Saturday, January 10, 2009

NUTS AND NOTHING BUT NUTS

The inimitable Mark Steyn gets to the heart of the problem:
In The Los Angeles Times, Joel Stein pooh-poohs mass peanut hysteria:

We did agree that it is strange how peanut allergies are only an issue in rich, lefty communities.

"We don't see this problem much in African American or poor communities. So there's something going on here. We don't see them in Ecuador and Guatemala," Christakis said.

A study of Jews of similar demographics and genetics in Britain and Israel found that British kids were 10 times more likely to have peanut allergies than Israelis. That's probably because Israeli kids have other things to be afraid of.

Indeed. They've got real nuts that really are trying to kill them. Speaking of which, this snippet from Gaza in The New York Times gets to the heart of the matter:

“Why are you so happy?” this reporter asked. “Look around you.”

A girl who looked about 18 screamed as a surgeon removed shrapnel from her leg. An elderly man was soaked in blood. A baby a few weeks old and slightly wounded looked around helplessly. A man lay with parts of his brain coming out. His family wailed at his side.

“Don’t you see that these people are hurting?” the militant was asked.

“But I am from the people, too,” he said, his smile incandescent. “They lost their loved ones as martyrs. They should be happy. I want to be a martyr, too.”

Hamas is a mental illness masquerading as a nationalist movement. When I was at Gitmo a couple of years back, one of the most philosophically interesting moments came during a conversation with the camp's mental health doctors on how you tell when a suicide bomber is feeling depressed. (emphasis mine)


Exactly.

I have been treating schizophrenic patients for almost 30 years now. Back when we used the older, first-generation antipsychotics the patients would get better, but they continued to have what we call the "negative" symptoms of schizophrenia:

-Loss of interest in everyday activities
-Appearing to lack emotion
-Reduced ability to plan or carry out activities
-Neglecting hygiene
-Social withdrawal
-Loss of motivation

These symptoms come about most likely because of a growing cognitive impairment and they are very much like the symptoms that someone who is depressed might have; except in the schizophrenic, they often are not aware of feelings of depression and do not complain of it. The point is that their illness impairs their cognitive functioning.

Steyn is correct when he says that "Hamas is a mental illness masquerading as a nationalist movement" in more ways than he knows. The degree of cognitive and emotional impairment--including lack of empathy, inappropriate affect, distorted perceptions and sociopathic behavior-- in these fanatics is quite disturbing to most normal people (except, of course, those who insist that it is just a "cultural" difference and part of the wide panoply of multicultural diversity on our wonderful planet--but then, those people are far from normal too).

Like schizophrenics who are too cognitively impaired to understand, the fanatics of Islam insist that nothing is wrong with them and they project their own illness onto the rest of the world. They are paranoid, delusional and completely cut off from appropriate and normal humanity.

Schizophrenics have a biological cause for their dysfunction. Hamas, Al-Qaeda et al have a social etiology for theirs. In order to treat this kind of mental illness (and make no mistake, it truly is a mental illness) you have to change the culture or society that breeds it.

Unfortunately, the idiots of the left counter any such efforts to change this sick, dysfunctional culture by positively reinforcing that culture whenever they get a chance. From allowing the sociopathic leaders of the culture to speak in civilized forums (see here and here) to contemplating direct negotiations with them** are tactics designed to foster the illusion that "they are just like us" and are somehow amenable to civilized discourse despite their severe cognitive impairment and tentative relationship to reality.

How many of you have tried to reason with paranoid and delusional patient? If you are the object of their delusion and considered to be the cause of all their problems in the first place, it is an especially useless endeavor. I have heard literally thousands of times from schizophrenics in the middle of acute psychotic episodes that it is their psychiatrist or the medications that are the problem--not them, as they desperately cling to their paranoia. That is why sometimes, when they are a danger to others or to themselves, society looks to psychiatrists to do something (usually involuntarily hospitalize them).

With those suffering from the psychosis of a deranged culture, there is no ability to hospitalize them, either involuntarily or voluntarily. In their case, behavioral and social methods must be used; and even those methods have serious limitations and can take a long time to have an effect. But, isolating regimes or cultures that are out of touch with reality and doing whatever is necessary to limit the impact of their violence (especially its export) and delusional thinking is absolutely necessary.

Defending one's self from them (as Israel is doing right now in Gaza) is not simply necessary, it is an existential imperative. You don't invite them into the civilized world until their behavior is civilized. You don't stand around passively while a psychotic person is attacking you in the ridiculous hope that he won't hurt you anyplace that might be lethal to you. You act to restrain him and use whatever force is necessary.

When that person has a biological mental illness like schizophrenia, it is a very tragic situation, particularly if they get hurt in the process. Your hope in this case is that if you get them into some sort of treatment that can minimize the cognitive impairment and put them back in touch with reality, then they can become partners in their own care. Let me be clear. I do not hospitalize patients involuntarily until and unless their behavior become a danger. If they are quietly psychotic and go about their own business without causing any serious problems to society as a whole, then they are safe from me.

When an individual or a group has a self-induced mental impairment--like Hamas and the Palestinians, for example--it is also quite tragic; but in their case you do what is necessary in the hope that negatively reinforcing their behavior, sometimes in the extreme, will cause them to change their behavior. At a minimum try to make sure that they do not get anything positive from the international community when they act out and cause violence and destruction. You can see how that behavioral strategy continues to be absent as the international community once again rushes in to defend Hamas and protect it from the consequences of its own actions. Yet, this would be the only treatment option--and a rather compassionate one at that--which might eventually force them to alter their sick culture.

And, one other thing. Schizophrenics are not more violent or dangerous than the general population. Often they are more of a danger to themselves because of their distortion of reality. This is not the case for the Islamic fanatics. Violence and hate are part and parcel of their illness. The former behavior helps them to delude themselves into believing they are strong and potent; and the latter simply justifies (for them) their barbaric behavior.


[**Note that in the link the date is Jan. 9, 2009 and the Obama team is contemplating direct talks with Hamas. How many of you remember when Obama sacked his foreign policy advisor and threw him under the bus when he proposed doing exactly the same thing back in May, 08 during the heat of the campaign? Don't you just love postmodern politics?]

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