Wednesday, February 27, 2008
The New York Times
February 25, 2008
Fewer Youths Jump Behind the Wheel at 16
By MARY M. CHAPMAN and MICHELINE MAYNARD
DETROIT — For generations, driver’s licenses have been tickets to freedom for America’s 16-year-olds, prompting many to line up at motor vehicle offices the day they were eligible to apply.
No longer. In the last decade, the proportion of 16-year-olds nationwide who hold driver’s licenses has dropped from nearly half to less than one-third, according to statistics from the Federal Highway Administration.
Reasons vary, including tighter state laws governing when teenagers can drive, higher insurance costs and a shift from school-run driver education to expensive private driving academies.
To that mix, experts also add parents who are willing to chauffeur their children to activities, and pastimes like surfing the Web that keep them indoors and glued to computers.
Jaclyn Frederick, 17, of suburban Detroit, is a year past the age when she could get a Michigan license. She said she planned to apply for one eventually, but sees no rush.
“Oh, I guess I just haven’t done it yet, you know?” said Jaclyn, a senior at Ferndale High School, in Ferndale, Mich.
“I get rides and stuff, so I’m not worried about it. I’ll get around to it, maybe this summer sometime.”
Until she does, she has company. The national rate of licensed 16-year-olds dropped to 29.8 percent in 2006 from 43.8 percent in 1998, according to the Federal Highway Administration.
The falling rate of teenage drivers is perplexing to Michael T. Marsden, an expert on car culture and dean of St. Norbert College in De Pere, Wis.
“It’s a big change in a major American ritual of driving as early as possible,” Mr. Marsden said.
The way students learn has undergone a major change, too. Twenty-five years ago most teenagers took driver’s education in their local schools. But the number of school systems offering the program has plummeted to about 20 percent today, from 90 percent in the 1980s, said Allen R. Robinson, chief executive of the American Driver and Traffic Safety Education Association, which represents high school and commercial driver education instructors.
“High schools are out of the business because of the cost,” said Henning Mortensen, owner of Bond Driving School in Sacramento.
Commercial driving academies have stepped in to fill the gap. For example, in Louisiana, the number of private schools has grown to about 60 this year, from just two in 1993, said Sheila Vernado, a spokeswoman for the Driving School Association of the Americas, which represents owners of commercial driving agencies.
In contrast to high schools, which offered driver’s education as a regular class or for a modest fee during the summer, driving schools charge higher rates. Mr. Mortensen, who has been in business since 1990, said his average program runs about $400.
Insurance costs are also rising. Where parents used to be able to add their young drivers to their policies for a nominal charge, it now costs 80 percent to 100 percent more to add a 16-year-old to a family’s auto policy, said Raleigh Floyd, a spokesman for the Allstate Corporation in Northbrook, Ill. The highest rate is charged if the teenager owns a vehicle, he said.
Over all, teenage drivers have the highest crash risk of any group. Car accidents account for one-third of all deaths of 16- to 18-year-olds, according to the National Highway Traffic Safety Administration.
Graduated driver-licensing laws, which delay awarding a full license until a teenager spends time with a parent or driving under certain conditions, are also keeping down the number of 16-year-olds on the road, said Frederik R. Mottola, executive director of the National Institute for Driver Behavior, which promotes driver education.
“Now people are learning that the more repetition you can give the teens, the better,” Mr. Mottola said.
These laws, in existence for about a decade, have helped reduce the number of fatal crashes involving 16-year-old drivers by about 11 percent, according to a 2006 study by the Johns Hopkins Bloomberg School of Public Health. That average increases to 20 percent for states with the strictest laws.
Forty-nine states allow young drivers to obtain restricted licenses before, on or within a few months of their 16th birthday. (The age for a restricted license is as low as 14 in some states.) New Jersey requires a driver to be 17 years old.
Sweeping changes to teenage driving laws in Illinois ranked the state among the nation’s most restrictive, said Melissa Savage, policy analyst for the National Conference of State Legislatures.
The Illinois laws, in effect since January, set a weekend driving curfew of 11 p.m. (10 p.m. on weeknights) for drivers up to 17 years old. They also tripled the length of a learner’s permit from 3 to 9 months and increased the number of training hours behind the wheel to 6 hours from 1 hour of actual driving time. (Previously, computer simulation could substitute for the other five hours.)
In Delaware, teenagers not fully licensed may not drive between 10 p.m. and 6 a.m.
Indeed, the fatal crash rate for 16-year-olds driving at night is twice as high as it is during the day, according to the National Transportation Safety Board.
At the other end of the spectrum are states like North Dakota, which allows a learner’s permit at 14 and has no minimum supervised-driving requirements, according to the Insurance Institute for Highway Safety, which evaluates graduated licensing laws.
Beyond the tighter regulations, some parents are just not encouraging lessons, said Naomi Drew, author of “Peaceful Parents, Peaceful Kids,” which studied family lifestyles.
“The roads are angrier these days,” she said. “Parents are worried for their children’s safety.”
One such parent is Teresa Sheffer, of Bethlehem, Ga. Her daughter, Kelsey, has had a permit for nearly two years, but is not yet fully licensed because of her mother’s safety concerns.
Ms. Sheffer, a pediatric nurse, even paid a police officer to drive with Kelsey to previous accident sites and graphically explain what had happened.
“This is in hope of instilling an element of fear,” Ms. Sheffer said. “Cars are lethal weapons, and I want to make sure she has the experience she needs, and knows what can happen when you don’t pay attention.”
Kelsey, who will turn 17 in June, said she had lost the motivation to pursue her full license. For now, her mother is happy to shuttle her to swimming and cheerleader practice.
“I’m disappointed, but if I had my license mom probably wouldn’t let me drive anyway,” Kelsey said. “But even if I did, I’d have to drive our minivan.” That prospect, she said, “is just totally not cool.”
February 25, 2008
Fewer Youths Jump Behind the Wheel at 16
By MARY M. CHAPMAN and MICHELINE MAYNARD
DETROIT — For generations, driver’s licenses have been tickets to freedom for America’s 16-year-olds, prompting many to line up at motor vehicle offices the day they were eligible to apply.
No longer. In the last decade, the proportion of 16-year-olds nationwide who hold driver’s licenses has dropped from nearly half to less than one-third, according to statistics from the Federal Highway Administration.
Reasons vary, including tighter state laws governing when teenagers can drive, higher insurance costs and a shift from school-run driver education to expensive private driving academies.
To that mix, experts also add parents who are willing to chauffeur their children to activities, and pastimes like surfing the Web that keep them indoors and glued to computers.
Jaclyn Frederick, 17, of suburban Detroit, is a year past the age when she could get a Michigan license. She said she planned to apply for one eventually, but sees no rush.
“Oh, I guess I just haven’t done it yet, you know?” said Jaclyn, a senior at Ferndale High School, in Ferndale, Mich.
“I get rides and stuff, so I’m not worried about it. I’ll get around to it, maybe this summer sometime.”
Until she does, she has company. The national rate of licensed 16-year-olds dropped to 29.8 percent in 2006 from 43.8 percent in 1998, according to the Federal Highway Administration.
The falling rate of teenage drivers is perplexing to Michael T. Marsden, an expert on car culture and dean of St. Norbert College in De Pere, Wis.
“It’s a big change in a major American ritual of driving as early as possible,” Mr. Marsden said.
The way students learn has undergone a major change, too. Twenty-five years ago most teenagers took driver’s education in their local schools. But the number of school systems offering the program has plummeted to about 20 percent today, from 90 percent in the 1980s, said Allen R. Robinson, chief executive of the American Driver and Traffic Safety Education Association, which represents high school and commercial driver education instructors.
“High schools are out of the business because of the cost,” said Henning Mortensen, owner of Bond Driving School in Sacramento.
Commercial driving academies have stepped in to fill the gap. For example, in Louisiana, the number of private schools has grown to about 60 this year, from just two in 1993, said Sheila Vernado, a spokeswoman for the Driving School Association of the Americas, which represents owners of commercial driving agencies.
In contrast to high schools, which offered driver’s education as a regular class or for a modest fee during the summer, driving schools charge higher rates. Mr. Mortensen, who has been in business since 1990, said his average program runs about $400.
Insurance costs are also rising. Where parents used to be able to add their young drivers to their policies for a nominal charge, it now costs 80 percent to 100 percent more to add a 16-year-old to a family’s auto policy, said Raleigh Floyd, a spokesman for the Allstate Corporation in Northbrook, Ill. The highest rate is charged if the teenager owns a vehicle, he said.
Over all, teenage drivers have the highest crash risk of any group. Car accidents account for one-third of all deaths of 16- to 18-year-olds, according to the National Highway Traffic Safety Administration.
Graduated driver-licensing laws, which delay awarding a full license until a teenager spends time with a parent or driving under certain conditions, are also keeping down the number of 16-year-olds on the road, said Frederik R. Mottola, executive director of the National Institute for Driver Behavior, which promotes driver education.
“Now people are learning that the more repetition you can give the teens, the better,” Mr. Mottola said.
These laws, in existence for about a decade, have helped reduce the number of fatal crashes involving 16-year-old drivers by about 11 percent, according to a 2006 study by the Johns Hopkins Bloomberg School of Public Health. That average increases to 20 percent for states with the strictest laws.
Forty-nine states allow young drivers to obtain restricted licenses before, on or within a few months of their 16th birthday. (The age for a restricted license is as low as 14 in some states.) New Jersey requires a driver to be 17 years old.
Sweeping changes to teenage driving laws in Illinois ranked the state among the nation’s most restrictive, said Melissa Savage, policy analyst for the National Conference of State Legislatures.
The Illinois laws, in effect since January, set a weekend driving curfew of 11 p.m. (10 p.m. on weeknights) for drivers up to 17 years old. They also tripled the length of a learner’s permit from 3 to 9 months and increased the number of training hours behind the wheel to 6 hours from 1 hour of actual driving time. (Previously, computer simulation could substitute for the other five hours.)
In Delaware, teenagers not fully licensed may not drive between 10 p.m. and 6 a.m.
Indeed, the fatal crash rate for 16-year-olds driving at night is twice as high as it is during the day, according to the National Transportation Safety Board.
At the other end of the spectrum are states like North Dakota, which allows a learner’s permit at 14 and has no minimum supervised-driving requirements, according to the Insurance Institute for Highway Safety, which evaluates graduated licensing laws.
Beyond the tighter regulations, some parents are just not encouraging lessons, said Naomi Drew, author of “Peaceful Parents, Peaceful Kids,” which studied family lifestyles.
“The roads are angrier these days,” she said. “Parents are worried for their children’s safety.”
One such parent is Teresa Sheffer, of Bethlehem, Ga. Her daughter, Kelsey, has had a permit for nearly two years, but is not yet fully licensed because of her mother’s safety concerns.
Ms. Sheffer, a pediatric nurse, even paid a police officer to drive with Kelsey to previous accident sites and graphically explain what had happened.
“This is in hope of instilling an element of fear,” Ms. Sheffer said. “Cars are lethal weapons, and I want to make sure she has the experience she needs, and knows what can happen when you don’t pay attention.”
Kelsey, who will turn 17 in June, said she had lost the motivation to pursue her full license. For now, her mother is happy to shuttle her to swimming and cheerleader practice.
“I’m disappointed, but if I had my license mom probably wouldn’t let me drive anyway,” Kelsey said. “But even if I did, I’d have to drive our minivan.” That prospect, she said, “is just totally not cool.”
The New York Times
February 26, 2008
Findings
The Advantages of Closing a Few Doors
By JOHN TIERNEY
The next time you’re juggling options — which friend to see, which house to buy, which career to pursue — try asking yourself this question: What would Xiang Yu do?
Xiang Yu was a Chinese general in the third century B.C. who took his troops across the Yangtze River into enemy territory and performed an experiment in decision making. He crushed his troops’ cooking pots and burned their ships.
He explained this was to focus them on moving forward — a motivational speech that was not appreciated by many of the soldiers watching their retreat option go up in flames. But General Xiang Yu would be vindicated, both on the battlefield and in the annals of social science research.
He is one of the role models in Dan Ariely’s new book, “Predictably Irrational,” an entertaining look at human foibles like the penchant for keeping too many options open. General Xiang Yu was a rare exception to the norm, a warrior who conquered by being unpredictably rational.
Most people can’t make such a painful choice, not even the students at a bastion of rationality like the Massachusetts Institute of Technology, where Dr. Ariely is a professor of behavioral economics. In a series of experiments, hundreds of students could not bear to let their options vanish, even though it was obviously a dumb strategy (and they weren’t even asked to burn anything).
The experiments involved a game that eliminated the excuses we usually have for refusing to let go. In the real world, we can always tell ourselves that it’s good to keep options open.
You don’t even know how a camera’s burst-mode flash works, but you persuade yourself to pay for the extra feature just in case. You no longer have anything in common with someone who keeps calling you, but you hate to just zap the relationship.
Your child is exhausted from after-school soccer, ballet and Chinese lessons, but you won’t let her drop the piano lessons. They could come in handy! And who knows? Maybe they will.
In the M.I.T. experiments, the students should have known better. They played a computer game that paid real cash to look for money behind three doors on the screen. (You can play it yourself, without pay, at tierneylab.blogs.nytimes.com.) After they opened a door by clicking on it, each subsequent click earned a little money, with the sum varying each time.
As each player went through the 100 allotted clicks, he could switch rooms to search for higher payoffs, but each switch used up a click to open the new door. The best strategy was to quickly check out the three rooms and settle in the one with the highest rewards.
Even after students got the hang of the game by practicing it, they were flummoxed when a new visual feature was introduced. If they stayed out of any room, its door would start shrinking and eventually disappear.
They should have ignored those disappearing doors, but the students couldn’t. They wasted so many clicks rushing back to reopen doors that their earnings dropped 15 percent. Even when the penalties for switching grew stiffer — besides losing a click, the players had to pay a cash fee — the students kept losing money by frantically keeping all their doors open.
Why were they so attached to those doors? The players, like the parents of that overscheduled piano student, would probably say they were just trying to keep future options open. But that’s not the real reason, according to Dr. Ariely and his collaborator in the experiments, Jiwoong Shin, an economist who is now at Yale.
They plumbed the players’ motivations by introducing yet another twist. This time, even if a door vanished from the screen, players could make it reappear whenever they wanted. But even when they knew it would not cost anything to make the door reappear, they still kept frantically trying to prevent doors from vanishing.
Apparently they did not care so much about maintaining flexibility in the future. What really motivated them was the desire to avoid the immediate pain of watching a door close.
“Closing a door on an option is experienced as a loss, and people are willing to pay a price to avoid the emotion of loss,” Dr. Ariely says. In the experiment, the price was easy to measure in lost cash. In life, the costs are less obvious — wasted time, missed opportunities. If you are afraid to drop any project at the office, you pay for it at home.
“We may work more hours at our jobs,” Dr. Ariely writes in his book, “without realizing that the childhood of our sons and daughters is slipping away. Sometimes these doors close too slowly for us to see them vanishing.”
Dr. Ariely, one of the most prolific authors in his field, does not pretend that he is above this problem himself. When he was trying to decide between job offers from M.I.T. and Stanford, he recalls, within a week or two it was clear that he and his family would be more or less equally happy in either place. But he dragged out the process for months because he became so obsessed with weighing the options.
“I’m just as workaholic and prone to errors as anyone else,” he says.. “I have way too many projects, and it would probably be better for me and the academic community if I focused my efforts. But every time I have an idea or someone offers me a chance to collaborate, I hate to give it up.”
So what can be done? One answer, Dr. Ariely said, is to develop more social checks on overbooking. He points to marriage as an example: “In marriage, we create a situation where we promise ourselves not to keep options open. We close doors and announce to others we’ve closed doors.”
Or we can just try to do it on our own. Since conducting the door experiments, Dr. Ariely says, he has made a conscious effort to cancel projects and give away his ideas to colleagues. He urges the rest of us to resign from committees, prune holiday card lists, rethink hobbies and remember the lessons of door closers like Xiang Yu.
If the general’s tactics seem too crude, Dr. Ariely recommends another role model, Rhett Butler, for his supreme moment of unpredictable rationality at the end of his marriage. Scarlett, like the rest of us, can’t bear the pain of giving up an option, but Rhett recognizes the marriage’s futility and closes the door with astonishing elan. Frankly, he doesn’t give a damn.
February 26, 2008
Findings
The Advantages of Closing a Few Doors
By JOHN TIERNEY
The next time you’re juggling options — which friend to see, which house to buy, which career to pursue — try asking yourself this question: What would Xiang Yu do?
Xiang Yu was a Chinese general in the third century B.C. who took his troops across the Yangtze River into enemy territory and performed an experiment in decision making. He crushed his troops’ cooking pots and burned their ships.
He explained this was to focus them on moving forward — a motivational speech that was not appreciated by many of the soldiers watching their retreat option go up in flames. But General Xiang Yu would be vindicated, both on the battlefield and in the annals of social science research.
He is one of the role models in Dan Ariely’s new book, “Predictably Irrational,” an entertaining look at human foibles like the penchant for keeping too many options open. General Xiang Yu was a rare exception to the norm, a warrior who conquered by being unpredictably rational.
Most people can’t make such a painful choice, not even the students at a bastion of rationality like the Massachusetts Institute of Technology, where Dr. Ariely is a professor of behavioral economics. In a series of experiments, hundreds of students could not bear to let their options vanish, even though it was obviously a dumb strategy (and they weren’t even asked to burn anything).
The experiments involved a game that eliminated the excuses we usually have for refusing to let go. In the real world, we can always tell ourselves that it’s good to keep options open.
You don’t even know how a camera’s burst-mode flash works, but you persuade yourself to pay for the extra feature just in case. You no longer have anything in common with someone who keeps calling you, but you hate to just zap the relationship.
Your child is exhausted from after-school soccer, ballet and Chinese lessons, but you won’t let her drop the piano lessons. They could come in handy! And who knows? Maybe they will.
In the M.I.T. experiments, the students should have known better. They played a computer game that paid real cash to look for money behind three doors on the screen. (You can play it yourself, without pay, at tierneylab.blogs.nytimes.com.) After they opened a door by clicking on it, each subsequent click earned a little money, with the sum varying each time.
As each player went through the 100 allotted clicks, he could switch rooms to search for higher payoffs, but each switch used up a click to open the new door. The best strategy was to quickly check out the three rooms and settle in the one with the highest rewards.
Even after students got the hang of the game by practicing it, they were flummoxed when a new visual feature was introduced. If they stayed out of any room, its door would start shrinking and eventually disappear.
They should have ignored those disappearing doors, but the students couldn’t. They wasted so many clicks rushing back to reopen doors that their earnings dropped 15 percent. Even when the penalties for switching grew stiffer — besides losing a click, the players had to pay a cash fee — the students kept losing money by frantically keeping all their doors open.
Why were they so attached to those doors? The players, like the parents of that overscheduled piano student, would probably say they were just trying to keep future options open. But that’s not the real reason, according to Dr. Ariely and his collaborator in the experiments, Jiwoong Shin, an economist who is now at Yale.
They plumbed the players’ motivations by introducing yet another twist. This time, even if a door vanished from the screen, players could make it reappear whenever they wanted. But even when they knew it would not cost anything to make the door reappear, they still kept frantically trying to prevent doors from vanishing.
Apparently they did not care so much about maintaining flexibility in the future. What really motivated them was the desire to avoid the immediate pain of watching a door close.
“Closing a door on an option is experienced as a loss, and people are willing to pay a price to avoid the emotion of loss,” Dr. Ariely says. In the experiment, the price was easy to measure in lost cash. In life, the costs are less obvious — wasted time, missed opportunities. If you are afraid to drop any project at the office, you pay for it at home.
“We may work more hours at our jobs,” Dr. Ariely writes in his book, “without realizing that the childhood of our sons and daughters is slipping away. Sometimes these doors close too slowly for us to see them vanishing.”
Dr. Ariely, one of the most prolific authors in his field, does not pretend that he is above this problem himself. When he was trying to decide between job offers from M.I.T. and Stanford, he recalls, within a week or two it was clear that he and his family would be more or less equally happy in either place. But he dragged out the process for months because he became so obsessed with weighing the options.
“I’m just as workaholic and prone to errors as anyone else,” he says.. “I have way too many projects, and it would probably be better for me and the academic community if I focused my efforts. But every time I have an idea or someone offers me a chance to collaborate, I hate to give it up.”
So what can be done? One answer, Dr. Ariely said, is to develop more social checks on overbooking. He points to marriage as an example: “In marriage, we create a situation where we promise ourselves not to keep options open. We close doors and announce to others we’ve closed doors.”
Or we can just try to do it on our own. Since conducting the door experiments, Dr. Ariely says, he has made a conscious effort to cancel projects and give away his ideas to colleagues. He urges the rest of us to resign from committees, prune holiday card lists, rethink hobbies and remember the lessons of door closers like Xiang Yu.
If the general’s tactics seem too crude, Dr. Ariely recommends another role model, Rhett Butler, for his supreme moment of unpredictable rationality at the end of his marriage. Scarlett, like the rest of us, can’t bear the pain of giving up an option, but Rhett recognizes the marriage’s futility and closes the door with astonishing elan. Frankly, he doesn’t give a damn.
Wednesday, February 20, 2008
The New York Times
February 19, 2008
Mind
‘Have You Ever Been in Psychotherapy, Doctor?’
By RICHARD A. FRIEDMAN, M.D.
A curious thing happened to one of my psychiatric residents not long ago. One of his patients caught him off guard with a challenging question: “Have you ever been in psychotherapy yourself?”
He was uncomfortable answering the question directly, so he spent some time trying to discover why it mattered to his patient. “He wanted to know if I knew what it felt like to be ill and helpless,” the resident said.
It was an interesting question, and it made me wonder whether one could be a good therapist without having been in psychotherapy. If the answer was no, it would appear to be at odds with what we do in the rest of medical practice.
After all, we don’t require neurologists to have a spinal tap or cardiac surgeons to have undergone bypass surgery before performing these medical procedures.
But there is something special about psychotherapy, I think, that sets it apart. Of course, the doctor-patient relationship is important in any clinical encounter. But in therapy, the relationship is the very instrument of the treatment.
If your cardiologist does not have the best bedside manner but effectively treats your hypertension, you might not be happy, but at least you are heading in the right medical direction. In contrast, if you do not have a rapport with your therapist, then the treatment is useless.
To be any good, a cardiologist should be an expert in the use of his instrument, whether the stethoscope or the cardiac catheter. But how does this principle apply to psychotherapists?
One way to think about it is that a therapist should not start exploring a patient’s mind without really knowing what is in his own. Therapists, just like their patients, bring their own life experiences into treatment, which influence their feelings about their patients — a process called countertransference.
Therapists who do not understand their own countertransference run the risk not just of misunderstanding their patients, but of confusing their own hang-ups with those of their patients.
Once a resident asked me to help him deal with a difficult patient, whom he actually dreaded seeing.
It was easy to see why. The patient, a 35-year-old man, told me that my resident was incapable of understanding him and then angrily dismissed his therapist as inexperienced (right) and unfeeling (wrong).
My resident turned out to have plenty of feeling that he did not know what to do with. He felt angry, humiliated and trapped. This patient, who felt disappointed and mistreated by the world, was simply giving the therapist a taste of his own narcissism.
It did not help that this patient bore a striking resemblance to my resident’s older brother, whom he found critical and demeaning. The resident had never had therapy himself, but just realizing the origin of his negative feelings helped him deal with this difficult patient.
Nowadays, most psychiatric residents finish their training without having had any personal psychotherapy. This is a departure from the past, when psychotherapy reigned supreme and a personal psychoanalysis was a rite of passage for trainees.
The explosion of neuroscience, along with the pressure of market forces, has had a powerful effect on the training of young psychiatrists. Not all of it is good.
Being a psychiatrist and psychopharmacologist, I could not be more thrilled with the promise of brain science. And there is no question that we have more effective biological treatments for the major psychiatric disorders than at any point in the past.
But even as we have been swept off our feet by sexy neuroscience, my field is in danger of losing touch with the rich psychological life of patients, something that is reflected in the waning popularity of therapy during residency training.
Does it really matter? After all, psychiatrists are too expensive and too few to treat the vast majority of patients who need psychotherapy. Psychiatrists of the future are more likely going to be consultants in the treatment of patients with the most serious mental illnesses like schizophrenia, mood disorders and complicated substance abuse.
All true, but we are far from understanding the ultimate cause of most psychiatric disorders, despite the promise of brain science. We can effectively relieve symptoms and increase functioning, but we still have to help our patients live with illness.
Psychiatrists who have had the humbling experience of therapy themselves know something of what it feels like to be a patient — the sense of frustration, anxiety and dependence it entails.
As such, they can better understand the emotional reactions patients have to their illness — and to their doctors.
I don’t know about you, but that sounds like the kind of psychiatrist I would want taking care of me.
Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.
February 19, 2008
Mind
‘Have You Ever Been in Psychotherapy, Doctor?’
By RICHARD A. FRIEDMAN, M.D.
A curious thing happened to one of my psychiatric residents not long ago. One of his patients caught him off guard with a challenging question: “Have you ever been in psychotherapy yourself?”
He was uncomfortable answering the question directly, so he spent some time trying to discover why it mattered to his patient. “He wanted to know if I knew what it felt like to be ill and helpless,” the resident said.
It was an interesting question, and it made me wonder whether one could be a good therapist without having been in psychotherapy. If the answer was no, it would appear to be at odds with what we do in the rest of medical practice.
After all, we don’t require neurologists to have a spinal tap or cardiac surgeons to have undergone bypass surgery before performing these medical procedures.
But there is something special about psychotherapy, I think, that sets it apart. Of course, the doctor-patient relationship is important in any clinical encounter. But in therapy, the relationship is the very instrument of the treatment.
If your cardiologist does not have the best bedside manner but effectively treats your hypertension, you might not be happy, but at least you are heading in the right medical direction. In contrast, if you do not have a rapport with your therapist, then the treatment is useless.
To be any good, a cardiologist should be an expert in the use of his instrument, whether the stethoscope or the cardiac catheter. But how does this principle apply to psychotherapists?
One way to think about it is that a therapist should not start exploring a patient’s mind without really knowing what is in his own. Therapists, just like their patients, bring their own life experiences into treatment, which influence their feelings about their patients — a process called countertransference.
Therapists who do not understand their own countertransference run the risk not just of misunderstanding their patients, but of confusing their own hang-ups with those of their patients.
Once a resident asked me to help him deal with a difficult patient, whom he actually dreaded seeing.
It was easy to see why. The patient, a 35-year-old man, told me that my resident was incapable of understanding him and then angrily dismissed his therapist as inexperienced (right) and unfeeling (wrong).
My resident turned out to have plenty of feeling that he did not know what to do with. He felt angry, humiliated and trapped. This patient, who felt disappointed and mistreated by the world, was simply giving the therapist a taste of his own narcissism.
It did not help that this patient bore a striking resemblance to my resident’s older brother, whom he found critical and demeaning. The resident had never had therapy himself, but just realizing the origin of his negative feelings helped him deal with this difficult patient.
Nowadays, most psychiatric residents finish their training without having had any personal psychotherapy. This is a departure from the past, when psychotherapy reigned supreme and a personal psychoanalysis was a rite of passage for trainees.
The explosion of neuroscience, along with the pressure of market forces, has had a powerful effect on the training of young psychiatrists. Not all of it is good.
Being a psychiatrist and psychopharmacologist, I could not be more thrilled with the promise of brain science. And there is no question that we have more effective biological treatments for the major psychiatric disorders than at any point in the past.
But even as we have been swept off our feet by sexy neuroscience, my field is in danger of losing touch with the rich psychological life of patients, something that is reflected in the waning popularity of therapy during residency training.
Does it really matter? After all, psychiatrists are too expensive and too few to treat the vast majority of patients who need psychotherapy. Psychiatrists of the future are more likely going to be consultants in the treatment of patients with the most serious mental illnesses like schizophrenia, mood disorders and complicated substance abuse.
All true, but we are far from understanding the ultimate cause of most psychiatric disorders, despite the promise of brain science. We can effectively relieve symptoms and increase functioning, but we still have to help our patients live with illness.
Psychiatrists who have had the humbling experience of therapy themselves know something of what it feels like to be a patient — the sense of frustration, anxiety and dependence it entails.
As such, they can better understand the emotional reactions patients have to their illness — and to their doctors.
I don’t know about you, but that sounds like the kind of psychiatrist I would want taking care of me.
Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.
Sunday, February 17, 2008
The New York Times
February 16, 2008
For ‘EcoMoms,’ Saving Earth Begins at Home
By PATRICIA LEIGH BROWN
SAN RAFAEL, Calif. — The women gathered in the airy living room, wine poured and pleasantries exchanged. In no time, the conversation turned lively — not about the literary merits of Geraldine Brooks or Cormac McCarthy but the pitfalls of antibacterial hand sanitizers and how to retool the laundry using only cold water and biodegradable detergent during non-prime-time energy hours (after 7 p.m.).
Move over, Tupperware. The EcoMom party has arrived, with its ever-expanding “to do” list that includes preparing waste-free school lunches; lobbying for green building codes; transforming oneself into a “locovore,” eating locally grown food; and remembering not to idle the car when picking up children from school (if one must drive). Here, the small talk is about the volatile compounds emitted by dry-erase markers at school.
Perhaps not since the days of “dishpan hands” has the household been so all-consuming. But instead of gleaming floors and sparkling dishes, the obsession is on installing compact fluorescent light bulbs, buying in bulk and using “smart” power strips that shut off electricity to the espresso machine, microwave, X-Box, VCR, coffee grinder, television and laptop when not in use.
“It’s like eating too many brownies one day and then jogging extra the next,” said Kimberly Danek Pinkson, 38, the founder of the EcoMom Alliance, speaking to the group of efforts to curb eco-guilt through carbon offsets for air travel.
Part “Hints from Heloise” and part political self-help group, the alliance, which Ms. Pinkson says has 9,000 members across the country, joins a growing subculture dedicated to the “green mom,” with blogs and Web sites like greenandcleanmom.blogspot.com and eco-chick.com. Web-based organizations like the Center for a New American Dream in Takoma Park, Md., advocate reducing consumption and offer a registry that helps brides “celebrate the less-material wedding of your dreams.”
At an EcoMom circle in Palo Alto, executive mothers whipped out spreadsheets to tally their goals, inspired by a 10-step program that urges using only nontoxic products for cleaning, bathing and make-up, as well as cutting down garbage by 10 percent.
“I used to feel anxiety,” said Kathy Miller, 49, an alliance member, recalling life before she started investigating weather-sensitive irrigation controls for her garden with nine growing zones. “Now I feel I’m doing something.”
The notion of “ecoanxiety” has crept into the culture here. It was the subject of a recent cover story in San Francisco magazine that quotes a Berkeley mother so stressed out about the extravagance of her nightly baths that she started to reuse her daughter’s bath water. Where there is ecoanxiety, of course, there are ecotherapists.
“The truth is, we’re not living very naturally,” said Linda Buzzell, a therapist in Santa Barbara who publishes the quarterly EcoTherapy News and often holds sessions in her backyard permaculture food forest. “We’re in our cars, staring at the computer screen, separated most of the day from the people we love.”
“Activism can help counteract depression,” Ms. Buzzell added. “But if we get caught up in trying to save the world single-handedly, we’re just going to burn out.”
Like many young women, Ms. Pinkson’s motherhood — her son Corbin is now 6 — coincided with Al Gore’s “An Inconvenient Truth” and the advent of treehugger.com and grist.com. A favorite online column is “Ask Umbra,” whose author weighs in on whether it is better to buy leather shoes or “pleather” ones that could contain solvents.
Shaina Forsman, a 13-year-old daughter of eco-mother Beth Forsman, said the alliance branch in San Rafael helped her mother take action at home. Her mother turned the thermostat down so low that Shaina sometimes wore a jacket inside, she said proudly. She was also monitoring time spent in the shower, so as not to waste water.
Shaina said she tried to get her mother to compost, but “we got ants.”
One of the country’s wealthiest places, Marin County, is hardly a hub of voluntary simplicity; its global footprint, according to county statistics, is 27 acres per person, a measure of the estimated amount of land it takes to support each person’s lifestyle (24 is the American average).
Members of the EcoMom Alliance “are fighting a values battle,” said Tim Kasser, an associate professor of psychology at Knox College in Galesburg, Ill., and the author of “The High Price of Materialism.” “They are surrounded by materialism trying to figure out how to create a life more oriented toward intrinsic values.”
Wendy Murphy, 41, a member of EcoMoms in San Anselmo, became an activist after she noticed that the new tablecloths in her children’s preschool contained polyvinyl chloride. She and a fellow mother, working with the Green Schools Initiative, a nonprofit in Berkeley, developed green guidelines for shopping, like buying chlorine-free cleaning products, low-formaldehyde furniture and toys made of natural materials.
The matter of toys is particularly thorny. At the EcoMom party in San Rafael, women traded ideas about recycled toys for birthday presents and children’s clothing swaps. Then there is the issue of the materials used in imported toys. “It’s ‘Mom, these come from China,’ ” Pam Nessi, 35, said of her daughters’ recent inspection of two of their dolls. “It can be overwhelming. You don’t want them to freak out.”
At last year’s Step It Up rallies, a day of environmental demonstrations across the country, the largest group of organizers were “mothers concerned about the disintegrating environment for their children,” said Bill McKibben, a founder of the event and author of “The End of Nature.”
Women have been instrumental in the environmental movement from the start, including their involvement in campaigns a century ago to save the Palisades along the Hudson River and sequoias in California and, more recently, Lois Gibbs’s fight against toxic waste at Love Canal.
In public opinion surveys, women express significantly higher levels of environmental concern than men, said Riley Dunlap, a professor of sociology at Oklahoma State University.
Lately “local lifestyle activism,” much of it driven by women, has been on the rise and is likely to continue, Dr. Dunlap said. “Just belonging to a national environmental organization, which seemed effective in the 1970s and ’80s, doesn’t work anymore, particularly in an era of government unresponsiveness,” he said.
Ms. Pinkson and her colleagues are well aware of “the mom demographic,” as they call it, in which, according to surveys for the Boston Consulting Group, women say they “influence or control” 80 percent of discretionary household purchases. Thus far, their thrust has been more about being green consumers than taking political action.
The eco life can occasionally spawn domestic strife.
Julie DeFord, a 33-year-old mother in Petaluma, said the high cost of organic produce prompted serious “conversations” between her and her husband, Curt, a lawyer, especially after seven nights of chard.
And ecomotherhood is not always sisterly.
At the EcoMom party recently, some guests took the hostess, Liz Held, to task for her wall-to-wall carpeting (potential off-gassing), her painted walls (unhealthful volatile organic compounds) and the freshly cut flowers that she had set out for the occasion (not organic). Their problems with the S.U.V. in the driveway were self-explanatory.
All the new eco-perfectionism did not seem to faze her. “I look around my house and think, ‘I haven’t changed all my light bulbs,’ ” she said. “But it doesn’t fill me with guilt. I think about all the things I’ve done so far. I just try to focus on the positive.”
February 16, 2008
For ‘EcoMoms,’ Saving Earth Begins at Home
By PATRICIA LEIGH BROWN
SAN RAFAEL, Calif. — The women gathered in the airy living room, wine poured and pleasantries exchanged. In no time, the conversation turned lively — not about the literary merits of Geraldine Brooks or Cormac McCarthy but the pitfalls of antibacterial hand sanitizers and how to retool the laundry using only cold water and biodegradable detergent during non-prime-time energy hours (after 7 p.m.).
Move over, Tupperware. The EcoMom party has arrived, with its ever-expanding “to do” list that includes preparing waste-free school lunches; lobbying for green building codes; transforming oneself into a “locovore,” eating locally grown food; and remembering not to idle the car when picking up children from school (if one must drive). Here, the small talk is about the volatile compounds emitted by dry-erase markers at school.
Perhaps not since the days of “dishpan hands” has the household been so all-consuming. But instead of gleaming floors and sparkling dishes, the obsession is on installing compact fluorescent light bulbs, buying in bulk and using “smart” power strips that shut off electricity to the espresso machine, microwave, X-Box, VCR, coffee grinder, television and laptop when not in use.
“It’s like eating too many brownies one day and then jogging extra the next,” said Kimberly Danek Pinkson, 38, the founder of the EcoMom Alliance, speaking to the group of efforts to curb eco-guilt through carbon offsets for air travel.
Part “Hints from Heloise” and part political self-help group, the alliance, which Ms. Pinkson says has 9,000 members across the country, joins a growing subculture dedicated to the “green mom,” with blogs and Web sites like greenandcleanmom.blogspot.com and eco-chick.com. Web-based organizations like the Center for a New American Dream in Takoma Park, Md., advocate reducing consumption and offer a registry that helps brides “celebrate the less-material wedding of your dreams.”
At an EcoMom circle in Palo Alto, executive mothers whipped out spreadsheets to tally their goals, inspired by a 10-step program that urges using only nontoxic products for cleaning, bathing and make-up, as well as cutting down garbage by 10 percent.
“I used to feel anxiety,” said Kathy Miller, 49, an alliance member, recalling life before she started investigating weather-sensitive irrigation controls for her garden with nine growing zones. “Now I feel I’m doing something.”
The notion of “ecoanxiety” has crept into the culture here. It was the subject of a recent cover story in San Francisco magazine that quotes a Berkeley mother so stressed out about the extravagance of her nightly baths that she started to reuse her daughter’s bath water. Where there is ecoanxiety, of course, there are ecotherapists.
“The truth is, we’re not living very naturally,” said Linda Buzzell, a therapist in Santa Barbara who publishes the quarterly EcoTherapy News and often holds sessions in her backyard permaculture food forest. “We’re in our cars, staring at the computer screen, separated most of the day from the people we love.”
“Activism can help counteract depression,” Ms. Buzzell added. “But if we get caught up in trying to save the world single-handedly, we’re just going to burn out.”
Like many young women, Ms. Pinkson’s motherhood — her son Corbin is now 6 — coincided with Al Gore’s “An Inconvenient Truth” and the advent of treehugger.com and grist.com. A favorite online column is “Ask Umbra,” whose author weighs in on whether it is better to buy leather shoes or “pleather” ones that could contain solvents.
Shaina Forsman, a 13-year-old daughter of eco-mother Beth Forsman, said the alliance branch in San Rafael helped her mother take action at home. Her mother turned the thermostat down so low that Shaina sometimes wore a jacket inside, she said proudly. She was also monitoring time spent in the shower, so as not to waste water.
Shaina said she tried to get her mother to compost, but “we got ants.”
One of the country’s wealthiest places, Marin County, is hardly a hub of voluntary simplicity; its global footprint, according to county statistics, is 27 acres per person, a measure of the estimated amount of land it takes to support each person’s lifestyle (24 is the American average).
Members of the EcoMom Alliance “are fighting a values battle,” said Tim Kasser, an associate professor of psychology at Knox College in Galesburg, Ill., and the author of “The High Price of Materialism.” “They are surrounded by materialism trying to figure out how to create a life more oriented toward intrinsic values.”
Wendy Murphy, 41, a member of EcoMoms in San Anselmo, became an activist after she noticed that the new tablecloths in her children’s preschool contained polyvinyl chloride. She and a fellow mother, working with the Green Schools Initiative, a nonprofit in Berkeley, developed green guidelines for shopping, like buying chlorine-free cleaning products, low-formaldehyde furniture and toys made of natural materials.
The matter of toys is particularly thorny. At the EcoMom party in San Rafael, women traded ideas about recycled toys for birthday presents and children’s clothing swaps. Then there is the issue of the materials used in imported toys. “It’s ‘Mom, these come from China,’ ” Pam Nessi, 35, said of her daughters’ recent inspection of two of their dolls. “It can be overwhelming. You don’t want them to freak out.”
At last year’s Step It Up rallies, a day of environmental demonstrations across the country, the largest group of organizers were “mothers concerned about the disintegrating environment for their children,” said Bill McKibben, a founder of the event and author of “The End of Nature.”
Women have been instrumental in the environmental movement from the start, including their involvement in campaigns a century ago to save the Palisades along the Hudson River and sequoias in California and, more recently, Lois Gibbs’s fight against toxic waste at Love Canal.
In public opinion surveys, women express significantly higher levels of environmental concern than men, said Riley Dunlap, a professor of sociology at Oklahoma State University.
Lately “local lifestyle activism,” much of it driven by women, has been on the rise and is likely to continue, Dr. Dunlap said. “Just belonging to a national environmental organization, which seemed effective in the 1970s and ’80s, doesn’t work anymore, particularly in an era of government unresponsiveness,” he said.
Ms. Pinkson and her colleagues are well aware of “the mom demographic,” as they call it, in which, according to surveys for the Boston Consulting Group, women say they “influence or control” 80 percent of discretionary household purchases. Thus far, their thrust has been more about being green consumers than taking political action.
The eco life can occasionally spawn domestic strife.
Julie DeFord, a 33-year-old mother in Petaluma, said the high cost of organic produce prompted serious “conversations” between her and her husband, Curt, a lawyer, especially after seven nights of chard.
And ecomotherhood is not always sisterly.
At the EcoMom party recently, some guests took the hostess, Liz Held, to task for her wall-to-wall carpeting (potential off-gassing), her painted walls (unhealthful volatile organic compounds) and the freshly cut flowers that she had set out for the occasion (not organic). Their problems with the S.U.V. in the driveway were self-explanatory.
All the new eco-perfectionism did not seem to faze her. “I look around my house and think, ‘I haven’t changed all my light bulbs,’ ” she said. “But it doesn’t fill me with guilt. I think about all the things I’ve done so far. I just try to focus on the positive.”
Friday, February 15, 2008
February 14, 2008, 7:07 pm
Overselling Overmedication
NYTimes
Tags: Big Pharma, mental disorders, overmedication
On the bookshelf behind me at work, I have two new books on the way the pharmaceutical industry is turning us into a nation of hypochondriacal pill-popping zombies: “Shyness: How Normal Behavior Became a Sickness” and “Our Daily Meds.” On the floor, windowsill and shelves of my office at home, I have quite a few more: “Generation Rx” … “The Last Normal Child” … “Toxic Psychiatry” … “Let Them Eat Prozac” … The latest volume, front and center now on my desk, is Charles Barber’s “Comfortably Numb: How Psychiatry Is Medicating a Nation.”
In the book, Barber argues that Americans are being vastly overmedicated for often relatively minor mental health concerns. This over-reliance on quick-fix medication is numbing our nation and dulling our awareness of real and pressing social issues and of non-psychopharmacological therapies and treatments.
Barber is hardly alone these days in this line of reasoning. The notion that American children and adults are being over-diagnosed and overmedicated for exaggerated or even fictitious mental disorders has now become one of the defining tropes of our era.
This storyline persists despite the fact that government research has repeatedly shown that most adults and children with mental health issues don’t get the specialized help that they need. It persists despite the fact that there’s really no way to meaningfully evaluate the degree of over-diagnosis and medication unique to our era, because to do so is essentially to look at the current era in a vacuum. We don’t know how many adults suffered from things like depression in the distant past because no one ever asked. The words and concepts through which we understand common mental health disorders today didn’t exist until the last few decades.
The narrative survives largely uncontested despite the fact, shared by psychiatrist Peter Kramer in his Slate review of Barber’s book, that only tiny numbers of people are receiving mental health services without real, clinical levels of mental health dysfunction or a history of mental illness or trauma. And despite the fact that, contrary to received wisdom, the United States is not a world leader when it comes to the use of psychiatric medications. (The U.S. is “’in the middle’ relative to other countries, and is not an outlier,” a study from M.I.T’s. Sloan School of Management, cited by Kramer, showed last year.)
Just because it feels like, just because it sounds like, just because soaring drug company profits and obnoxious direct to consumer advertising seem to indicate that everyone around us is popping pills like mad doesn’t mean that they are doing so. Nor does it mean that we’re in the grip of some new, previously unheard-of, and uniquely epoch-defining social phenomenon.
People have been unofficially drugging themselves for as long as they’ve had the capability to do so. They smoked cigarettes to boost their concentration. They drank cocktails with lunch and dinner — and more — to deal with anxiety and despair. Prior to the modern era of F.D.A.-regulated prescribing practices, they slugged down untold quantities of tonics and bromides.
All of which suggests that what social critics now identify as the signature event of our time (the urge to manage psychic pain through substance use) may, in fact, almost always have been a facet of the human condition. It may just be that we’re better at it than ever before – with cleaner, safer, less addictive and debilitating tools at our disposal.
Is that a terrible thing to say?
And what if, examined in the light of basic facts, and with a perturbing bit of common sense thrown into the mix, the popular storyline of our fatal corruption by Big Pharma turns out to be, if not utterly baseless, then at least greatly exaggerated?
Kramer, the author of the 1993 bestseller “Listening to Prozac” and, more recently, “Freud: Inventor of the Modern Mind” and “Against Depression,” makes a quite compelling case in his Slate review that the received wisdom about psychiatric drug use today is ahistorical, narrow in its cultural understanding and factually, often wrong.
To illustrate his point, he details research he did for the Carter administration to investigate the then deeply-held belief that a generation of women were being over-medicated with “mother’s little helpers” like Valium. “This inquiry occurred in the context of a broader discussion about whether America was becoming an overmedicated society – whether we were peculiarly averse to discomfort and enamored of the quick fix,” he writes. Yet, after convening a team of experts from the National Institute of Mental Health and other government agencies and studying women’s drug use and physicians’ prescribing patterns, Kramer’s group found that “little in the scientific literature suggested a crisis or even a uniquely American response to anxiety.”
Searching the data didn’t produce a convincing narrative about women being drugged into submission. But the belief that they were was itself deeply meaningful.
“The worries expressed about Valium were our worries: women were being given these more diverse responsibilities, weren’t being given their due, their voices weren’t being heard, the culture in general had a sort of oddness about it, we had a general sense of anxiety or unease and these issues were being explained through the idea that we’re just giving medication to women and not talking to them,” Kramer told me in an interview this week. “There was a sense that something was being covered over. Those issues found their symbol in Valium.”
There’s a lot in this little parable that’s relevant today.
Let’s get beyond statistics, percentage changes in diagnosis rates and billions earned off human suffering by Big Pharma. And let’s just try for a moment to get real.
Most of the critics decrying the over-medicalization of the American mind rest their arguments upon the bedrock assumption that people who have nothing wrong with them – happy-go-lucky types who essentially make a wrong turn on their way to Starbucks or soccer and end up in the consulting room – are being medicated for largely fictitious concerns.
But search your minds and memories: Have you, or people close to you, ever taken medication in a lazy or thoughtless way? Eagerly? As a lark? Ask around a bit; find out what kind of desperation led others to the point where they had to accept psychopharmacological help.
(Write and tell me. Tell us all. But please don’t send abstract social observations or share stories about people you don’t actually know. First-hand knowledge and real life only, thanks.)
The psychiatrists I’ve interviewed over the course of the past four years say that they have yet to be swamped by frivolous patients showing up in their offices looking for pills to help them tweak troublesome little aspects of their personalities. “Not only have I not encountered many [such patients], I haven’t encountered any in my office or even in detailed phone calls,” Kramer, most recently, told me.
There are good reasons to harbor considerable distrust about whether some psychiatrists’ prescribing practices really have patients’ best interests in mind. The Times has repeatedly and extensively covered the pernicious gravy train of payments from the pharmaceutical industry to psychiatrists who help promote their latest products; studies have indicated that receiving drug company money does influence doctors’ prescribing habits.
This is a disturbing, even disgusting, state of affairs. But it’s a fixable situation: Doctors and universities could in the future just say no to the drug money that is believed to corrupt them. They could be required to say no by law. Provided, of course, that the government stepped in to fund more and better research.
Harder to fix is the current social malaise that drives the belief that we have become a Prozac (and Concerta and Zyprexa and Effexor) Nation. What is its cause? How has it spun itself into a storyline about mentally vulnerable children and adults that is largely at odds with the facts?
What purpose does that narrative serve? What do we gain – or lose — through its continuation?
The downside is stigma, misunderstanding, and a lot of righteous indignation. I’m still working on figuring out the upside.
Overselling Overmedication
NYTimes
Tags: Big Pharma, mental disorders, overmedication
On the bookshelf behind me at work, I have two new books on the way the pharmaceutical industry is turning us into a nation of hypochondriacal pill-popping zombies: “Shyness: How Normal Behavior Became a Sickness” and “Our Daily Meds.” On the floor, windowsill and shelves of my office at home, I have quite a few more: “Generation Rx” … “The Last Normal Child” … “Toxic Psychiatry” … “Let Them Eat Prozac” … The latest volume, front and center now on my desk, is Charles Barber’s “Comfortably Numb: How Psychiatry Is Medicating a Nation.”
In the book, Barber argues that Americans are being vastly overmedicated for often relatively minor mental health concerns. This over-reliance on quick-fix medication is numbing our nation and dulling our awareness of real and pressing social issues and of non-psychopharmacological therapies and treatments.
Barber is hardly alone these days in this line of reasoning. The notion that American children and adults are being over-diagnosed and overmedicated for exaggerated or even fictitious mental disorders has now become one of the defining tropes of our era.
This storyline persists despite the fact that government research has repeatedly shown that most adults and children with mental health issues don’t get the specialized help that they need. It persists despite the fact that there’s really no way to meaningfully evaluate the degree of over-diagnosis and medication unique to our era, because to do so is essentially to look at the current era in a vacuum. We don’t know how many adults suffered from things like depression in the distant past because no one ever asked. The words and concepts through which we understand common mental health disorders today didn’t exist until the last few decades.
The narrative survives largely uncontested despite the fact, shared by psychiatrist Peter Kramer in his Slate review of Barber’s book, that only tiny numbers of people are receiving mental health services without real, clinical levels of mental health dysfunction or a history of mental illness or trauma. And despite the fact that, contrary to received wisdom, the United States is not a world leader when it comes to the use of psychiatric medications. (The U.S. is “’in the middle’ relative to other countries, and is not an outlier,” a study from M.I.T’s. Sloan School of Management, cited by Kramer, showed last year.)
Just because it feels like, just because it sounds like, just because soaring drug company profits and obnoxious direct to consumer advertising seem to indicate that everyone around us is popping pills like mad doesn’t mean that they are doing so. Nor does it mean that we’re in the grip of some new, previously unheard-of, and uniquely epoch-defining social phenomenon.
People have been unofficially drugging themselves for as long as they’ve had the capability to do so. They smoked cigarettes to boost their concentration. They drank cocktails with lunch and dinner — and more — to deal with anxiety and despair. Prior to the modern era of F.D.A.-regulated prescribing practices, they slugged down untold quantities of tonics and bromides.
All of which suggests that what social critics now identify as the signature event of our time (the urge to manage psychic pain through substance use) may, in fact, almost always have been a facet of the human condition. It may just be that we’re better at it than ever before – with cleaner, safer, less addictive and debilitating tools at our disposal.
Is that a terrible thing to say?
And what if, examined in the light of basic facts, and with a perturbing bit of common sense thrown into the mix, the popular storyline of our fatal corruption by Big Pharma turns out to be, if not utterly baseless, then at least greatly exaggerated?
Kramer, the author of the 1993 bestseller “Listening to Prozac” and, more recently, “Freud: Inventor of the Modern Mind” and “Against Depression,” makes a quite compelling case in his Slate review that the received wisdom about psychiatric drug use today is ahistorical, narrow in its cultural understanding and factually, often wrong.
To illustrate his point, he details research he did for the Carter administration to investigate the then deeply-held belief that a generation of women were being over-medicated with “mother’s little helpers” like Valium. “This inquiry occurred in the context of a broader discussion about whether America was becoming an overmedicated society – whether we were peculiarly averse to discomfort and enamored of the quick fix,” he writes. Yet, after convening a team of experts from the National Institute of Mental Health and other government agencies and studying women’s drug use and physicians’ prescribing patterns, Kramer’s group found that “little in the scientific literature suggested a crisis or even a uniquely American response to anxiety.”
Searching the data didn’t produce a convincing narrative about women being drugged into submission. But the belief that they were was itself deeply meaningful.
“The worries expressed about Valium were our worries: women were being given these more diverse responsibilities, weren’t being given their due, their voices weren’t being heard, the culture in general had a sort of oddness about it, we had a general sense of anxiety or unease and these issues were being explained through the idea that we’re just giving medication to women and not talking to them,” Kramer told me in an interview this week. “There was a sense that something was being covered over. Those issues found their symbol in Valium.”
There’s a lot in this little parable that’s relevant today.
Let’s get beyond statistics, percentage changes in diagnosis rates and billions earned off human suffering by Big Pharma. And let’s just try for a moment to get real.
Most of the critics decrying the over-medicalization of the American mind rest their arguments upon the bedrock assumption that people who have nothing wrong with them – happy-go-lucky types who essentially make a wrong turn on their way to Starbucks or soccer and end up in the consulting room – are being medicated for largely fictitious concerns.
But search your minds and memories: Have you, or people close to you, ever taken medication in a lazy or thoughtless way? Eagerly? As a lark? Ask around a bit; find out what kind of desperation led others to the point where they had to accept psychopharmacological help.
(Write and tell me. Tell us all. But please don’t send abstract social observations or share stories about people you don’t actually know. First-hand knowledge and real life only, thanks.)
The psychiatrists I’ve interviewed over the course of the past four years say that they have yet to be swamped by frivolous patients showing up in their offices looking for pills to help them tweak troublesome little aspects of their personalities. “Not only have I not encountered many [such patients], I haven’t encountered any in my office or even in detailed phone calls,” Kramer, most recently, told me.
There are good reasons to harbor considerable distrust about whether some psychiatrists’ prescribing practices really have patients’ best interests in mind. The Times has repeatedly and extensively covered the pernicious gravy train of payments from the pharmaceutical industry to psychiatrists who help promote their latest products; studies have indicated that receiving drug company money does influence doctors’ prescribing habits.
This is a disturbing, even disgusting, state of affairs. But it’s a fixable situation: Doctors and universities could in the future just say no to the drug money that is believed to corrupt them. They could be required to say no by law. Provided, of course, that the government stepped in to fund more and better research.
Harder to fix is the current social malaise that drives the belief that we have become a Prozac (and Concerta and Zyprexa and Effexor) Nation. What is its cause? How has it spun itself into a storyline about mentally vulnerable children and adults that is largely at odds with the facts?
What purpose does that narrative serve? What do we gain – or lose — through its continuation?
The downside is stigma, misunderstanding, and a lot of righteous indignation. I’m still working on figuring out the upside.
Monday, February 11, 2008
The New York Times
February 12, 2008
Mind
You Remind Me of Me
By BENEDICT CAREY
Artful persuasion depends on eye contact, but not just any kind. If one person prefers brief glances and the other is busy staring deeply, then it may not matter how good the jokes are or how much they both loved “Juno.” Rhythm counts.
Voice cadence does, too. People who speak in loud, animated bursts tend to feed off others who do the same, just as those who are lower key tend to relax in a cool stream of measured tones.
“Myself, I’m very conscious of people’s body position,” said Ray Allieri of Wellesley, Mass., a former telecommunications executive with 20 years in marketing and sales. “If they’re leaning back in their chair, I do that, and if they’re forward on their elbows, I tend to move forward,”
Psychologists have been studying the art of persuasion for nearly a century, analyzing activities like political propaganda, television campaigns and door-to-door sales. Many factors influence people’s susceptibility to an appeal, studies suggest, including their perception of how exclusive an opportunity is and whether their neighbors are buying it.
Most people are also strongly sensitive to rapport, to charm, to the social music in the person making the pitch. In recent years, researchers have begun to decode the unspoken, subtle elements that come into play when people click.
They have found that immediate social bonding between strangers is highly dependent on mimicry, a synchronized and usually unconscious give and take of words and gestures that creates a current of good will between two people.
By understanding exactly how this process works, researchers say, people can better catch themselves when falling for an artful pitch, and even sharpen their own social skills in ways they may not have tried before.
“Really good salespeople, and for that matter good con artists, have known about these skills and used them forever,” Jeremy Bailenson, a psychologist at Stanford, said. “All we’re doing now is measuring and describing more precisely what it is they’re doing, whether consciously or not.”
Imitation is one of the most common and recognizable behaviors in the animal kingdom. Just as baby chimps learn to climb by aping their elders, so infants pick up words and gestures by copying parents. They sense and mimic peers’ behavior from early on, too, looking up at the ceiling if others around them do so or mirroring others’ cringes of fear and anxiety.
Such behavioral contagion probably evolved early for survival, some scientists argue. It is what scatters a flock well before most members see a lunging predator.
Yet by drawing on apparently similar skills, even in seemingly trivial ways, people can prompt almost instantaneous cooperation from complete strangers.
In a recent experiment, Rick van Baaren, a psychologist at Nijmegen University in the Netherlands, had student participants go to a lab and give their opinions about a series of advertisements. A member of his research team mimicked half the participants while they spoke, roughly mirroring the posture and the position of their arms and legs, taking care not to be too obvious.
Minutes later, the experimenter dropped six pens on the floor, making it look like an accident.
In several versions of this simple sequence, participants who had been mimicked were two to three times as likely to pick up the pens as those who had not.
The mimicry had not only increased good will toward the researcher within minutes, the study concluded, but it also prompted “an increased pro-social orientation in general.”
That orientation applies to far more than dropped pens. In a study due out in the spring, Robin Tanner and Tanya Chartrand, psychologists at Duke, led a research team that tested how being mimicked might affect the behavior of a potential client or investor.
The team had 37 Duke students try out what was described as a new sports drink, Vigor, and answer a few questions about it. The interviewer mimicked about half the participants using a technique Dr. Chartrand had developed in earlier studies.
The technique involved mirroring a person’s posture and movements, with a one- to two-second delay. If he crosses his legs, then wait two seconds and do the same, with opposite legs. If she touches her face, wait a beat or two and do that. If he drums his fingers or taps a toe, wait again and do something similar.
The idea is to be a mirror but a slow, imperfect one. Follow too closely, and most people catch it — and the game is over.
In the study, the researchers set up the interviews so each student’s experience was virtually identical, except for the mimicking.
None of the copied participants picked up on the mimicry. But by the end of the short interview, they were significantly more likely than the others to consume the new drink, to say they would buy it and to predict its success in the market.
In a similar experiment, the psychologists found that this was especially true if the participants knew that the interviewer, the mimic, had a stake in the product’s success.
“This is somewhat counterintuitive,” Dr. Chartrand said in an interview. “Normally, you’d expect when people realize that someone was invested in a product and trying to sell it to them, their reaction would be attenuated. They’d be less enthusiastic.
“But we found that people who were mimicked actually felt more strongly about the product when they knew the other person was invested in it.”
Any amiable conversation provides ample evidence of this subconscious social waltz. Smiles are contagious. So is nodding, in an amiable conversation.
Accents converge quickly and automatically. A country chime or an Irish whistle can seemingly infect the voice of a New Yorker in a 10-minute phone call.
“I especially find myself falling into a Southern accent, which is crazy,” Mr. Allieri, the telecom executive, said. “I’m from Boston.
“But I think what good salespeople really do is pick up on physical cues and respond to them without thinking much about it.”
It is one thing to move like a naturally synchronized swimmer through the pools of everyday conversation without thinking, however. It is another to deliberately employ mimicry to persuade or seduce.
Dr. Bailenson, the Stanford psychologist, has been testing the effects of different forms of mimicry by programming a computer-generated figure, an avatar, to mirror the movements and gestures of people in a study.
He has found that his subjects pick up the mimicry when it is immediate and precise. If the avatar is slightly out of sync, however — waits four seconds, for instance — then the mimicking goes unnoticed, and the usual rules apply. The virtual creating comes across as warm and convincing, as if controlled by another human.
“The point is it’s a delicate balance to get it right, and I suspect that people who are good at this know how to do it intuitively,” Dr. Bailenson said.
Or they have developed ways to engage their skills indirectly.
Veldon Smith, a musician and legendary salesman living in Centennial, Colo., who spent 30 years in the automobile parts business before retiring a few years ago, said:
“One thing I always did, I learned as much as possible about a client before I visited, what their problem was, what they were worried about. Then I would go in with a story about myself being in the same predicament.
“So when I walked in, I was in exactly the same frame of mind as the customer. I was immediately on the same wavelength. Everything else kind of flowed out of that.”
One reason subtle mimicry is so instantly beguiling may be that it draws on and, perhaps, activates brain circuits involved in feelings of empathy.
In several studies, Jean Decety, a neuroscientist at the University of Chicago, has shown that some of the same brain regions that are active when a person feels pain also flare up when that person imagines someone else like a loved one feeling the same sting or ache.
A similar process almost certainly occurs when a person takes pleasure in the good fortune of a friend or the apparent enjoyment of a conversation partner, Dr. Decety said.
“When you’re being mimicked in a good way, it communicates a kind of pleasure, a social high you’re getting from the other person, and I suspect it activates the areas of the brain involved in sensing reward,” he said.
Social mimicry can and does go wrong. At its malicious extreme, it curdles into mockery, which is why people often recoil when they catch of whiff of mimicry, ending any chance of a social bond. Preliminary studies suggest that the rules change if there is a wide cultural gap between two people. For almost everyone else, however, subtle mimicry comes across as a form of flattery, the physical dance of charm itself. And if that kind of flattery doesn’t close a deal, it may just be that the customer isn’t buying.
Everyone has the right to be charmed but not seduced.
February 12, 2008
Mind
You Remind Me of Me
By BENEDICT CAREY
Artful persuasion depends on eye contact, but not just any kind. If one person prefers brief glances and the other is busy staring deeply, then it may not matter how good the jokes are or how much they both loved “Juno.” Rhythm counts.
Voice cadence does, too. People who speak in loud, animated bursts tend to feed off others who do the same, just as those who are lower key tend to relax in a cool stream of measured tones.
“Myself, I’m very conscious of people’s body position,” said Ray Allieri of Wellesley, Mass., a former telecommunications executive with 20 years in marketing and sales. “If they’re leaning back in their chair, I do that, and if they’re forward on their elbows, I tend to move forward,”
Psychologists have been studying the art of persuasion for nearly a century, analyzing activities like political propaganda, television campaigns and door-to-door sales. Many factors influence people’s susceptibility to an appeal, studies suggest, including their perception of how exclusive an opportunity is and whether their neighbors are buying it.
Most people are also strongly sensitive to rapport, to charm, to the social music in the person making the pitch. In recent years, researchers have begun to decode the unspoken, subtle elements that come into play when people click.
They have found that immediate social bonding between strangers is highly dependent on mimicry, a synchronized and usually unconscious give and take of words and gestures that creates a current of good will between two people.
By understanding exactly how this process works, researchers say, people can better catch themselves when falling for an artful pitch, and even sharpen their own social skills in ways they may not have tried before.
“Really good salespeople, and for that matter good con artists, have known about these skills and used them forever,” Jeremy Bailenson, a psychologist at Stanford, said. “All we’re doing now is measuring and describing more precisely what it is they’re doing, whether consciously or not.”
Imitation is one of the most common and recognizable behaviors in the animal kingdom. Just as baby chimps learn to climb by aping their elders, so infants pick up words and gestures by copying parents. They sense and mimic peers’ behavior from early on, too, looking up at the ceiling if others around them do so or mirroring others’ cringes of fear and anxiety.
Such behavioral contagion probably evolved early for survival, some scientists argue. It is what scatters a flock well before most members see a lunging predator.
Yet by drawing on apparently similar skills, even in seemingly trivial ways, people can prompt almost instantaneous cooperation from complete strangers.
In a recent experiment, Rick van Baaren, a psychologist at Nijmegen University in the Netherlands, had student participants go to a lab and give their opinions about a series of advertisements. A member of his research team mimicked half the participants while they spoke, roughly mirroring the posture and the position of their arms and legs, taking care not to be too obvious.
Minutes later, the experimenter dropped six pens on the floor, making it look like an accident.
In several versions of this simple sequence, participants who had been mimicked were two to three times as likely to pick up the pens as those who had not.
The mimicry had not only increased good will toward the researcher within minutes, the study concluded, but it also prompted “an increased pro-social orientation in general.”
That orientation applies to far more than dropped pens. In a study due out in the spring, Robin Tanner and Tanya Chartrand, psychologists at Duke, led a research team that tested how being mimicked might affect the behavior of a potential client or investor.
The team had 37 Duke students try out what was described as a new sports drink, Vigor, and answer a few questions about it. The interviewer mimicked about half the participants using a technique Dr. Chartrand had developed in earlier studies.
The technique involved mirroring a person’s posture and movements, with a one- to two-second delay. If he crosses his legs, then wait two seconds and do the same, with opposite legs. If she touches her face, wait a beat or two and do that. If he drums his fingers or taps a toe, wait again and do something similar.
The idea is to be a mirror but a slow, imperfect one. Follow too closely, and most people catch it — and the game is over.
In the study, the researchers set up the interviews so each student’s experience was virtually identical, except for the mimicking.
None of the copied participants picked up on the mimicry. But by the end of the short interview, they were significantly more likely than the others to consume the new drink, to say they would buy it and to predict its success in the market.
In a similar experiment, the psychologists found that this was especially true if the participants knew that the interviewer, the mimic, had a stake in the product’s success.
“This is somewhat counterintuitive,” Dr. Chartrand said in an interview. “Normally, you’d expect when people realize that someone was invested in a product and trying to sell it to them, their reaction would be attenuated. They’d be less enthusiastic.
“But we found that people who were mimicked actually felt more strongly about the product when they knew the other person was invested in it.”
Any amiable conversation provides ample evidence of this subconscious social waltz. Smiles are contagious. So is nodding, in an amiable conversation.
Accents converge quickly and automatically. A country chime or an Irish whistle can seemingly infect the voice of a New Yorker in a 10-minute phone call.
“I especially find myself falling into a Southern accent, which is crazy,” Mr. Allieri, the telecom executive, said. “I’m from Boston.
“But I think what good salespeople really do is pick up on physical cues and respond to them without thinking much about it.”
It is one thing to move like a naturally synchronized swimmer through the pools of everyday conversation without thinking, however. It is another to deliberately employ mimicry to persuade or seduce.
Dr. Bailenson, the Stanford psychologist, has been testing the effects of different forms of mimicry by programming a computer-generated figure, an avatar, to mirror the movements and gestures of people in a study.
He has found that his subjects pick up the mimicry when it is immediate and precise. If the avatar is slightly out of sync, however — waits four seconds, for instance — then the mimicking goes unnoticed, and the usual rules apply. The virtual creating comes across as warm and convincing, as if controlled by another human.
“The point is it’s a delicate balance to get it right, and I suspect that people who are good at this know how to do it intuitively,” Dr. Bailenson said.
Or they have developed ways to engage their skills indirectly.
Veldon Smith, a musician and legendary salesman living in Centennial, Colo., who spent 30 years in the automobile parts business before retiring a few years ago, said:
“One thing I always did, I learned as much as possible about a client before I visited, what their problem was, what they were worried about. Then I would go in with a story about myself being in the same predicament.
“So when I walked in, I was in exactly the same frame of mind as the customer. I was immediately on the same wavelength. Everything else kind of flowed out of that.”
One reason subtle mimicry is so instantly beguiling may be that it draws on and, perhaps, activates brain circuits involved in feelings of empathy.
In several studies, Jean Decety, a neuroscientist at the University of Chicago, has shown that some of the same brain regions that are active when a person feels pain also flare up when that person imagines someone else like a loved one feeling the same sting or ache.
A similar process almost certainly occurs when a person takes pleasure in the good fortune of a friend or the apparent enjoyment of a conversation partner, Dr. Decety said.
“When you’re being mimicked in a good way, it communicates a kind of pleasure, a social high you’re getting from the other person, and I suspect it activates the areas of the brain involved in sensing reward,” he said.
Social mimicry can and does go wrong. At its malicious extreme, it curdles into mockery, which is why people often recoil when they catch of whiff of mimicry, ending any chance of a social bond. Preliminary studies suggest that the rules change if there is a wide cultural gap between two people. For almost everyone else, however, subtle mimicry comes across as a form of flattery, the physical dance of charm itself. And if that kind of flattery doesn’t close a deal, it may just be that the customer isn’t buying.
Everyone has the right to be charmed but not seduced.
The New York Times
February 10, 2008
Op-Ed Contributor
Learning From Britney’s Troubles
By MIA FONTAINE
THE involuntary hospitalization of Britney Spears last week brought back memories. Ten years ago, when I was 15, I was a high school dropout and heroin addict, living in the back of a dealer’s van. My mom first noticed red flags at 14: rapid weight loss, self-mutilation, coming home high, irregularly showering. The therapist she had me see, as well as my school counselor, believed that, cutting aside, my actions were typical teenage behavior. The first time I ran away, though, my mother formed her own conclusions, and got a 5150 issued — California code for the involuntary 72-hour psychiatric hold that Ms. Spears was under, before she left the hospital on Wednesday.
I wish I had seen my first, forced hospitalization as the gift it was.
For Ms. Spears, when the 72 hours called for under the 5150 order ended last Sunday, one of three things could have happened: she could have signed herself out or voluntarily committed herself, or doctors at her hospital could have issued another hold, called a 5250, after determining she was “gravely disabled.”
Curiously, the paparazzi — often blamed for contributing to Ms. Spears’s problems — may well helped with the solution this time: they provided ample documentation to support the doctors’ decision to issue a 5250, which can extend a hold as long as 14 days. For patients whose every move isn’t followed and recorded, however, an extension is exceedingly difficult to obtain. Unlike the 5150, which can be issued by any qualified California officer or clinician, the extended hold must be upheld by a court-appointed commissioner.
Involuntary hospitalization becomes still more complicated when you’re dealing with bipolar disease, the very nature of which is cyclical. Being crazy doesn’t make you stupid. As long as you refrain from attempting suicide, homicide or any other documentable action (legally, there needs to be “specific and articulable” evidence of your inability to function normally to continue a hold), you’re free to sign yourself out. Which, 14 days after my admittance, I did, despite my mother’s protests.
As a minor, I would have needed parental consent to get a tattoo, yet when it came to my mental health, the law put me, a drug-addled teenager, in complete control. Only when I landed in a Utah jail with felony drug charges was I finally compelled to receive treatment. By chance, the state I was in at the time of my arrest was one of the few that gave parents the ability to put children in treatment over their objections.
This reality is at odds with the popular conception, abetted by Hollywood movies, of involuntary commitment (sane people being forced into psychiatric hospitals is a horror film staple, after all). Oddly enough, it was a former actor, Ronald Reagan, who did much to restrict its use. As California’s governor in 1967, Mr. Reagan signed a law that set a national precedent of required judicial hearings for extended involuntary commitment (the 5250) and the prohibition of forced medication, among others.
Hamstrung by the new laws, parents of mentally ill and drug-addicted young adults can now do little but stand by helplessly. What’s more, bizarre behavior once limited to adolescents — sudden weight loss, public temper tantrums, gruesome exhibitionism — are enshrined on the covers of Us Weekly and Star. (It’s a sad paradox that Ms. Spears fell prey to the culture she was helping create.)
Ms. Spears’s situation outlines the dangers of blurring the line between socially celebrated behavior and behavior with profound psychological causes. And while her friends and relatives (and a world of transfixed fans) seem to be able to differentiate the two, and recognize that Ms. Spears needs help, now our legal system can’t or doesn’t care to treat someone until he or she has endangered others or themselves, often irreversibly.
Granted, the laws that once allowed us to force adults into treatment could be abused: extreme electroshock therapy, lobotomies, philandering husbands committing their wives, embarrassingly promiscuous daughters being locked up. But in trying to eliminate the possibility that someone could be wrongly committed, we have cast out Britney Spears, and others much less famous, from the havens where they might have been helped.
They need to be brought back.
Mia Fontaine is the co-author of the memoir “Comeback: A Mother and Daughter’s Journey Through Hell and Back.”
February 10, 2008
Op-Ed Contributor
Learning From Britney’s Troubles
By MIA FONTAINE
THE involuntary hospitalization of Britney Spears last week brought back memories. Ten years ago, when I was 15, I was a high school dropout and heroin addict, living in the back of a dealer’s van. My mom first noticed red flags at 14: rapid weight loss, self-mutilation, coming home high, irregularly showering. The therapist she had me see, as well as my school counselor, believed that, cutting aside, my actions were typical teenage behavior. The first time I ran away, though, my mother formed her own conclusions, and got a 5150 issued — California code for the involuntary 72-hour psychiatric hold that Ms. Spears was under, before she left the hospital on Wednesday.
I wish I had seen my first, forced hospitalization as the gift it was.
For Ms. Spears, when the 72 hours called for under the 5150 order ended last Sunday, one of three things could have happened: she could have signed herself out or voluntarily committed herself, or doctors at her hospital could have issued another hold, called a 5250, after determining she was “gravely disabled.”
Curiously, the paparazzi — often blamed for contributing to Ms. Spears’s problems — may well helped with the solution this time: they provided ample documentation to support the doctors’ decision to issue a 5250, which can extend a hold as long as 14 days. For patients whose every move isn’t followed and recorded, however, an extension is exceedingly difficult to obtain. Unlike the 5150, which can be issued by any qualified California officer or clinician, the extended hold must be upheld by a court-appointed commissioner.
Involuntary hospitalization becomes still more complicated when you’re dealing with bipolar disease, the very nature of which is cyclical. Being crazy doesn’t make you stupid. As long as you refrain from attempting suicide, homicide or any other documentable action (legally, there needs to be “specific and articulable” evidence of your inability to function normally to continue a hold), you’re free to sign yourself out. Which, 14 days after my admittance, I did, despite my mother’s protests.
As a minor, I would have needed parental consent to get a tattoo, yet when it came to my mental health, the law put me, a drug-addled teenager, in complete control. Only when I landed in a Utah jail with felony drug charges was I finally compelled to receive treatment. By chance, the state I was in at the time of my arrest was one of the few that gave parents the ability to put children in treatment over their objections.
This reality is at odds with the popular conception, abetted by Hollywood movies, of involuntary commitment (sane people being forced into psychiatric hospitals is a horror film staple, after all). Oddly enough, it was a former actor, Ronald Reagan, who did much to restrict its use. As California’s governor in 1967, Mr. Reagan signed a law that set a national precedent of required judicial hearings for extended involuntary commitment (the 5250) and the prohibition of forced medication, among others.
Hamstrung by the new laws, parents of mentally ill and drug-addicted young adults can now do little but stand by helplessly. What’s more, bizarre behavior once limited to adolescents — sudden weight loss, public temper tantrums, gruesome exhibitionism — are enshrined on the covers of Us Weekly and Star. (It’s a sad paradox that Ms. Spears fell prey to the culture she was helping create.)
Ms. Spears’s situation outlines the dangers of blurring the line between socially celebrated behavior and behavior with profound psychological causes. And while her friends and relatives (and a world of transfixed fans) seem to be able to differentiate the two, and recognize that Ms. Spears needs help, now our legal system can’t or doesn’t care to treat someone until he or she has endangered others or themselves, often irreversibly.
Granted, the laws that once allowed us to force adults into treatment could be abused: extreme electroshock therapy, lobotomies, philandering husbands committing their wives, embarrassingly promiscuous daughters being locked up. But in trying to eliminate the possibility that someone could be wrongly committed, we have cast out Britney Spears, and others much less famous, from the havens where they might have been helped.
They need to be brought back.
Mia Fontaine is the co-author of the memoir “Comeback: A Mother and Daughter’s Journey Through Hell and Back.”
Sunday, February 10, 2008
Metaphors matter. - title of my inspiration day book with 365 stories and metaphors.
Wednesday, February 06, 2008
The New York Times
February 5, 2008
Well
Coping With the Caveman in the Crib
By TARA PARKER-POPE
If there is such a person as a “baby whisperer,” it is the pediatrician Dr. Harvey Karp, whose uncanny ability to quiet crying babies became the best-selling book “The Happiest Baby on the Block.”
Dr. Karp’s method, endorsed by child advocates and demonstrated in television appearances and a DVD version of his book, shows fussy babies who are quickly, almost eerily soothed by a combination of tight swaddling, loud shushing and swinging, which he says mimics the sensations of the womb.
Now Dr. Karp, assistant professor of pediatrics at the University of California, Los Angeles, has turned his attention to the toddler years, that explosive period of development when children learn language, motor skills and problem solving, among other things. The rapid pace at which all these changes occur is nothing short of astonishing, but it can also be overwhelming to little brains. A wailing baby is nothing compared with the defiant behavior and tantrums common among toddlers.
In his latest book, “The Happiest Toddler on the Block,” Dr. Karp tries to teach parents the skills to communicate with and soothe tantrum-prone children. In doing so, however, he redefines what being a toddler means. In his view, toddlers are not just small people. In fact, for all practical purposes, they’re not even small Homo sapiens.
Dr. Karp notes that in terms of brain development, a toddler is primitive, an emotion-driven, instinctive creature that has yet to develop the thinking skills that define modern humans. Logic and persuasion, common tools of modern parenting, “are meaningless to a Neanderthal,” Dr. Karp says.
The challenge for parents is learning how to communicate with the caveman in the crib. “All of us get more primitive when we get upset, that’s why they call it ‘going ape,’ ” Dr. Karp says. “But toddlers start out primitive, so when they get upset, they go Jurassic on you.”
Improving the ways parents cope with crying and tantrums isn’t just a matter of convenience. “The No. 1 precipitant to child abuse is the kid who cries and gets upset and doesn’t settle down and whines and whines,” says Robert Fox, professor of psychology at Marquette University and director of the behavior clinic at Penfield Children’s Center in Milwaukee. “It’s a real vulnerable situation for abuse.”
Dr. Karp’s baby program has been endorsed by several government health agencies, leaders of Prevent Child Abuse America and others. Dr. Karp will discuss his toddler program in an address to the Early Head Start program, which provides early childhood services to low-income families.
But Dr. Karp’s method of toddler communication is not for the self-conscious. It involves bringing yourself, both mentally and physically, down to a child’s level when he or she is upset. The goal is not to give in to a child’s demands, but to communicate in a child’s own language of “toddler-ese.”
This means using short phrases with lots of repetition, and reflecting the child’s emotions in your tone and facial expressions. And, most awkward, it means repeating the very words the child is using, over and over again.
For instance, a toddler throwing a tantrum over a cookie might wail, “I want it. I want it. I want cookie now.”
Often, a parent will adopt a soothing tone saying, “No, honey, you have to wait until after dinner for a cookie.”
Such a response will, almost certainly, make matters worse. “It’s loving, logical and reasonable,” notes Dr. Karp. “And it’s infuriating to a toddler. Now they have to say it over harder and louder to get you to understand.”
Dr. Karp adopts a soothing, childlike voice to demonstrate how to respond to the toddler’s cookie demands.
“You want. You want. You want cookie. You say, ‘Cookie, now. Cookie now.’ ”
It’s hard to imagine an adult talking like this in a public place. But Dr. Karp notes that this same form of “active listening” is a method adults use all the time. The goal is not simply to repeat words but to make it clear that you hear someone’s complaint. “If you were upset and fuming mad, I might say, ‘I know. I know. I know. I get it. I’m really really sorry. I’m sorry.’ That sounds like gibberish out of context,” he says.
On his DVD, Dr. Karp demonstrates the method. Within seconds, teary-eyed toddlers calm and look at him quizzically as he repeats their concerns back at them. Once the child has calmed, a parent can explain the reason for saying no, offer the child comfort and a happy alternative to the original demand.
Dr. Karp also offers methods for teaching children patience, and he suggests regularly giving children small victories — like winning at a game of wrestling. “If you give them these little victories all day long, when you want them to do something for you, they’re much more likely to do it.”
Sometimes, excessive tantrums can signal an underlying health problem, so parents with a difficult child should consult with a pediatrician.
“The thing about toddlers is that they are uncivilized,” Dr. Karp says. “Our job is to civilize them, to teach them to say please and thank you, don’t spit and scratch and don’t pee anywhere you want. These are the jobs you have with a toddler.”
February 5, 2008
Well
Coping With the Caveman in the Crib
By TARA PARKER-POPE
If there is such a person as a “baby whisperer,” it is the pediatrician Dr. Harvey Karp, whose uncanny ability to quiet crying babies became the best-selling book “The Happiest Baby on the Block.”
Dr. Karp’s method, endorsed by child advocates and demonstrated in television appearances and a DVD version of his book, shows fussy babies who are quickly, almost eerily soothed by a combination of tight swaddling, loud shushing and swinging, which he says mimics the sensations of the womb.
Now Dr. Karp, assistant professor of pediatrics at the University of California, Los Angeles, has turned his attention to the toddler years, that explosive period of development when children learn language, motor skills and problem solving, among other things. The rapid pace at which all these changes occur is nothing short of astonishing, but it can also be overwhelming to little brains. A wailing baby is nothing compared with the defiant behavior and tantrums common among toddlers.
In his latest book, “The Happiest Toddler on the Block,” Dr. Karp tries to teach parents the skills to communicate with and soothe tantrum-prone children. In doing so, however, he redefines what being a toddler means. In his view, toddlers are not just small people. In fact, for all practical purposes, they’re not even small Homo sapiens.
Dr. Karp notes that in terms of brain development, a toddler is primitive, an emotion-driven, instinctive creature that has yet to develop the thinking skills that define modern humans. Logic and persuasion, common tools of modern parenting, “are meaningless to a Neanderthal,” Dr. Karp says.
The challenge for parents is learning how to communicate with the caveman in the crib. “All of us get more primitive when we get upset, that’s why they call it ‘going ape,’ ” Dr. Karp says. “But toddlers start out primitive, so when they get upset, they go Jurassic on you.”
Improving the ways parents cope with crying and tantrums isn’t just a matter of convenience. “The No. 1 precipitant to child abuse is the kid who cries and gets upset and doesn’t settle down and whines and whines,” says Robert Fox, professor of psychology at Marquette University and director of the behavior clinic at Penfield Children’s Center in Milwaukee. “It’s a real vulnerable situation for abuse.”
Dr. Karp’s baby program has been endorsed by several government health agencies, leaders of Prevent Child Abuse America and others. Dr. Karp will discuss his toddler program in an address to the Early Head Start program, which provides early childhood services to low-income families.
But Dr. Karp’s method of toddler communication is not for the self-conscious. It involves bringing yourself, both mentally and physically, down to a child’s level when he or she is upset. The goal is not to give in to a child’s demands, but to communicate in a child’s own language of “toddler-ese.”
This means using short phrases with lots of repetition, and reflecting the child’s emotions in your tone and facial expressions. And, most awkward, it means repeating the very words the child is using, over and over again.
For instance, a toddler throwing a tantrum over a cookie might wail, “I want it. I want it. I want cookie now.”
Often, a parent will adopt a soothing tone saying, “No, honey, you have to wait until after dinner for a cookie.”
Such a response will, almost certainly, make matters worse. “It’s loving, logical and reasonable,” notes Dr. Karp. “And it’s infuriating to a toddler. Now they have to say it over harder and louder to get you to understand.”
Dr. Karp adopts a soothing, childlike voice to demonstrate how to respond to the toddler’s cookie demands.
“You want. You want. You want cookie. You say, ‘Cookie, now. Cookie now.’ ”
It’s hard to imagine an adult talking like this in a public place. But Dr. Karp notes that this same form of “active listening” is a method adults use all the time. The goal is not simply to repeat words but to make it clear that you hear someone’s complaint. “If you were upset and fuming mad, I might say, ‘I know. I know. I know. I get it. I’m really really sorry. I’m sorry.’ That sounds like gibberish out of context,” he says.
On his DVD, Dr. Karp demonstrates the method. Within seconds, teary-eyed toddlers calm and look at him quizzically as he repeats their concerns back at them. Once the child has calmed, a parent can explain the reason for saying no, offer the child comfort and a happy alternative to the original demand.
Dr. Karp also offers methods for teaching children patience, and he suggests regularly giving children small victories — like winning at a game of wrestling. “If you give them these little victories all day long, when you want them to do something for you, they’re much more likely to do it.”
Sometimes, excessive tantrums can signal an underlying health problem, so parents with a difficult child should consult with a pediatrician.
“The thing about toddlers is that they are uncivilized,” Dr. Karp says. “Our job is to civilize them, to teach them to say please and thank you, don’t spit and scratch and don’t pee anywhere you want. These are the jobs you have with a toddler.”
disneyfication
The act of taming the world to make it all safe, clean, and completely simlar to a theme park.
To remove the sharp edges and darkness that is life.
NYC suffered from disneyfication under Rudy, and now is as boring as any small town USA
To censor or bar so that the entire world is safe for a 3 year old to walk into at any time; to prohibit all adult activities; to censor with the aim of 'protecting families'.
They got rid of all the adult book stores as part of their plan for the disneyfication of down town.
The act of taming the world to make it all safe, clean, and completely simlar to a theme park.
To remove the sharp edges and darkness that is life.
NYC suffered from disneyfication under Rudy, and now is as boring as any small town USA
To censor or bar so that the entire world is safe for a 3 year old to walk into at any time; to prohibit all adult activities; to censor with the aim of 'protecting families'.
They got rid of all the adult book stores as part of their plan for the disneyfication of down town.
Friday, February 01, 2008
The New York Times
January 31, 2008
The Slow Life Picks Up Speed
By PENELOPE GREEN
“I HAVE a little spiel I like to give about thread,” Natalie Chanin said the other day. “The ladies laugh at me and call it my Oprah moment, but here’s how it goes: It’s called loving your thread, and it’s all about talking to the thread, coaxing it to take the path of least resistance. At the crux of it, that’s what Slow Design is all about.”
Ms. Chanin runs a company, Alabama Chanin, that sells exquisite hand-stitched garments made from old T-shirts and home goods like flea market chairs with seats woven out of Goodwill neckties. Designed by Ms. Chanin and her collaborator, Butch Anthony, and hand-made by artisans — the ladies, as she calls them — in her hometown of Florence, Ala., her products are examples of Slow Design, which is not so much a metabolic term as it is a philosophical one.
Slow means that Alabama Chanin is run on the tenets of the Slow Food movement, which essentially challenges one to use local ingredients harvested and put together in a socially and environmentally responsible way. Above all it emphasizes slowness in the creation and consumption of products as a corrective to the frenetic pace of 21st-century life. “Good, clean and fair” is the Slow Food credo, and it has — rather slowly — begun to make its way out of the kitchen and into the rest of the house.
While Slow Food is now in its third decade, an established global movement with an official manifesto and about 85,000 members in over 100 countries, Slow Design is still in its infancy. But it does have an increasing number of proselytizers, like John Brown, an architect in Calgary, Alberta, whose year-old Web site, theslowhome.com, urges consumers to say no to “fast-food architecture,” and Geir Berthelsen, a Norwegian motivational speaker whose Web site slowplanet.com, which is to go online in mid-March, has as its goal to be a hub for all things slow, from slow travel to slow shopping to slow design, he said. Ms. Chanin, meanwhile, has a book, “Alabama Stitch Book: Projects and Stories Celebrating Hand-Sewing, Quilting, and Embroidery for Contemporary Sustainable Design” (Stewart, Tabori & Chang) due out in March. It gives instructions on how to make her stenciled, poetry-embellished sheets and teaches her Slow credo, which is to use discarded materials to make something new — and to take as long as necessary doing it.
For some designers, that means leaving the studio. Christien Meindertsma, a Dutch designer, knits rugs on needles as long as yardsticks with wool spun from the fleece of Welsh sheep she’s seen in person. That’s very slow, meeting your wool. (Ms. Meindertsma’s company is called Flocks.)
Other objects for the home are being designed to operate like speed bumps for those who may be living life too fast: Thorunn Arnadottir, an Icelandic designer, made a clock using a string of beads draped over a notched metal disc. One bead drops every five minutes, marking time in a way that seems to slow it down. Remove the beads, and you get to stop time. A rattan basket designed by Alastair Fuad-Luke, a British sustainable design facilitator, as he described himself recently, will tip over if filled too quickly, “thus momentarily slowing you down as you rebalance it,” explained Mr. Fuad-Luke. (A student of Mr. Fuad-Luke’s once designed an actual speed bump for a living room. “You’d either step over it,” he said, “or perhaps you’d lie down and give it a cuddle.”)
Katrin Svana Eythorsdottir, another designer from Iceland, made a “chandelier” from beads of glucose that clung to twine and caught the natural light. After five months, the chandelier disintegrated (as Ms. Eythorsdottir, who wanted to create a temporary, biodegradable object, had intended). It is true that a decomposing chandelier seems sort of fast, but as it turns out a domestic object with a built-in expiration date is a slow notion, said Carolyn Strauss, a designer, curator and the founder of SlowLab, a three-year-old design think tank with offices in Manhattan and Amsterdam that’s devoted to searching out the slow in cutting-edge design.
“You wouldn’t buy that chandelier and go away on a two-week vacation,” Ms. Strauss said. “It’s an object you’d really cherish because of its temporary and therefore precious nature.”
Ms. Strauss admires what she calls the slowest sofa ever made, a group project from Raw Nerve, a graphic design and branding company in London. Their Life Is Suite couch began as a tufted leather number that eight Raw Nerve designers found on the street one day a few years ago. “We could see it had quite a life,” said Kieran McMillan, Raw Nerve’s director, who explained how the designers spent weeks creating eight imaginary stories — about a couple bickering, for example, and a grandfather reading to a child — and printed them on fabric with which they reupholstered the sofa. “We also thought about all the things that might have fallen in between the seats, like coins and playing cards and the heel of a shoe, and made images of those, too. Then we thought about the parents of the sofa — which is made from wood and leather — so there’s a picture of a cow and a tree on there as well.”
Unlike similar sofas and chairs they’ve made since, this Life Is Suite sofa is not for sale. “It’s our pride and joy,” Mr. McMillan said.
Slow may be green and eco-friendly, but it tucks more into its pockets. While Pottery Barn’s new Botanica line of furniture is made with sustainable materials like soy foam, organic cotton and recycled plastic bottles, the fact that it is mass-produced from cotton grown in India means it can never be slow.
Here’s a poignant example of slow gone fast. Natalie Chanin’s first company, Project Alabama, also ran on slow principles, making couture garments hand-stitched by the same ladies who now work at Alabama Chanin. But it was so successful — with hosannas from Vogue magazine and $2 million in sales in 2005 — that Ms. Chanin’s business partners decided to outsource the work to India.
Since the company abandoned its original mission, said Ms. Chanin, who resigned in 2006, “I decided to start over.”
Slow, as Carl Honoré, a Canadian journalist living in London, pointed out, is sometimes just a state of mind. His 2005 book, “In Praise of Slow: Challenging the Cult of Speed” (HarperOne), collected all manner of slow movements, from tantric sex to Slow Food to the Society for the Deceleration of Time, a civic group based Austria that once called on Olympics organizers to award gold medals to athletes who had the slowest times.
“Sometimes it’s more of a click in attitude than anything else,” said Mr. Honoré, who once got a speeding ticket on his way to a Slow Food meal in Italy, where the movement was born.
Slow is also an idea, it seems, whose time has come. “When I was researching the book,” he continued, “if you Googled slow movement, there wasn’t anything. As a growing cultural quake it just wasn’t there. Now, of course, there are hundreds of sites, and every week I get an e-mail from a student wanting to write his or her thesis on slow cities or slow design.” As a result, traffic and queries at inpraiseofslow.com, Mr. Honoré’s blog, are overwhelming him, and he’s handing off his slow duties to Slowplanet, a Web site that he and Mr. Berthelsen are setting up together. “The time is now ripe for trying to formalize this slow revolution,” Mr. Berthelsen, the founder of the World Institute of Slowness, an advocacy group based in Kristiansand, Norway, said slowly last week. (He’d been to the dentist, he explained, and the Novocain hadn’t worn off yet). In his lectures to corporate Europe, Mr. Berthelsen, urges workers to work smarter, not faster or harder, and to become more aware of the process than the product. “I always lived under the mantra that the fast will beat the big ... but the slow will beat the fast.”
In a world on hyperdrive, science is proving him to be right. A 2005 study sponsored by Hewlett-Packard showed that the I.Q.s of workers who responded quickly to the constant barrage of e-mails they received during the day fell 10 points, more than double the I.Q. drop of someone smoking marijuana.
“Fast isn’t turning us into Masters of the Universe,” Mr. Honoré said. “It’s turning us into Cheech and Chong.”
Mr. Brown, in Calgary, who makes his case for the artisanal house (designed by an actual architect, not a developer) on theslowhome.com, would go even further, suggesting that fast can make you fat and make you sick.
“A cookie cutter house in a new development is like a Big Mac and fries,” he said the other day. Not only are you undernourished by awkward spaces and huge houses, he said, but far-away developments require lots of driving, stealing your time and your health. Mr. Brown’s hope is to raise awareness “about resources and options,” he said. “If you learn about materials, think about where your house comes from, you’re going to be more involved with the culture of the house, rather than just engaging with it as a financial instrument.”
Mr. Brown and others are essentially rebranding familiar ideas — like those of the New Urbanists, for example — not only about how to build responsibly but how to stay grounded in a too-fast, overdeveloped age.
“Slow is just a new word to understand old problems,” Mr. Honoré said. “It’s a re-freshening of ideas that have been there since time immemorial. But there’s a new appeal about the word slow. It’s pithy, it’s countercultural.”
But it may not be American. Mr. Honoré’s publisher in the United States couldn’t get a handle on the word. “They thought it was ungrammatical or something,” he said. Which is why in this country his book is titled, “In Praise of Slowness,” much to Mr. Honoré’s amusement. “Slow is the word that’s escaped from the Anglosphere and attached itself to everything going,” he said, listing a few examples, like Italy’s Slow Cities and Japan’s Slow Life movement, “whereas Slowness hasn’t.”
In any case, evangelists for the movement are coming to New York, America’s fastest city, on Feb. 25. On that day, members of the Art of Slow Living, an Italian civic group, will be handing out symbolic speeding tickets to frantic pedestrians, said its organizer, Bruno Contigiani — that is, if he can get a permit from the Parks Department to organize in Union Square. Feb. 25 falls on a Monday, which, as Mr. Contigiani pointed out in an e-mail message, is a hard day to slow down.
January 31, 2008
The Slow Life Picks Up Speed
By PENELOPE GREEN
“I HAVE a little spiel I like to give about thread,” Natalie Chanin said the other day. “The ladies laugh at me and call it my Oprah moment, but here’s how it goes: It’s called loving your thread, and it’s all about talking to the thread, coaxing it to take the path of least resistance. At the crux of it, that’s what Slow Design is all about.”
Ms. Chanin runs a company, Alabama Chanin, that sells exquisite hand-stitched garments made from old T-shirts and home goods like flea market chairs with seats woven out of Goodwill neckties. Designed by Ms. Chanin and her collaborator, Butch Anthony, and hand-made by artisans — the ladies, as she calls them — in her hometown of Florence, Ala., her products are examples of Slow Design, which is not so much a metabolic term as it is a philosophical one.
Slow means that Alabama Chanin is run on the tenets of the Slow Food movement, which essentially challenges one to use local ingredients harvested and put together in a socially and environmentally responsible way. Above all it emphasizes slowness in the creation and consumption of products as a corrective to the frenetic pace of 21st-century life. “Good, clean and fair” is the Slow Food credo, and it has — rather slowly — begun to make its way out of the kitchen and into the rest of the house.
While Slow Food is now in its third decade, an established global movement with an official manifesto and about 85,000 members in over 100 countries, Slow Design is still in its infancy. But it does have an increasing number of proselytizers, like John Brown, an architect in Calgary, Alberta, whose year-old Web site, theslowhome.com, urges consumers to say no to “fast-food architecture,” and Geir Berthelsen, a Norwegian motivational speaker whose Web site slowplanet.com, which is to go online in mid-March, has as its goal to be a hub for all things slow, from slow travel to slow shopping to slow design, he said. Ms. Chanin, meanwhile, has a book, “Alabama Stitch Book: Projects and Stories Celebrating Hand-Sewing, Quilting, and Embroidery for Contemporary Sustainable Design” (Stewart, Tabori & Chang) due out in March. It gives instructions on how to make her stenciled, poetry-embellished sheets and teaches her Slow credo, which is to use discarded materials to make something new — and to take as long as necessary doing it.
For some designers, that means leaving the studio. Christien Meindertsma, a Dutch designer, knits rugs on needles as long as yardsticks with wool spun from the fleece of Welsh sheep she’s seen in person. That’s very slow, meeting your wool. (Ms. Meindertsma’s company is called Flocks.)
Other objects for the home are being designed to operate like speed bumps for those who may be living life too fast: Thorunn Arnadottir, an Icelandic designer, made a clock using a string of beads draped over a notched metal disc. One bead drops every five minutes, marking time in a way that seems to slow it down. Remove the beads, and you get to stop time. A rattan basket designed by Alastair Fuad-Luke, a British sustainable design facilitator, as he described himself recently, will tip over if filled too quickly, “thus momentarily slowing you down as you rebalance it,” explained Mr. Fuad-Luke. (A student of Mr. Fuad-Luke’s once designed an actual speed bump for a living room. “You’d either step over it,” he said, “or perhaps you’d lie down and give it a cuddle.”)
Katrin Svana Eythorsdottir, another designer from Iceland, made a “chandelier” from beads of glucose that clung to twine and caught the natural light. After five months, the chandelier disintegrated (as Ms. Eythorsdottir, who wanted to create a temporary, biodegradable object, had intended). It is true that a decomposing chandelier seems sort of fast, but as it turns out a domestic object with a built-in expiration date is a slow notion, said Carolyn Strauss, a designer, curator and the founder of SlowLab, a three-year-old design think tank with offices in Manhattan and Amsterdam that’s devoted to searching out the slow in cutting-edge design.
“You wouldn’t buy that chandelier and go away on a two-week vacation,” Ms. Strauss said. “It’s an object you’d really cherish because of its temporary and therefore precious nature.”
Ms. Strauss admires what she calls the slowest sofa ever made, a group project from Raw Nerve, a graphic design and branding company in London. Their Life Is Suite couch began as a tufted leather number that eight Raw Nerve designers found on the street one day a few years ago. “We could see it had quite a life,” said Kieran McMillan, Raw Nerve’s director, who explained how the designers spent weeks creating eight imaginary stories — about a couple bickering, for example, and a grandfather reading to a child — and printed them on fabric with which they reupholstered the sofa. “We also thought about all the things that might have fallen in between the seats, like coins and playing cards and the heel of a shoe, and made images of those, too. Then we thought about the parents of the sofa — which is made from wood and leather — so there’s a picture of a cow and a tree on there as well.”
Unlike similar sofas and chairs they’ve made since, this Life Is Suite sofa is not for sale. “It’s our pride and joy,” Mr. McMillan said.
Slow may be green and eco-friendly, but it tucks more into its pockets. While Pottery Barn’s new Botanica line of furniture is made with sustainable materials like soy foam, organic cotton and recycled plastic bottles, the fact that it is mass-produced from cotton grown in India means it can never be slow.
Here’s a poignant example of slow gone fast. Natalie Chanin’s first company, Project Alabama, also ran on slow principles, making couture garments hand-stitched by the same ladies who now work at Alabama Chanin. But it was so successful — with hosannas from Vogue magazine and $2 million in sales in 2005 — that Ms. Chanin’s business partners decided to outsource the work to India.
Since the company abandoned its original mission, said Ms. Chanin, who resigned in 2006, “I decided to start over.”
Slow, as Carl Honoré, a Canadian journalist living in London, pointed out, is sometimes just a state of mind. His 2005 book, “In Praise of Slow: Challenging the Cult of Speed” (HarperOne), collected all manner of slow movements, from tantric sex to Slow Food to the Society for the Deceleration of Time, a civic group based Austria that once called on Olympics organizers to award gold medals to athletes who had the slowest times.
“Sometimes it’s more of a click in attitude than anything else,” said Mr. Honoré, who once got a speeding ticket on his way to a Slow Food meal in Italy, where the movement was born.
Slow is also an idea, it seems, whose time has come. “When I was researching the book,” he continued, “if you Googled slow movement, there wasn’t anything. As a growing cultural quake it just wasn’t there. Now, of course, there are hundreds of sites, and every week I get an e-mail from a student wanting to write his or her thesis on slow cities or slow design.” As a result, traffic and queries at inpraiseofslow.com, Mr. Honoré’s blog, are overwhelming him, and he’s handing off his slow duties to Slowplanet, a Web site that he and Mr. Berthelsen are setting up together. “The time is now ripe for trying to formalize this slow revolution,” Mr. Berthelsen, the founder of the World Institute of Slowness, an advocacy group based in Kristiansand, Norway, said slowly last week. (He’d been to the dentist, he explained, and the Novocain hadn’t worn off yet). In his lectures to corporate Europe, Mr. Berthelsen, urges workers to work smarter, not faster or harder, and to become more aware of the process than the product. “I always lived under the mantra that the fast will beat the big ... but the slow will beat the fast.”
In a world on hyperdrive, science is proving him to be right. A 2005 study sponsored by Hewlett-Packard showed that the I.Q.s of workers who responded quickly to the constant barrage of e-mails they received during the day fell 10 points, more than double the I.Q. drop of someone smoking marijuana.
“Fast isn’t turning us into Masters of the Universe,” Mr. Honoré said. “It’s turning us into Cheech and Chong.”
Mr. Brown, in Calgary, who makes his case for the artisanal house (designed by an actual architect, not a developer) on theslowhome.com, would go even further, suggesting that fast can make you fat and make you sick.
“A cookie cutter house in a new development is like a Big Mac and fries,” he said the other day. Not only are you undernourished by awkward spaces and huge houses, he said, but far-away developments require lots of driving, stealing your time and your health. Mr. Brown’s hope is to raise awareness “about resources and options,” he said. “If you learn about materials, think about where your house comes from, you’re going to be more involved with the culture of the house, rather than just engaging with it as a financial instrument.”
Mr. Brown and others are essentially rebranding familiar ideas — like those of the New Urbanists, for example — not only about how to build responsibly but how to stay grounded in a too-fast, overdeveloped age.
“Slow is just a new word to understand old problems,” Mr. Honoré said. “It’s a re-freshening of ideas that have been there since time immemorial. But there’s a new appeal about the word slow. It’s pithy, it’s countercultural.”
But it may not be American. Mr. Honoré’s publisher in the United States couldn’t get a handle on the word. “They thought it was ungrammatical or something,” he said. Which is why in this country his book is titled, “In Praise of Slowness,” much to Mr. Honoré’s amusement. “Slow is the word that’s escaped from the Anglosphere and attached itself to everything going,” he said, listing a few examples, like Italy’s Slow Cities and Japan’s Slow Life movement, “whereas Slowness hasn’t.”
In any case, evangelists for the movement are coming to New York, America’s fastest city, on Feb. 25. On that day, members of the Art of Slow Living, an Italian civic group, will be handing out symbolic speeding tickets to frantic pedestrians, said its organizer, Bruno Contigiani — that is, if he can get a permit from the Parks Department to organize in Union Square. Feb. 25 falls on a Monday, which, as Mr. Contigiani pointed out in an e-mail message, is a hard day to slow down.
