way for a moment, exclaimed “Dear me! What a difference there is between me now and me last spring this time: then so hypochondriacal” (he used that word, though perhaps in substantive form) “and now feeling my mind so cleared up and restored to sanity. It is the difference between life and death.” He had a great effusion. I was afraid of interfering with it, or possibly checking it, but I ventured to ask what especially in his opinion had promoted the change. He said several things: the reading of Renouvier (specially his vindication of the freedom of the will) and Wordsworth, whom he has been feeding on now for a good while; but especially his having given up the notion that all mental disorder is required to have a physical basis. This had become perfectly untrue to him. He saw that the mind did act irrespectively of material coercion, and could be dealt with therefore at first-hand, and this was health to his bones.

We see in the above that at this time James viewed his experience that led to his departure from medical school as a “mental disorder.” Moreover, his conceptualization of it had begun to develop from a physiological pathology model to one that gives at least some freedom to the will. In time, his views begin to develop even further.

Letter to Henry James, 1885

The two brothers. Henry is on the left and Professor William James is on the right

William James and his younger brother, Henry, shared an especially close fraternal bond. Historians have greatly benefited from this because the letters that the two brilliant men shared reveal insights about their deepest concerns.

In 1885, now a medical school graduate and teacher at Harvard, James writes to Henry:

To suggest personal will and effort to one “all sicklied o’er” with the sense of weakness, of helpless failure, and of fear, is to suggest the most horrible of things to him. What he craves is to be consoled in his very impotence, to feel the Powers of the Universe recognize and secure him, all passive and failing as he is.

In James’s letter to his brother, we see he has discovered that in marked contrast to his own favorable reaction to suggestions about the effectiveness of will and effort, some people react with horror. Such people view themselves as helpless, weak, passive, and failing. Rather than looking to a creative force within themselves, they look for the Powers of the Universe to fix them.

The Mature James

Toward the end of James’s career, he adds a new way of viewing the types of concerns that affected him so profoundly when he was young. We begin to see this new way when James discusses individuals who view themselves as “healthy-minded.” These individuals believe that those who worry are “morbid-minded” and “diseased.”

James responds to this name calling by stating that those referred to as morbid-minded have argued that “the world’s meaning most comes home to us when we lay them most to heart.”

After describing the argument between the so-called “healthy-minded” and the “morbid-minded,” James then states:

In our attitude, not yet abandoned, of impartial onlookers, what are we to say of this quarrel? It seems to me that we are bound to say that morbid-mindedness ranges over the wider scale of experience, and that its survey is the one that overlaps. The method of averting one’s attention from evil, and living in the light of good is splendid as long as it will work. It will work with many persons; it will work far more generally than most of us are ready to suppose; and within the sphere of its successful operation there is nothing to be said against it as a religious solution. But it breaks down importantly as soon as melancholy comes; and even though one be quite free from melancholy one’s self, there is no doubt that healthy-mindedness is inadequate as a philosophical doctrine, because the evil facts which it refuses positively to account for are a genuine portion of reality; and may after all be the best key to life’s significance, and possibly the only openers of our eyes to the deepest levels of truth.

To James, people confront events daily that create feelings of helplessness, pain, sadness, horror, and dread. James argued that the feelings that go along with these kinds of events can lead toward truth. Thus, he counteracts any tendency to assume that those referred to as morbid-minded are automatically inferior to those referred to as “mentally healthy.”

The Development of James’s Views About Mental Health Concerns

And so, starting from James’s own bout with a challenging experience, we see that his views develop over the years. Initially, mental health concerns are “mental disorders” which require a physical basis. He then changes his mind, coming to believe these experiences are not completely controlled by one’s physiology, and therefore they could be dealt with through philosophical and poetic means.

It then occurs to him that in contrast to the benefits that his new perspective had for him, others prefer, even crave, to believe they are helpless in the face of these types of experiences. Finally, James comes to believe that some people can derive benefits from the kinds of challenging experiences that, to many, are properly viewed as symptoms of a diseased mind.

Like James, I have undergone a similar developmental trajectory. As I have dealt with my own challenging experiences, I have, over a good many years, learned to greet them as old friends who have valuable messages to share with me. Sometimes they stay a little longer than I would like, and I may find it frustrating that they don’t always come right out and tell me what these messages are. But my patience, through meditation and the maturity that sometimes comes in the course of passing years, has been steadily improving.

Well, I hope this discussion has deepened the reader’s views of the nature of experiences that lead to people expressing concerns to mental health professionals. Until next time, may all of your concerns be addressed with wisdom, love, and kindness.

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Tags challenge, Henry James, mental disorders, mental health, name calling, William James, wisdom

conflict resolution DSM Name calling psychiatrists psychiatry psychopathology The Diagnostic and Statistical Manual of Mental Disorders

Psychiatric Name Calling: Is There An Alternative?

Post author By Dr. Jeffrey Rubin
Post date February 24, 2015
5 Comments on Psychiatric Name Calling: Is There An Alternative?

The publishers of The Diagnostic and Statistical Manual of Mental Disorders (DSM) currently hold a monopoly for classifying the concerns that lead people to seek mental health services. Recently on this blog, in a series of articles, I have been pointing out numerous faults of the DSM. To check out some examples of these, see my posts titled Name Calling by Psychiatrists: Is it Time to Put a Stop to it? and Are “Mental Illnesses” Really Potentially Helpful Tools?

In these critical posts, I have touched upon what I believe would be a distinctly better alternative to the DSM and argued that its creation, in breaking up this monopoly, would stimulate through creative competition, improved mental health services. Today, let’s take a closer look at this.

The Classification and Statistical Manual of Mental Health Concerns (CSM)

I called this proposed alternative manual, the CSM, and you can find a much fuller description of it in a peer reviewed journal HERE. In brief, its first chapter would begin by stating that the developed of the CSM fully recognize that individuality outruns any classification system. It is for this reason that the CSM does not seek to classify anyone. Instead, it classifies the expressed concerns of individuals seeking to have their concerns addressed by a mental health service provider.

The CSM begins from the perspective of the person seeking services. Because the expression of a mental health concern is a clearly observable event, by making it the event being classified in the CSM it solves the reliability problems that have been plaguing the DSM’s far more abstract concept of “mental disorders.”

After this statement, the CSM would clearly define its main construct:

A mental health concern occurs when a person seeking mental health services expresses to a mental health service provider a concern about any of these topics: behavior, emotion, mood, meaning of life, managing chronic pain, work, relationships, education, eating, cognition, sleep and challenging life situations.

Each of these topics would have separate major sections in the second chapter, and under each section would be a list of more specific concerns.

This second chapter would be devoted to listing all of the concerns that professionals tend to hear from those seeking their services. Each concern would be given a code that would be used for various administrative purposes such as insurance forms and computer filing systems. And then there would be, for each concern, a list of related search terms that can be used to assist people who want to utilize a search engine to find all the relevant literature regarding that particular concern.

The list of concerns would be identified by two types of surveys. First, a large sample of mental health service providers would be asked to list the various concerns that they are asked to address in their practice without couching them in pathological language and to stick as closely as possible to the language used by those seeking their services. So, a concern about feeling blue might simply be classified “feeling blue,” rather than the DSM’s “Major Depressive Disorder;” a concern about a child’s above average activity level might simply be classified as “above average activity level” rather than the DSM’s “Attention Deficit Hyperactivity Disorder.” The second type of survey that would be used to generate the list of concerns that would appear in the CSM, would ask the membership of mental health service user organizations to list the various concerns that led them to seek mental health services. They, too, would be asked to avoid pathological terminology. For a number of practical reasons, a maximum of four words would be used for classifying each expressed concern in this chapter.

The final chapter of the CSM would be devoted to describing good practice guidelines for the use of psychological formulation, which is an assessment approach that is consistent with the CSM’s philosophy of not pathologizing individuals. Psychological formulation provides an approach that expands on the brief expressed concerns of individuals by developing a narrative of several paragraphs. It can be defined as the process involving a mental health service user and a mental health service provider co-constructing a hypothesis or ‘best guess’ about the origins of the mental health service user’s concerns in the context of his or her relationships, social circumstances, life events, and the sense that he or she has made of them. Once it has been established what the concerns are, the immediate next question is, ‘How do we jointly understand these experiences, why they arose, and how we might be able to address them?’

Unlike diagnosis, this type of psychological formulation is not about making an expert judgement, but about working closely with the individual to develop a shared understanding which will evolve over time. And, unlike diagnosis, it draws attention to the service user’s resources and strengths in surviving what are nearly always very challenging life situations.

Defending the CSM Approach

Now, some believe that the psychological formulation is all that is needed as an alternative to the DSM and that there is no need to join it with any classification manual such as the CSM. But keep in mind that currently the DSM is used by insurance companies and other third party payers such as Medicaid, Medicare, and Social Security. Insurance companies and these other third party payers have a form that must be filled out whenever someone seeks mental health services under their plan. This form has a little box that currently says, “Diagnosis.” In that box, mental health professionals must fill in the DSM code that corresponds to their so-called diagnosis of the person seeking services.

With the CSM proposal, all that we would be asking insurance companies to do differently in order to add value for their customers, is to slightly change that little box. Instead of just saying “Diagnosis” as it currently says, that box would add two little words, so it would end up saying “Diagnosis or Concern.” Then, when mental health professionals fill in the box, they would be given the choice to either write in the letters “DSM” and its code number that corresponds to its so-called diagnosis, or they would write the letters CSM and its code number that corresponds to the expressed concern. Mental health consumers would be given the choice to go to pathologizing mental health service providers or those using the CSM approach.

That’s all the change that would be required in order to increase value for insurance customers as well as other third party payers. And a major goal that all third party payers have is to increase value for their customers. The cost and effort for these payers would be minimum and we would have numerous testimonials from customers that documents that this change would be viewed as a significant improvement.

A psychological formulation approach, which requires several paragraphs to be completed, would be far too cumbersome for these payers to incorporate into their bureaucratic system. Moreover, a short word or phrase that could replace terms like “Major Depressive Disorder” or “Attention Deficit Hyperactivity Disorder” is necessary for other practical forms of communication. For example, if I want to write a title for a research article, it would not be practical to insert into it several paragraphs. The psychological formulation approach would become far more widely used if it has some practical way of providing some short terms that are consistent with its non-pathologizing approach to conceptualizing an individual’s mental health concerns.

Some may 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. Since insurance companies only cover people with more serious conditions known as “mental disorders,” so the argument goes, this limits the amount of people who can get to see a mental health professional.

Insurance and other third party payer executives are not stupid. They would readily understand, with a little explaining, that mental health service providers now using the current DSM do not turn anyone with a mental health insurance policy away who comes to their office expressing what I refer to as a mental health concern. Professionals are in the business of increasing their clients. Let’s be honest here; there are “close enough” matches throughout the DSM for anyone with mental health insurance coverage who currently wants mental health services to get it.

Here’s another reason why the CSM would improve the psychological formulation approach. In pretty much any of the advanced countries in the world, there is a rather large segment of the population that believes science has been an enormous help advancing our knowledge. The CSM, as already mentioned, is even more consistent with principles of science than the DSM because it solves the problem of reliability that has been a mess with the DSM. And for science minded people, each branch of science must have a system of classification that helps to organize concepts, to retrieve relevant research, and to be useful in formulating programs of research. In my view, the pairing of psychological formulation with the CSM’s list of brief descriptors of mental health concerns will fit well with this worldview.

And so, these are some of my arguments for uniting in the CSM proposal a classification system and the psychological formulation proposal. Together, both can clearly improve value for consumers of mental health services by providing a new choice, but only if consumers of mental health services role up their sleeves, organize, and effectively advocate for this type of change.

In summary then, the CSM is more consistent with principles of science. It is close enough to the worldview and administrative requirements of all of the stakeholders in the mental health field, thus reducing resistance that often comes with proposed changes. And the creation of the CSM would break up the DSM monopoly, thereby spurring creative approaches for understanding the nature of anguish, sadness and tears.

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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 and social intelligence. To begin at the very first post you can click HERE.

Tags CSM, DSM, mental disorders, mental health, mental health concerns, mental health service, mental health services, mental illness, name calling, negative criticism, psychiatry, The Classification and Statistical Manual of Mental Health Concerns

conflict resolution DSM Mental Illness psychiatry psychopathology The Diagnostic and Statistical Manual of Mental Disorders William James

Are “Mental Illnesses” Really Potentially Helpful Tools?

Post author By Dr. Jeffrey Rubin
Post date February 17, 2015
6 Comments on Are “Mental Illnesses” Really Potentially Helpful Tools?

If your behavior, thoughts, or feelings become a concern, for a fee, many psychiatrists, psychologists, and social workers are eager to translate your experiences into a language of symptoms, diagnoses, psychopathology, and mental illness. In an earlier post I provided negative criticism about this type of name-calling (see here). Today, we focus in on an additional problem with the pathologizing approach.

Psychiatric Name-Calling Simplistically Devalues What William James Referred to as “Exceptional Experiences”

Tools can be used for good or evil. A hammer can be used to drive in nails in the construction of a life-preserving shelter or to bludgeon an innocent person to death. A car can be used to rush a child to an emergency room so that life-preserving treatment can be administered, or it can be used to tragically end a prom night. Are experiences that are oftentimes referred to as pathological really tools, and is it up to each one of us to use them either for good or evil?

The first time I came across this question occurred while reading about William James’s 1896 series of lectures on “Exceptional Mental States.” Harvard psychologist, Eugene Taylor, had reconstructed these lectures from James’s original handwritten lecture notes, newspaper reports, letters, and a variety of other sources.

At the very beginning of the lectures, James argues that experiences that are commonly viewed as unhealthy or morbid are really “an essential part of every character,” and give life “a truer sense of values.” To support his contention, James first provides three examples of famous individuals who suffered from melancholy, a term that corresponds closely with what modern pathologizers call “major depressive disorder.” St. Paul, the religious figure of the New Testament, Cesare Lombrosa, a late 19th-century Italian criminologist, and Immanual Kant, the 18th-century German philosopher, became, according to their histories, better as a result of their troubling experiences.

Not only is melancholy far more normal and potentially beneficial than the pathologizers would like us to believe, so too, James argues, are delusions and hallucinations. James tells us that the belief in the possession by demons, which is often viewed as a delusion by pathologizers, is remarkably common. “[It] is the one most articulately expressed doctrine of both Testaments, and . . . reined for seventeen hundred years, hardly challenged in churches.”

James then goes on to tell his audience about Buddhist sects in Japan that have priests who believe they can put themselves into a trance so that a god can speak through them. These people seek to cultivate these experiences, apparently believing that they provide some benefits to their sect.

Although hallucinations can be construed as a symptom of mental illness to some, James presents the case of Socrates who “once stood motionless for many hours in the cold and spoke of having a guiding demon.” Attempting to counter the association between pathologies and hallucinations, James states,

Even if this demon [of Socrates] were really meant hallucinations of hearing, we know now that one in eight or ten of the population has had such an experience and that for insanity we must resort to other tests than these.

Like melancholy, delusions, and hallucinations, the “symptoms” of obsessions and manias are treated in James’s lectures as experiences that are normal and potentially beneficial. Thus, James states that there is no end to the possible types of obsessions that we see all around us. And what about “the anti-slavery mania?” Is this to be viewed as pathological? What benefit can such experiences have? James tells his audience about Henry Borg, founder of the American Society for the Prevention of Cruelty to Animals; Charles Henry Parkhurst, a Presbyterian clergyman and reformer who launched a furious attack on organized crime in state government that led to an official investigation; Dorothea Dix, a mid-19th-century humanitarian who visited the insane asylums and successfully advocated for legislation to improve the care for those now labeled mentally ill; General Booth, founder of the Salvation Army; Frances Willard, a suffragette; and others. “These persons,” said James, “are not insane, not maniacs, not melancholics, not deluded.”

Later, he states, “Individuals are types of themselves and enslavement to conventional names and their associations is only too apt to blind the student to the facts before him.”

As Taylor (1984) closes his reconstruction of the lecture series, he quotes James as follows:

There is a strong tendency among these pathological writers I have cited… to represent the line of mental health as a very narrow crack, which one must tread with bated breath, between foul friends on the one side and gulfs of despair on the other. Now health is a term of subjective appreciation, not of objective description….There is no purely objective standard of sound health. Any peculiarity that is of use to a man is a point of soundness in him, and what makes a man sound for one function may make him unsound for another…. The trouble is that such writers . . . use the descriptive names of symptoms merely as an artifice for giving objective authority to their personal dislikes. The medical terms become mere appreciative clubs to knock a man down with. . . . The only sort of being, in fact, who can remain as the typical normal man, after all the individuals with degenerative symptoms have been rejected, must be a perfect nullity . . . Who shall absolutely say that the morbid has no revelations about the meaning of life? That the healthy minded view so-called is all?

The Review of the Evidence

It may seem a fanciful theory that the experiences now referred to as mental illnesses can be potentially helpful. However, in 2010, Robert Whitaker published a book titled Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness. To write the book, he pored through the scientific literature for the past 50 years and found a dramatic increase in the number of people who are pathologized, which led to an astonishing increase in psychiatric drug consumption. And more people then ever before became disabled for longer and longer periods of time.

Here is just one of many such studies that Whitaker describes.

In the 1980s, Martin Harrow, a psychologist at the University of Illinois, began a long-term study of 64 newly diagnosed schizophrenia patients. Every few years, he assessed how they were doing. Were they symptomatic? In recovery? Employed? Were they taking antipsychotic medications? The collective fate of the off-med and medicated patients began to diverge after two years, and by the end of 4.5 years, it was the off-medication group that was doing much better. Nearly 40% of the off-med group were “in recovery” and more than 60% were working, whereas only 6% of the medicated patients were “in recovery” and few were working. This divergence in outcomes remained throughout the next ten years, such that at the 15-year follow-up, 40% of those off drugs were in recovery, versus 5% of the medicated group.

Whitaker also found studies that compared cultures, like our own, that employed the pathologizing model with cultures that framed exceptional experiences as potentially beneficial. Countries infected with the pathologizing approach had outcomes significantly poorer.

These findings lead me to conclude that it is time to have a reasonable discussion about embracing other models of care.

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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 and social intelligence. To begin at the very first post you can click HERE.

Tags Anatomy of an Epidemic: Magic Bullets, and the Astonishing Rise of Mental Illness, hallucinations, insults, Leo Tolstoy, melancholy, mental disorders, mental illness, name calling, pathologizing, psychiatric disorders, psychiatric drug treatment, Psychiatric Drugs, psychiatric medication treatment, Robert Whitaker, William James

conflict resolution insults teasing

The Art and Abuse of Insults

Post author By Dr. Jeffrey Rubin
Post date February 9, 2015
No Comments on The Art and Abuse of Insults

Many of my posts leave some feeling like I insulted them. In one post, for example, I took the position that when it comes to responding to criticism there are four levels of maturity (see HERE). Some people who respond to criticism in a way that matches the description of the immature levels let me know that they felt I had insulted them. In another post (see HERE), I took the position that psychiatrists do not really diagnose people with mental disorders; instead, they merely convert the expressed concerns of people into psychiatric jargon. Here again, I heard from people who complained that I had insulted them.

And so, when I published last week’s post titled “Insults By Jews As Works Of Art,” the negative reaction of some people had not surprised me. What was a surprise is that the discussion that came out of these reactions proved to clarify and deepen my own understanding of the nature of insults. In the hope that this may do the same for my readers, let’s take a look at what transpired. Names and a few minor details have been changed to protect privacy issues.

The Exchange

Matt said that my “Insults By Jews As Works Of Art” post is inappropriate, and he suggested to the person who moderates one of the groups that we belong to that I be removed immediately.

I replied:

“In my opinion, the topic of insults is very appropriate. Everywhere we look, whether at schools, the workplace, family gatherings or watching TV, insults occur, and sometimes this is just playful stuff, but too often it escalates a conflict, a fight breaks out, and occasionally someone needs medical attention. On other occasions, the insults cross the line into bullying, people become depressed and some become suicidal.

“With regards to Matt suggesting that I be removed from this group because of my recent post on insults, hmmm, maybe a curse would here be an appropriate response, something like:

“Matt, may you wake up tomorrow and find you’re stuck in a country where freedom to express opposing views is banned.

“I hope this is recognized as an attempt at a humorous quip. I have no ill will toward Matt, although I do disagree with him on this issue.

“Rather than suggesting that I be removed from the group, I think it would have been much more helpful if he, and others who disagreed with what I had written, rewrote the sentence that is viewed as most objectionable so that it would be at least a little less objectionable. Alternatively, or additionally, writing a brand new sentence that could be inserted into some specific place in the post would be far more helpful than a one-sentence criticism stating the post was not appropriate. It is not too late to do this, and I encourage group members to do so.”

One group member seeking to defend me, wrote:

“Your post was interesting as a sociological examination of a prominent ethnic group, its stereotypes, and its communal self-concept.”

Another wrote,

“This made my day Jeffrey, and made me laugh – thank you! Made me have a think about my roots as well!”

A couple of people disagreed with the idea that I should be removed from the group:

“What I like about it [your post] is that it is not vulgar. Just benign insults that are insults. It is like the Egyptian insult, “May you live in interesting times.” When these are translated to English, they kinda lose their meaning. Most of the Jewish insults feel like they were translated from Yiddish; they have that flow.

“It can show students and adults that insults can be sophisticated and not vulgar, and with any luck, aren’t even recognized as insults until later.”

A person that we will here call Nick wrote in part,

“I do believe you had good intentions behind your piece and would have not published it if you knew so many people would have taken it negatively. In other words, while I do not agree with you all the time I am not for banning you from this group. However, I do say all of this praying that you do understand why what you did is offensive and you are apologetic rather than trying to defend.”

I replied to Nick in part as follows:

“Just to clarify, I believe my intentions were good, and I certainly did not intend to offend anyone. However, I well knew that it would indeed offend some. Since it is Black History Month, I’ll point out that Martin Luther King, whenever he wrote his speeches, had good intentions, did not seek to offend, but well knew his speeches were going to offend. Mark Twain had his books banned, George Barnard Shaw was hated in many circles, and Salman Rushdie had people calling for his murder.

“There are two Yiddish sayings that might capture a little of what I’m trying to communicate. The first is, ‘If you want people to respect you for your wisdom, just agree with everything they tell you.’ The second states that ‘A Rabbi that has not been thrown out of a congregation because of offending them is no Rabbi.’

“If you write opinion pieces, some will agree with you, some will disagree but appreciate hearing a different view of an issue, and some become offended. That goes with the territory. Living up to a principle that one should never express an opinion that has any chance to offend means never expressing an opinion.

“Moreover, when in my last post I referred to some insults as works of art, what I meant to convey is this, true works of art are not just meant to be merely decorative. Rather, they are meant to stir up, prod, challenge the thinking, and deepen the thinking of society. I think great comedy is part of art, and I think Jews, Italians, Blacks, Methodists, and all other groups of people have some comedians who artfully express this form of art. I happen to be Jewish, therefore, I know far more about Jewish humor than that of other groups, so I used that as an example.”

Another person wrote:

“Keep in mind that ALL humor is aggressive and hurtful in some way. There is not one “belly-laugh” joke that does not attempt to hurt or belittle someone or something. No, puns don’t count – you don’t laugh, you groan. I do not intend to live in a world without laughter, and we laugh when someone or something hurts!!!”

To this, another group member wrote that he felt this statement overgeneralized. Among my friends, when we insult one another in a playful way, I think most of the time no one is getting hurt, and much laughter comes from this. But there is an edge to many comedians who are seeking something beyond pure laughter.

Jon wrote,

“The Jewish cultural DNA is at least one part philosopher, one part cynic and one part humorist, among much else, of course.”

Jon did find my title offensive, and proposed, as an alternative, “The Art and Abuse of Insults and Teasing – A Cultural and Historical Perspective.” He pointed out that “This would highlight the universality, celebrate the creativity in humor, and hit us square between the eyes with the destructive power as we slide along that slippery slope.”

Nice. Although I decided not to change the title, I do agree his was conceptually distinctly better than mine. I had already published the post under the original title and to change it a week later could be confusing. And I wondered if Jon’s title may come across as a bit too academic for the larger audience that the post seeks to interest and to do justice to the title would require a much longer piece that my post tended to be. I did take part of Jon’s suggested title for this post. Moreover, in order to demonstrate a little more of the universality of humor in the form of insults I now offer some non-Jewish examples.

Last week I mentioned that Rodney Dangerfield, a Jew, was a master at insulting himself. Here’s Abraham Lincoln, a non-Jew, offering humor in a similar manner.

Last week’s post pointed out that Don Rickles, a Jew, was a master at insulting people who were insulting him. Here’s Winston Churchill, a non-Jew, at the same game:

I, for one, don’t like this Churchill comeback. It strikes me as mean. Yet I know someone who brought it to my attention and he thought it was very funny. It is strange how two people can have such different reactions to such comments.

Here are a couple other insults demonstrating that the art is indeed universal:

Sally wrote:

“It [my post] conflates deliberate personal insults, deliberate wishes of harm to another, consensual teasing, and comedic performance, and ties it up with an anti-Semitic bow.”

I replied:

“Sally, I love your turn of phrase. At the same time, I disagree with you that I conflated deliberate wishes of harm to another from consensual teasing. I made in my last post a distinct point of separating that issue as we move toward the end of the post. Nevertheless, I will think about using in any future writings on this issue the part of your sentence that points to the need to avoiding conflating deliberate personal insults, deliberate wishes of harm to another, consensual teasing, and comedic performance. This is very well said, makes the point I had wished to make clearer, and I thank you for this feedback.

“I didn’t mean to write in a way that suggested anything that could be interpreted as anti-Semitic.”

Well, those are some thoughts from the feedback. I hope that we can keep the dialogue going, particularly because there is urgency in our communities to address in helpful ways the very issues that we have been discussing.

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Tags bullied, bullies, bullying, conflict management, George Barnard Shaw, insults, Mark Twain, Martin Luther King, playful teasing, Salman Rushdie, Winston Churchill, Works Of Art