HERNANDO COLUMBUS, HIS FATHER’S SON. The Catalogue of Shipwrecked Books – Edward Wilson-Lee.

“Remember that you are dust, and unto dust you will return.”

Young Columbus and the Quest for a Universal Library.

Hernando’s travels in the realm of knowledge and the new routes he pioneered through it were in a very real sense akin to what his father had achieved.

To reconstruct Hernando’s life from his books is to find him present at many of the most significant events of the age of Renaissance, Reformation and exploration.

The fascinating history of Christopher Columbus’s illegitimate son Hernando, guardian of his father’s flame, courtier, bibliophile and catalogue supreme, whose travels took him to the heart of 16th century Europe.

This is the scarcely believable and wholly true story of Christopher Columbus’ bastard son Hernando, who sought to equal and surpass his father’s achievements by creating a universal library. His father sailed across the ocean to explore the known boundaries of the world for the glory of God, Spain and himself. His son Hernando sought instead to harness the vast powers of the new printing presses to assemble the world’s knowledge in one place, his library in Seville.

Hernando was one of the first and greatest visionaries of the print age, someone who saw how the scale of available information would entirely change the landscape of thought and society.

His was an immensely eventful life. As a youth, he spent years travelling in the New World, and spent one living with his father in a shipwreck off Jamaica. He created a dictionary and a geographical encyclopaedia of Spain, helped to create the first modern maps of the world, spent time in almost every major European capital, and associated with many of the great people of his day, from Ferdinand and Isabel to Erasmus, Thomas More, and Dürer. He wrote the first biography of his father, almost single-handedly creating the legend of Columbus that held sway for many hundreds of years, and was highly influential in crafting how Europe saw the world his father reached in 1492. He also amassed the largest collection of printed images and of printed music of the age, started what was perhaps Europe’s first botanical garden, and created by far the greatest private library Europe had ever seen, dwarfing with its 15,000 books every other library of the day.

Edward Wilson-Lee has written the first major modern biography of Hernando, and the first of any kind available in English. In a work of dazzling scholarship, The Catalogue of Shipwrecked Books tells an enthralling tale of the age of print and exploration, a story with striking lessons for our own modern experiences of information revolution and Globalisation.

Seville, Spain, 12 July 1539

On the morning of his death, Hernando Colén called for a bowl of dirt to be brought to him in bed. He told his servants that he was too weak to raise his arms and instructed them to rub the soil on his face. While many of them had been with him for a decade or more and were intensely loyal, they refused on this occasion to obey his orders, thinking he must finally have taken leave of his senses.

Hernando mustered the strength he needed and reached into the bowl by himself, smearing his face with the silt of the Guadalquivir, the river that meandered through Seville and held his house in the crook of its arm. As he painted himself with mud, Hernando spoke some words in Latin that began to make sense of this performance for those who had gathered at his side: remember that you are dust, he said, and unto dust you will return.

On the opposite bank of the river, Hernando’s father Christopher Columbus, Admiral of the Ocean Sea had recently been raised from the same soil, from a grave in which he had lain for thirty years. If Hernando’s word is to be believed (and for many things in Columbus’ life we have only Hernando’s word) the men who opened his tomb may have been surprised to find, along with the explorer’s bones, a pile of chains. These chains were a link to a moment in Hernando’s past, when at twelve years old his mostly absent father appeared bound in them, returning as a prisoner from the paradise he looked upon as his discovery and his gift to Spain.

The meaning of the great explorer’s grave-goods, of these chains that he wished to be placed with him in his tomb, was something Hernando only divulged late in life, when he came to write his father’s story. But the dust with which he painted himself on the morning of his death would have made sense to all around him: it was a symbol of abject humility, humility he knew he could afford to vaunt because there was no doubt he had achieved something extraordinary. Hernando, the man who was welcoming his impending decay with open arms, had built an engine capable of withstanding for ever the onslaught of time. He died shortly after this performance, at eight o’clock in the morning.

An hour later the next act in Hernando’s strange death pageant began. Those closest to him had gathered at his house for the reading of his will, reaching his Italianate villa by the river by passing through the Puerta de Goles (‘Hercules Gate’) and the garden of unknown plants. Hernando had an extraordinary memory, an obsession with lists, and a delicate conscience, so his will tabulated in minute detail the people to whom he felt he owed something, right down to a mule-driver whom he had shortchanged nearly two decades previously.

But after the tables of his conscience had been cleared, his testament moved on to its great crescendo, a declaration all but incomprehensible to his time. The main heir to his fortune was not a person at all, but rather his marvellous creation, his library. As this was the first time in living memory that someone in Europe had left their worldly wealth to a group of books, the act itself must have been somewhat confusing; but it was even harder to make sense of given the form of the library in question. Most of Hernando’s books were not like the precious manuscripts treasured by the great libraries of the day venerated tomes of theology, philosophy and law, books that were often sumptuously bound to reflect the great value placed upon them. Instead, much of Hernando’s collection consisted of books by authors of no fame or reputation, flimsy pamphlets, ballads printed on a single page and designed for pasting on tavern walls, and other such things that would have seemed just so much trash to many of his contemporaries.

To some eyes, the great explorer’s son had left a legacy of rubbish. Yet to Hernando these things were priceless because they brought him closer to the goal of a library that would collect everything, to become universal in a sense never before imagined. It was not even clear where this strange and multifarious collection began and ended: in addition to all these written works, there were chests and chests of printed images the largest collection ever gathered and more printed music than had ever been brought together before. As some accounts would have it, even the garden outside had begun to collect the plant life of the world and arrange it in its beds. There was, however, no word yet for such a botanical garden.

Visitors to the library would have been greeted by the strangest of sights. The scale of the collection must surely have been impressive, by far the largest private library of the day, blurring the vision as the number of individual items expanded beyond what could be taken in at a glance. Contributing to this disorientation, they might have noticed next that the walls of the library had disappeared. In their place were row upon row of books standing upright on their spines, stacked in this new vertical way in specially designed wooden cases. To the modern viewer these kinds of bookshelves are so familiar as to escape notice, but visitors to the library were encountering these as the first of their kind.

This was just one of many elements in Hernando’s fabulous library design that defied explanation, beginning with the inscription at the entrance proudly declaring the edifice was founded on shit. Inside the library, the baffling marvels multiplied: the bookless cages in which readers were supposed to sit, the chests full of volumes that should be turned over two or three times a year but were not for reading, the bookshop of useless titles.

Then there was the army of paid readers, and the fiendishly complex system of security and surveillance. Most mysterious of all, perhaps, was the master blueprint for the library, which lay in pieces: more than ten thousand scraps of paper, to be precise, each bearing a different hieroglyphic symbol. Each of the myriad ways these pieces could be put together suggested a different path through the library.

It was possible to puzzle out some elements of the design by simple logic: the creation of the bookshelves, for instance, had been a matter of necessity. While previous collections, with hundreds or a few thousand volumes, might be stacked on tables or in chests and could be found at will by a librarian of good memory, a library on the scale of Hernando’s would have overwhelmed even the most capacious of human minds and quickly overflowed from most rooms. The new bookshelves took very little space from any room and displaced the weight of the books on to the walls behind them. They formed orderly ranks, so that their call-numbers could be read from left to right, in a sequence like a line of text; storing the books vertically also meant each one could be removed easily, unlike the horizontal stacks where removing the bottom book would make those above topple.

But here the logic of the library-explorer may have broken down. What did the line of text, made up of the titles of the books in sequence, actually say? How was the wanderer in the library to navigate their way through this world of books? As anyone who has ambled through a library will know, order is everything. The ways in which books can be organised multiplies rapidly as the collection grows, and each shows the universe in a slightly different light. Order the books alphabetically by author and the wanderer will find all of the Pérezes and the Patels together, whether or not their books share anything else. Ordering by size will save space by fitting books of the same height into snug shelves, but this puts pocket novels in the same place as prayer books.

The wanderer in the library is lost without the order that catalogues and shelving systems create; Hernando referred to such unmapped collections as ‘dead’. But even with a map the wanderer is stuck with the order given to them by the librarian, unable to go through the collection in any other way, especially in a book-hoard flooded as Hernando’s was with the kind of cheap print previously excluded from these civilised spaces.

Breaking old paradigms, whether by discovering a new continent or by allowing a new universe of information into the decorous space of the library, was useless or even dangerous unless there was a new paradigm to take its place, a new vision of what these expanded worlds meant. Without this those who had once felt at home in the world would simply be stranded in a pathless sea of information. As a solution, Hernando’s library aimed not simply to be universal but to provide a set of propositions about how that universe fit together. Some of these propositions could be found in the books kept at the centre of the library, colour-coded in leather that was black, red or white, or embossed which contained his catalogues (including the enchanting and mysteriously named Catalogue of Shipwrecked Books) while others can only be pieced together from the ten thousand pieces of the final map to the collection, with their hieroglyphic signs.

But not everything in the library fitted on to the shelves or could be put in the catalogues. Hernando’s will left strict instructions that as soon as both of his executors were together, they were to open in each other’s presence a chest containing his personal papers. An inventory of these survives, though now worm-eaten and delicate as a form left in ash. Among other things, it lists

designs for a house

ballads for singing

recipes for medicine

a catalogue of plants and gardens

the case of Doha Isabel de Gamboa

the art of making nautical maps

a book of the travels of the emperor

plans for the conquest of Persia and Arabia

a system of charity for the poor

a verse life of Columbus

a poetical treatise

certain geographical writings on Spain

a dictionary

a dialogue between Goodwill, Power and Justice

a ledger of Columbus’ writings

certain papers on the de Arana family

Most of the hundred-odd entries in the inventory are illegible, but the parts that can be deciphered begin to give some sense of the myriad adventures of Hernando’s extraordinary mind. Some of these works by Hernando survive the immense dictionary he compiled by hand, the geographical encyclopedia he began on a personal tour around the whole of Spain, but many are lost entirely. The list, moreover, is not complete, and omits many of the things in which he played a part, including the maps he helped create, some of which changed the shape of the known world. Some of his works were likely not listed because they were no longer in his possession at the time of his death.

Among those writings mysteriously missing from this list is perhaps the most famous document of all: the biography of Columbus which was printed, in Italian translation, under Hernando’s name in Venice three decades after his death. To this Life and Deeds of the Admiral we owe much of what we know about the great explorer, including the details of his early life and many of his voyages, especially the fourth voyage, the part of Columbus’ life we know most richly and intimately because Hernando was there as an eyewitness.

Though Hernando was not quite eighteen when his father died, he had the kind of intense knowledge of him that no one else could possibly have not only as his son, but as someone who had lived with him, in a confined space and facing death, for more than a year in a strange land. The fact that the Life was not mentioned among Hernando’s papers, and the curious circumstances surrounding its appearance in Italy long after his death, has led to endless controversies. The original Spanish version of this work has never been found, so we are entirely reliant on the Italian translation. Various theories emerged, many proposing a forgery undertaken in Hernando’s name, a conspiracy to falsify the life of one of history’s greatest figures.

But the missing pieces of this puzzle were waiting to be found in the labyrinthine remnants of Hernando’s library. Somewhat over four thousand titles today form the Biblioteca Colombina, housed in a wing of Seville Cathedral, all silence and spotless marble like a mausoleum. These are only a fraction of the books that made up this once immense library, but this fraction along with the map of the original collections that survives in the catalogues is more than enough to reconstruct the life of an extraordinary man in resplendent detail, detail almost unthinkable for most people who lived in his time. This is because Hernando’s books contain within their covers not just an exquisitely detailed map of the Renaissance world, but also a map of his life. In every book he bought, Hernando recorded the date and place of its acquisition and how much it cost, often also noting where and when he read it, if he met with the author, or from whom he received the book if it was a gift. He also responded in many cases to what the books said, though as will become apparent he had his own singular way of doing so. These many fragments, when pieced together, give an account of one of the most fascinating lives in a period filled with entrancing characters; of a man who not only saw more of the world and what it had to offer than almost any of his contemporaries, but also one whose insights into this changing world were astonishingly prescient.

To reconstruct Hernando’s life from his books is to find him present at many of the most significant events of the age of Renaissance, Reformation and exploration. But Hernando’s view of these events is rather like one of the deceptive, ‘anamorphic’ paintings of which the age was so fond, in which a picture viewed from another angle reveals something entirely different. This is in part because Hernando’s mind moved ceaselessly from event to system, from a single thing to a general framework into which it could be fitted. This will quickly become clear in the story of his life, for while most biographies start with a list of documents about their subject that need to be set in order, many of the documents through which we know about Hernando are themselves lists: catalogues, encyclopedias, inventories, logbooks, which he compiled obsessively and compulsively. We should not be deceived by the staid and impersonal appearance of these lists, documents which at first seem all fact and no interpretation. To the trained eye, each contains a story: how the list-maker imagines the place for which they have packed the items, their way of seeing the world that lies behind a particular kind of ordering, the secrets being hidden by omissions from the list.

If Hernando attempted to bring order to his rapidly expanding world by reducing it to catalogue entries and finding ways of organising these lists that seemed logical, he was far from immune to distorting influences, distortions that can be traced to the core of his being. Much of his life can be explained by his desire to become worthy of, perhaps even equal to, the father he worshipped, though this was a father whom he in a sense created, as he slowly and deliberately shaped our collective memory of Columbus into the man known today.

In death and in life, many of Hernando’s actions were in conversation with the father he last saw in his youth, but whose voice he continued to hear and record long after. Their relationship, both before and after the explorer’s death, was inevitably affected by the fact that Hernando was not the product of a legitimate union, he was, in the delicate Spanish phrase, a natural son. Although Columbus never paid this distinction much mind, the circumstances of his birth meant Hernando could win legitimacy only by showing himself to be his father’s son in spirit. Hernando’s travels in the realm of knowledge and the new routes he pioneered through it were in a very real sense akin to what his father had achieved.

For all that he died nearly five centuries ago, Hernando’s discovery of his world bears striking, sometimes uncanny, resemblance to the one we are collectively discovering every day. Perhaps no one has been as helpless in the face of information as those who have lived through the beginning of the twenty-first century: the digital revolution has increased the amount of available information exponentially, and as a result we are wholly reliant on the search algorithms developed to navigate it, tools whose modes of ordering and ranking and categorising are quickly remaking our lives. The invention of print was another such revolution, and the tools developed in response to it profoundly shaped the world until yesterday, during the age of print. The way of seeing things created by the print library has become so natural to us as to be all but invisible; we forget that its form is far from inevitable, that it was the product of specific decisions with immense consequences, consequences which our current age, sleepwalking into new ways of organising knowledge by search algorithms, seems likely to face on an even larger and more pervasive scale.

Allegory of the Transience of Life (ca. 1480-90), 33.3 x 22.6 cm, engraving printed on vellum. In the collection of the British Museum. This print by the anonymous fifteenth century engraver Master I. A. M. of Zwolle is one example of the early prints collected by Hernando Columbus.

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Hernando was, in a sense, one of the first and greatest visionaries of the age of print. If his life has escaped the notice of previous generations, it was perhaps because the power of tools that order our reservoirs of information was not as obvious. To reconstruct his life is not only to recover a vision of the Renaissance age in unparalleled depth, but also to reflect upon the passions and intrigues that lie beneath our own attempts to bring order to the world.

PART I

THE SORCERER’S APPRENTICE

1 Return from Ocean

Hernando Colén’s earliest recorded memory is characteristically precise. It was an hour before sunrise on Wednesday, the 25th of September 1493. He was standing next to his older half-brother, Diego, looking out at the harbour of Cadiz. Dancing on the water in front of him was a constellation of lamps, on and above the decks of seventeen ships about to weigh anchor, preparing to return to the islands in the west where their father had first made landfall less than a year before. Christopher Columbus was now the ‘Admiral of the Ocean Sea’ and was of sufficient fame that chroniclers took down each detail of the scene in front of the five-year-old Hernando.

The fleet was formed of a number of lighter craft from Cantabria in the north of Spain, vessels made with wooden joinery so as not to be weighed down with iron nails, as well as the slower but more durable caravels. On board the ships were thirteen hundred souls, including artisans of every sort and labourers to reap the miraculous and uninterrupted harvests of which Columbus had told, but also wellbred caballeros who went for adventure rather than work.

A favourable wind had begun to freshen, and as the dawn grew behind the city the dots of lamplight would slowly have been connected by the cabins and masts and riggings to which they were fixed. The scene and the mood were triumphant: tapestries hung from the sides of the ships and pennants fluttered from the braided cables, while the stems were draped in the royal ensigns of the Reyes Catélicos (Catholic Monarchs), Ferdinand of Aragon and Isabella of Castile, the great sovereigns whose marriage had united a fragmented Spain. The piercing fanfare of hautboys, bagpipes, trumpets and clarions was so loud, according to one observer, that the Sirens and the spirits of the water were astonished, and the seabed resounded with the cannonades. At the harbour mouth a Venetian convoy, returning from a trade mission to Britain, augmented the noise with their own gunpowder salutes, preparing to follow Columbus part of the way in the hope of learning something of his course.

It is unclear whether, in later life, Hernando could reach back beyond this earliest recorded memory to the rather different circumstances in which, earlier that year, his father had returned from his first voyage across the Atlantic. Columbus had arrived back in Europe with only one of the three vessels with which he had left Spain on 3 August 1492: his flagship Santa Maria had run aground off Hispaniola on Christmas Eve, and on the return voyage he had lost sight of the Pinta during a storm near the Azores. Thirty-nine of Columbus’ original crew of ninety or so had been left on the other side of the ocean, in the newly founded settlement of La Navidad in Hispaniola, a town built from the shipwrecked lumber of the Santa Maria with the assistance of the local king or cacique, Guacanagari, and named in honour of the Christmas Day on which it was founded.

Columbus’ skeleton crew for the return voyage had been reduced to just three men when the rest were taken prisoner by unfriendly islanders in the Azores, though he did eventually secure their release. And when the great explorer finally did reach Europe in the only ship remaining to him, the Nina, he was running under bare poles after another heavy storm had split the sails. To make matters worse, he had arrived back not in Spain but in Portugal, dragging his ship past the Rock of Sintra to take shelter under the Castle of Almada in Lisbon estuary, where he was treated with suspicion before eventually receiving a summons to make his report to King Joéo. Though later reports would focus on the crowds who covered the harbour in their skiffs, swarming to see the island natives whom Columbus had brought home as part of his plunder, Columbus’ royal audience was for all intents and purposes an imprisonment, and his release was in part prompted by Joéo’s doubts regarding the discoverer’s claims. Hernando’s written records of these early events would record the hardship but leave out much of the confusion of this first return, of the forlorn man and his outlandish claims.

Hernando’s early life was unusual, perhaps unprecedented because from the youngest age his personal recollections of his father would have contended with widely circulated written accounts of Columbus’ exploits. He may have been present at Cordoba in March when a letter was read aloud at the cathedral announcing his father’s discoveries, and he kept as central relics in his library several editions of the letter, printed first at Barcelona, through which the discoveries were announced to the world. Hernando’s later collecting was to place at the heart of his universal library precisely this kind of cheap print whose first rustlings could be heard in these reports on Columbus’ voyage. The letter that was to be the common reading matter of Europe was written by Columbus when he landed in Portugal, and the crowds of Jews embarking from Lisbon harbour for Fez in north Africa would have served as a reminder that his ocean crossing would be forced to compete for public attention.

The tumultuous course of recent events had reached a peak of intensity in the early months of 1492, when with the taking of Granada Ferdinand and Isabella finally completed the Reconquista, the capture of the Spanish peninsula from the Muslims who had ruled it (almost whole or in parts) for seven hundred years, a crusade which was cast as the righteous restoration of Christian rule. In an attempt to transform the small symbolic victory at Granada into a turning point in the ancient clash between the Abrahamic faiths, the Reyes Catolicos celebrated their military triumph by presenting the Jews in their dominions with an ultimatum: forced conversion or exile. This was only an escalation of a long-standing Spanish history of persecuting those of the Jewish faith, but it proved a decisive one. Despite the fact that the Jewish community had been established in Iberia even longer than the Muslims, and had been central to the flourishing of culture and society in Arabic Spain, many of them could not stomach the price of keeping their homes, which included agreeing that their sacred Talmud was merely a forgery designed to stop the onward march of the Christian faith. Those who chose to stay also faced the prospect of having their property confiscated by the likes of Tomas de Torquemada, the leader of the Inquisition set up in 1478, who would use this fortune to finance a golden age of Spanish art and exploration.

A great multitude prepared to leave, and in their number went many of the greatest intellectuals of fifteenth-century Spain. Forced, as one chronicler records, to sell their houses for a donkey and their vineyards for a little bread, they made the most of the disaster by casting it as a new Exodus, in which the Lord of Hosts would lead them in triumph to the Promised Land. Observing this pathetic scene did not restrain the same chronicler from accusing them of secretly taking much of the kingdom’s gold with them. The rabbis attempted to alleviate any feeling of desperation by having the women and children sing to the sounds of timbrels as they walked away from their homes. Though the Jews were given temporary asylum in Portugal, their safe haven there lasted only as long as Columbus’ first voyage, and when their paths crossed in Lisbon the Jews were on the move again, boarding ships bound for north Africa.

Even in his travel-worn state Columbus was quick to find a way for his own expedition to play a part in this grand historic narrative. His voyage west had, after all, been given royal sanction from the camp at Santa Fe outside the walls of Granada, at which Ferdinand and Isabella were celebrating the recent capitulation of the city’s last Muslim king, Boabdil, and from which they would also later issue the edict expelling the Jews. The letter he sent ahead to Barcelona from Portugal sang of the marvellous fertility of the islands he had found, in perpetual bloom, and the naked innocence of the native people, who were willing to part with the abundant gold of that region for a few trifles from the visitors they regarded as descended from heaven. If the Jews had a new Exodus, Columbus offered Christians a new Eden. The letter announced that even if the natives knew nothing of Castile or of Christ, they showed themselves miraculously ready to serve both. As a token of their part in an expanded Spanish empire, Columbus had renamed these islands as he took possession of them, so that they now reflected the hierarchy of Spanish power, from Christ the Saviour on down through the monarchs and royal children:

San Salvador

Santa Maria de la Concepción

Fernandina

Isabela

Juana

Hispaniola

In its final paragraph the letter makes clear what has been implicit in the preceding pages, namely, that these islands Columbus had encountered should be added to the list of famous victories achieved by the Catholic Monarchs, one which like the conquest of the Moorish kingdoms and the expulsion of the Jews would expand both the dominion of the Church and fill the coffers of Spain.

This letter, soon printed again in Latin at Rome and Basel, and accompanied by a picture showing one man guiding a ship towards an endless and fertile archipelago, was one of the central relics of Hernando’s childhood, at once cheap and priceless, flimsy and timeless, manufactured and intimate, widely distributed and intensely personal. Overwriting the native place names with Spanish ones was only one of the word-tricks by which this New World was transformed, tricks that included set speeches through which Columbus and others legally ‘took possession’ of the islands, even though these speeches meant nothing to the indigenous peoples listening to them.

The former names began to lose their authority, and often were soon lost altogether, as Spanish power came to seem natural in a place with so many Spanish names. For all the momentous consequences of their actions, Columbus and his crew often seemed little conscious of the power of this act of naming. As Hernando was later to record, the last named island, Hispaniola, was so called because they caught there the same fish available in Spain (grey mullet, bass, salmon, shad, dory, skate, corvinas, sardines, crayfish).

The power of Columbus’ names to change the world was often at odds with the casual way in which he chose them: to commemorate a particular event or an impression of the landscape, or, as here, because it brought back a memory of somewhere he had been before. One of the most powerful experiences for Columbus the explorer, and for the European audience of his feats, was the feeling of having found the familiar in an unexpected place, and around these familiar things the European imagination of the New World began to form.

. . .

from

The Catalogue of Shipwrecked Books

by Edward Wilson-Lee

get it at Amazon.com

CHILDHOOD TRAUMA AND MENTAL ‘ILLNESS’. Beyond the smoke – Johann Hari.

Depression isn’t a disease; depression is a normal response to abnormal life experiences.

The medical team, and all their friends, expected these people, who had been restored to health to react with joy. Except they didn’t react that way. The people who did best, and lost the most weight were often thrown into a brutal depression, or panic, or rage. Some of them became suicidal.

Was there anything else that happened in your life when you were eleven? Well, Susan replied that was when my grandfather began to rape me.

“Overweight is overlooked, and that’s the way I need to be.”

What we had perceived as the problem, major obesity, was in fact, very frequently, the solution to problems that the rest of us knew nothing about. Obesity, he realized, isn’t the fire. It’s the smoke.

For every category of traumatic experience you go through as a kid, you are radically more likely to become depressed as an adult. The greater the trauma, the greater your risk of depression, anxiety, or suicide.

Emotional abuse especially, is more likely to cause depression than any other kind of trauma, even sexual molestation. Being treated cruelly by your parents is the biggest driver of depression, out of all these categories.

We have failed to see depression as a symptom of something deeper that needs to be dealt with. There’s a house fire inside many of us, and we’ve been concentrating on the smoke.

When the women first came into Dr. Vincent Felitti’s office some of them found it hard to fit through the door. These patients weren’t just a bit overweight: they were eating so much that they were rendering themselves diabetic and destroying their own internal organs. They didn’t seem to be able to stop themselves. They were assigned here, to his clinic, as their last chance.

It was the mid-1980s, and in the California city of San Diego, Vincent had been commissioned by the not-for-profit medical provider Kaiser Permanente to look into the fastest-growing driver of their costs, obesity. Nothing they were trying was working, so he was given a blank sheet of paper. Start from scratch, they said. Total blue-sky thinking. Figure out what we can do to deal with this. And so the patients began to come. But what he was going to learn from them led, in fact, to a major breakthrough in a very different area: how we think about depression and anxiety.

As he tried to scrape away all the assumptions that surround obesity, Vincent learned about a new diet plan based on a maddeningly simple thought. It asked: What if these severely overweight people simply stopped eating, and lived off the fat stores they’d built up in their bodies until they were down to a normal weight? What would happen?

In the news, curiously, there had recently been an experiment in which this was tried, eight thousand miles away, for somewhat strange reasons. For years in Northern Ireland if you were put in jail for being part of the Irish Republican Army’s violent campaign to drive the British out of Northern Ireland, you were classed as a political prisoner. That meant you were treated differently from people who committed (say) bank robberies. You were allowed to wear your own clothes, and you didn’t have to perform the same work as other inmates.

The British government decided to shut down that distinction, and they argued that the prisoners were simply common criminals and shouldn’t get this different treatment anymore. So the prisoners decided to protest by going on a hunger strike. They began, slowly, to waste away.

So the designers of this new diet proposal looked into the medical evidence about these Northern Ireland hunger strikers to find out what killed them. It turns out that the first problem they faced was a lack of potassium and magnesium. Without them, your heart stops beating properly. Okay, the radical dieters thought, what if you give people supplements of potassium and magnesium? Then that doesn’t happen. If you have enough fat on you, you get a few months more to live, until a protein deficiency kills you.

Okay, what if you also give people the supplements that will prevent that? Then, it turns out, you get a year to live, provided there’s enough fat. Then you’ll die from a lack of vitamin C, scurvy, or other deficiencies.

Okay, what if you give people supplements for that, too? Then it looks as though you’ll stay alive, Vincent discovered in the medical literature, and healthy, and you’ll lose three hundred pounds a year. Then you can start eating again, at a healthy level.

All this suggested that in theory, even the most obese person would be down to a normal weight within a manageable time. The patients coming to him had been through everything, every fad diet, every shaming, every prodding and pulling. Nothing had worked. They were ready to try anything. So, under careful monitoring, and with lots of supervision, they began this program. And as the months passed, Vincent noticed something. It worked. The patients were shedding weight. They were not getting sick, in fact, they were returning to health. People who had been rendered disabled by constant eating started to see their bodies transform in front of them.

Their friends and relatives applauded. People who knew them were amazed. Vincent believed he might have found the solution to extreme overweight. “I thought my god, we’ve got this problem licked,” he said.

And then something happened that Vincent never expected.

In the program, there were some stars, people who shed remarkable amounts of weight, remarkably quickly. The medical team, and all their friends, expected these people who had been restored to health to react with joy. Except they didn’t react that way.

The people who did best, and lost the most weight were often thrown into a brutal depression, or panic, or rage. Some of them became suicidal. Without their bulk, they felt they couldn’t cope. They felt unbelievably vulnerable. They often fled the program, gorged on fast food, and put their weight back on very fast.

Vincent was baffled. They were fleeing from a healthy body they now knew they could achieve, toward an unhealthy body they knew would kill them. Why? He didn’t want to be an arrogant, moralistic doctor, standing over his patients, wagging his finger and telling them they were ruining their lives, that’s not his character. He genuinely wanted to help them save themselves. So he felt desperate. That’s why he did something no scientist in this field had done with really obese people before. He stopped telling them what to do, and started listening to them instead. He called in the people who had panicked when they started to shed the pounds, and asked them: What happened when you lost weight? How did you feel?

There was one twenty-eight-year-old woman, who I’ll call Susan to protect her medical confidentiality. In fifty-one weeks, Vincent had taken Susan down from 408 pounds to 132 pounds. It looked like he had saved her life. Then, quite suddenly, for no reason anyone could see, she put on 37 pounds in the space of three weeks. Before long, she was back above 400 pounds. So Vincent asked her gently what had changed when she started to lose weight. It seemed mysterious to both of them. They talked for a long time. There was, she said eventually, one thing. When she was very obese, men never hit on her, but when she got down to a healthy weight, one day she was propositioned by a man, a colleague who she happened to know was married. She fled, and right away began to eat compulsively, and she couldn’t stop.

This was when Vincent thought to ask a question he hadn’t asked his patients before. When did you start to put on weight? If it was (say) when you were thirteen, or when you went to college, why then, and not a year before, or a year after?

Susan thought about the question. She had started to put on weight when she was eleven years old, she said. So he asked: Was there anything else that happened in your life when you were eleven? Well, Susan replied that was when my grandfather began to rape me.

Vincent began to ask all his patients these three simple questions. How did you feel when you lost weight? When in your life did you start to put on weight? What else happened around that time? As he spoke to the 183 people on the program, he started to notice some patterns. One woman started to rapidly put on weight when she was twenty-three. What happened then? She was raped. She looked at the ground after she confessed this, and said softly: “Overweight is overlooked, and that’s the way I need to be.”

“I was incredulous,” he told me when I sat with him in San Diego. “It seemed every other person I was asking was acknowledging such a history. I kept thinking, it can’t be. People would know if this was true. Somebody would’ve told me. Isn’t that what medical school is for?” When five of his colleagues came in to conduct further interviews, it turned out some 55 percent of the patients in the program had been sexually abused, far more than people in the wider population. And even more, including most of the men, had had severely traumatic childhoods.

Many of these women had been making themselves obese for an unconscious reason: to protect themselves from the attention of men, who they believed would hurt them. Being very fat stops most men from looking at you that way. It works. It was when he was listening to another grueling account of sexual abuse that it hit Vincent. He told me later:

“What we had perceived as the problem, major obesity, was in fact, very frequently, the solution to problems that the rest of us knew nothing about.”

Vincent began to wonder if the anti-obesity programs, including his own, had been doing it all wrong, by (for example) giving out nutritional advice. Obese people didn’t need to be told what to eat; they knew the nutritional advice better than he did. They needed someone to understand why they ate. After meeting a person who had been raped, he told me, “I thought with a tremendously clear insight that sending this woman to see a dietitian to learn how to eat right would be grotesque.”

Far from teaching the obese people, he realized they were the people who could teach him what was really going on. So he gathered the patients in groups of around fifteen, and asked them: “Why do you think people get fat? Not how. How is obvious. I’m asking why. What are the benefits?” Encouraged to think about it for the first time, they told him. The answers came in three different categories. The first was that it is sexually protective: men are less interested in you, so you are safer. The second was that it is physically protective: for example, in the program there were two prison guards, who lost between 100 and 150 pounds each. Suddenly, as they shed their bulk, they felt much more vulnerable among the prisoners, they could be more easily beaten up. To walk through those cell blocks with confidence, they explained, they needed to be the size of a refrigerator.

And the third category was that it reduced people’s expectations of them. “You apply for a job weighing four hundred pounds, people assume you’re stupid, lazy,” Vincent said. If you’ve been badly hurt by the world, and sexual abuse is not the only way this can happen, you often want to retreat. Putting on a lot of weight is, paradoxically, a way of becoming invisible to a lot of humanity.

“When you look at a house burning down, the most obvious manifestation is the huge smoke billowing out,” he told me. It would be easy, then, to think that the smoke is the problem, and if you deal with the smoke, you’ve solved it. But “thank God that fire departments understand that the piece that you treat is the piece you don’t see, the flames inside, not the smoke billowing out. Otherwise, house fires would be treated by bringing big fans to blow the smoke away. [And that would] make the house burn down faster.”

Obesity, he realized, isn’t the fire. It’s the smoke.

One day, Vincent went to a medical conference dedicated to obesity to present his findings. After he had spoken, a doctor stood up in the audience and explained: “People who are more familiar with these matters recognize that these statements by patients describing their sexual abuse, are basically fabrications, to provide a cover for their failed lives. It turned out people treating obesity had noticed before that a disproportionate number of obese people described being abused. They just assumed that they were making excuses.

Vincent was horrified. He had in fact verified the abuse claims of many of his patients, by talking to their relatives, or to law enforcement officials who had investigated them. But he knew he didn’t have hard scientific proof yet to rebut people like this. His impressions from talking to individual patients, even gathering the figures from within his group, didn’t prove much. He wanted to gather proper scientific data. So he teamed up with a scientist named Dr. Robert Anda, who had specialized for years in the study of why people do self-destructive things like smoking. Together, funded by the Center for Disease Control, a major US. agency funding medical research, they drew up a way of testing all this, to see if it was true beyond the small sample of people in Vincent’s program.

They called it the Adverse Childhood Experiences (ACE) Study, and it’s quite simple. It’s a questionnaire. You are asked about ten different categories of terrible things that can happen to you when you’re a kid, from being sexually abused, to being emotionally abused, to being neglected. And then there’s a detailed medical questionnaire, to test for all sorts of things that could be going wrong with you, like obesity, or addiction. One of the things they added to the list, almost as an afterthought, was the question: Are you suffering from depression?

This survey was then given to seventeen thousand people who were seeking health care, for a whole range of reasons, from Kaiser Permanente in San Diego. The people who filled in the form were somewhat wealthier and a little older than the general population, but otherwise fairly representative of the city’s population.

When the results came in, they added them up, at first, to see if there were any correlations.

It turned out that for every category of traumatic experience you went through as a kid, you were radically more likely to become depressed as an adult. If you had six categories of traumatic events in your childhood, you were five times more likely to become depressed as an adult than somebody who didn’t have any. If you had seven categories of traumatic events as a child, you were 3,100 percent more likely to attempt to commit suicide as an adult.

“When the results came out, I was in a state of disbelief,” Dr. Anda told me. “I looked at it and I said, really? This can’t be true.” You just don’t get figures like this in medicine very often. Crucially, they hadn’t just stumbled on proof that there is a correlation, that these two things happen at the same time. They seemed to have found evidence that these traumas help cause these problems. How do we know? The greater the trauma, the greater your risk of depression, anxiety, or suicide. The technical term for this is “dose-response effect.” The more cigarettes you smoke, the more your risk of lung cancer goes up, that’s one reason we know smoking causes cancer. In the same way, the more you were traumatized as a child, the more your risk of depression rises.

Curiously, it turned out emotional abuse was more likely to cause depression than any other kind of trauma, even sexual molestation. Being treated cruelly by your parents was the biggest driver of depression, out of all these categories.

When they showed the results to other scientists, including the Centers for Disease Control (CDC), who cofunded the research, they too were incredulous. “The study shocked people,” Dr. Anda told me. “People didn’t want to believe it. People at the CDC didn’t want to believe it. There was resistance within the CDC when I brought the data around, and the medical journals, initially, didn’t want to believe it, because it was so astonishing that they had to doubt it. Because it made them challenge the way they thought about childhood. It challenged so many things, all at one time.” In the years that followed, the study has been replicated many times, and it always finds similar results. But we have barely begun, Vincent told me, to think through its implications.

So Vincent, as he absorbed all this, came to believe that we have been making the same mistake with depression that he had been making before with obesity. We have failed to see it as a symptom of something deeper that needs to be dealt with. There’s a house fire inside many of us, Vincent had come to believe, and we’ve been concentrating on the smoke.

Many scientists and psychologists had been presenting depression as an irrational malfunction in your brain or in your genes, but he learned that Allen Barbour, an internist at Stanford University, had said that depression isn’t a disease; depression is a normal response to abnormal life experiences. “I think that’s a very important idea,” Vincent told me. “It takes you beyond the comforting, limited idea that the reason I’m depressed is I have a serotonin imbalance, or a dopamine imbalance, or what have you.” It is true that something is happening in your brain when you become depressed, he says, but that “is not a causal explanation”; it is “a necessary intermediary mechanism.”

Some people don’t want to see this because, at least at first, “it’s more comforting,” Vincent said, to think it’s all happening simply because of changes in the brain. “It takes away an experiential process and substitutes a mechanistic process.” It turns your pain into a trick of the light that can be banished with drugs. But they don’t ultimately solve the problem, he says, any more than just getting the obese patients to stop eating solved their problems. “Medications have a role,” he told me. “Are they the ultimate be and end-all? No. Do they sometimes short-change people? Absolutely.”

To solve the problem for his obese patients, Vincent said, they had all realized, together, that they had to solve the problems that were leading them to eat obsessively in the first place. So he set up support groups where they could discuss the real reasons why they ate and talk about what they had been through. Once that was in place, far more people became able to keep going through the fasting program and stay at a safe weight. He was going to start exploring a way to do this with depression, with startling results.

More than anyone else I spoke to about the hidden causes of depression, Vincent made me angry. After I met with him, I went to the beach in San Diego and raged against what he had said. I was looking hard for reasons to dismiss it. Then I asked myself. Why are you so angry about this? It seemed peculiar, and I didn’t really understand it. Then, as I discussed it with some people I trust, I began to understand.

If you believe that your depression is due solely to a broken brain, you don’t have to think about your life, or about what anyone might have done to you. The belief that it all comes down to biology protects you, in a way, for a while. If you absorb this different story, though, you have to think about those things. And that hurts.

I asked Vincent why he thinks traumatic childhoods so often produce depressed and anxious adults, and he said that he honestly doesn’t know. He’s a good scientist. He didn’t want to speculate. But I think I might know, although it goes beyond anything I can prove scientifically.

When you are a child and you experience something really traumatic, you almost always think it is your fault. There’s a reason for this, and it’s not irrational; like obesity, it is, in fact, a solution to a problem most people can’t see. When I was young, my mother was ill a lot, and my father was mostly gone, usually in a different country. In the chaos of that, I experienced some extreme acts of violence from an adult in my life. For example, I was strangled with an electrical cord on one occasion. By the time I was sixteen, I left to go and live in another city, away from any adults I knew, and when I was there, I found myself, like many people who have been treated this way at a formative age, seeking out dangerous situations where I was again treated in ways I should not have been treated.

Even now, as a thirty-seven-year-old adult, I feel like writing this down, and saying it to you, is an act of betrayal of the adult who carried out these acts of violence, and the other adults who behaved in ways they shouldn’t have.

I know you can’t figure out who these people are from what I’ve written. I know that if I saw an adult strangling a child with an electrical cord, it would not even occur to me to blame the child, and that if I heard somebody try to suggest such a thing, I would assume they were insane. I know rationally where the real betrayal lies in this situation. But still, I feel it. It’s there, and that feeling almost stopped me from saying this.

Why do so many people who experience violence in childhood feel the same way? Why does it lead many of them to self-destructive behavior, like obesity, or hard core addiction, or suicide? I have spent a lot of time thinking about this. When you’re a child, you have very little power to change your environment. You can’t move away, or force somebody to stop hurting you. So you have two choices. You can admit to yourself that you are powerless, that at any moment, you could be badly hurt, and there’s simply nothing you can do about it. Or you can tell yourself it’s your fault. If you do that, you actually gain some power, at least in your own mind. If it’s your fault, then there’s something you can do that might make it different. You aren’t a pinball being smacked around a pinball machine. You’re the person controlling the machine. You have your hands on the dangerous levers.

In this way, just like obesity protected those women from the men they feared would rape them, blaming yourself for your childhood traumas protects you from seeing how vulnerable you were and are. You can become the powerful one. If it’s your fault, it’s under your control.

But that comes at a cost. If you were responsible for being hurt, then at some level, you have to think you deserved it. A person who thinks they deserved to be injured as a child isn’t going to think they deserve much as an adult, either.

This is no way to live. But it’s a misfiring of the thing that made it possible for you to survive at an earlier point in your life.

You might have noticed that this cause of depression and anxiety is a little different from the ones I have discussed up to now, and it’s different from the ones I’m going to discuss next.

As I mentioned before, most people who have studied the scientific evidence accept that there are three different kinds of causes of depression and anxiety, biological, psychological, and social. The causes I’ve discussed up to now, and will come back to in a moment, are environmental. I’ll come to biological factors soon.

But childhood trauma belongs in a different category. It’s a psychological cause. By discussing it here, I’m hoping childhood trauma can indicate toward the many other psychological causes of depression that are too specific to be discussed in a big, broad way. The ways our psyches can be damaged are almost infinite. I know somebody whose wife cheated on him for years with his best friend and who became deeply depressed when he found out. I know somebody who survived a terror attack and was almost constantly anxious for a decade after. I know someone whose mother was perfectly competent and never cruel to her but was relentlessly negative and taught her always to see the worst in people and to keep them at a distance. You can’t squeeze these experiences into neat categories, it wouldn’t make sense to list “adultery,” “terror attacks,” or “cold parents” as causes of depression and anxiety.

But here’s what we know.

Psychological damage doesn’t have to be as extreme as childhood violence to affect you profoundly. Your wife cheating on you with your best friend isn’t a malfunction in your brain. But it is a cause of deep psychological distress, and it can cause depression and anxiety. If you are ever told a story about these problems that doesn’t talk about your personal psychology, don’t take it seriously.

Dr. Anda, one of the pioneers of this research, told me it had forced him to turn his thinking about depression and other problems inside out.

“When people have these kind of problems, it’s time to stop asking what’s wrong with them,” he said, “and time to start asking what happened to them.”

from

Lost Connections. Uncovering the Real Causes of Depression and the Unexpected Solutions

by Johann Hari

get it at Amazon.com

JUNK VALUES. CONSUMERISM LITERALLY IS DEPRESSING – Johann Hari.

Just as we have shifted en masse from eating food to eating junk food, we have also shifted from having meaningful values to having junk values.

All this mass-produced fried chicken looks like food, and it appeals to the part of us that evolved to need food; yet it doesn’t give us what we need from food, nutrition. Instead, it fills us with toxins.

In the same way, all these materialistic values, telling us to spend our way to happiness, look like real values; they appeal to the part of us that has evolved to need some basic principles to guide us through life; yet they don’t give us what we need from values, a path to a satisfying life.

Studies show that materialistic people are having a worse time, day by day, on all sorts of fronts. They feel sicker, and they are angrier. Something about a strong desire for materialistic pursuits actually affects their day-to-day lives, and decreases the quality of their daily experience. They experienced less joy, and more despair.

For thousands of years, philosophers have been suggesting that if you overvalue money and possessions, or if you think about life mainly in terms of how you look to other people, you will be unhappy.

Modern research indicates that materialistic people, who think happiness comes from accumulating stuff and a superior status, have much higher levels of depression and anxiety. The more our kids value getting things and being seen to have things, the more likely they are to be suffering from depression and anxiety.

The pressure, in our culture, runs overwhelmingly one way, spend more; work more. We live under a system that constantly distracts us from what’s really good about life. We are being propagandized to live in a way that doesn’t meet our basic psychological needs, so we are left with a permanent, puzzling sense of dissatisfaction.

The more materialistic and extrinsically motivated you become, the more depressed you will be.

When I was in my late twenties, I got really fat. It was partly a side effect of antidepressants, and partly a side effect of fried chicken. I could still, from memory, talk you through the relative merits of all the fried chicken shops in East London that were the staples of my diet, from Chicken Cottage to Tennessee Fried Chicken (with its logo of a smiling cartoon chicken holding a bucket of fried chicken legs: who knew cannibalism could be an effective marketing tool?). My own favorite was the brilliantly named Chicken Chicken Chicken. Their hot wings were, to me, the Mona Lisa of grease.

One Christmas Eve, I went to my local branch of Kentucky Fried Chicken, and one of the staff behind the counter saw me approaching and beamed. “Johann!” he said. “We have something for you!” The other staff turned and looked at me expectantly. From somewhere behind the grill and the grizzle, he took out a Christmas card. I was forced, by their expectant smiles, to open it in front of them. “To our best customer,” it said, next to personal messages from every member of the staff.

I never ate at KFC again.

Most of us know there is something wrong with our physical diets. We aren’t all gold medalists in the consumption of lard like I was, but more and more of us are eating the wrong things, and it is making us physically sick. As I investigated depression and anxiety, I began to learn something similar is happening to our values, and it is making many of us emotionally sick.

This was discovered by an American psychologist named Tim Kasser, so I went to see him, to learn his story.

As a little boy, Tim arrived in the middle of a long stretch of swampland and open beaches. His dad worked as a manager at an insurance company, and in the early 1970s, he was posted to a place called Pinellas County, on the west coast of Florida. The area was mostly undeveloped and had plenty of big, broad outdoor spaces for a kid to play, but this county soon became the fastest growing in the entire United States, and it was about to be transformed in front of Tim’s eyes. “By the time I left Florida,” he told me, “it was a completely different physical environment. You couldn’t drive along the beach roads anymore and see the water, because it was all condos and high-rises. Areas that had been open land with alligators and rattlesnakes became subdivision after subdivision after shopping mall.”

Tim was drawn to the shopping malls that replaced the beaches and marshes, like all the other kids he knew. There, he would play Asteroids and Space Invaders for hours. He soon found himself longing for stuff, the toys he saw in ads.

It sounds like Edgware, where I am from. I was eight or nine when its shopping mall, the Broadwalk Centre, opened, and I remember wandering around its bright storefronts and gazing at the things I wanted to buy in a thrilled trance. I obsessively coveted the green plastic toy of Castle Grayskull, the fortress where the cartoon character He-Man lived, and Care-a-Lot, the home in the clouds of some animated creatures called the Care Bears. One Christmas, my mother missed my hints and failed to buy me Care-a-Lot, and I was crestfallen for months. I ached and pined for that lump of plastic.

Like most kids at the time, I spent at least three hours a day watching TV, usually more, and whole days would pass in the summer when my only break from television would be to go to the Broadwalk Centre and back again. I don’t remember anyone ever telling me this explicitly, but it seemed to me then that happiness meant being able to buy lots of the things on display there. I think my nine-year-old self, if you had asked him what it meant to be happy, would have said: somebody who could walk through the Broadwalk Centre and buy whatever he wanted. I would ask my dad how much each famous person I saw on television earned, and he would guess, and we would both marvel at what we would do with the money. It was a little bonding ritual, over a fantasy of spending.

I asked Tim if, in Pinellas County where he grew up, he ever heard anyone talking about a different way of valuing things, beyond the idea that happiness came from getting and possessing stuff. “Well, I think, not growing up. No,” he said. In Edgware, there must have been people who acted on different values, but I don’t think I ever saw them.

When Tim was a teenager, his swim coach moved away one summer and gave him a small record collection, and it included albums by John Lennon and Bob Dylan. As he listened to them, he realized they seemed to be expressing something he didn’t really hear anywhere else. He began to wonder if there were hints of a different way to live lying in their lyrics, but he couldn’t find anyone to discuss it with.

It was only when Tim went to study at Vanderbilt University, a very conservative college in the South, at the height of the Reagan years, that it occurred to him, slowly, to think more deeply about this. In 1984, he voted for Ronald Reagan, but he was starting to think a lot about the question of authenticity. “I was stumbling around,” he told me. “I think I was questioning just about everything. I wasn’t just questioning these values. I was questioning lots about myself, I was questioning lots about the nature of reality and the values of society.” He feels like there were pinatas all around him and he was hitting chaotically at them all. He added: “I think I went through that phase for a long time, to be honest.”

When he went to graduate school, he started to read a lot about psychology. It was around this time that Tim realized something odd.

For thousands of years, philosophers had been suggesting that if you overvalue money and possessions, or if you think about life mainly in terms of how you look to other people, you will be unhappy, that the values of Pinellas County and Edgware were, in some deep sense, mistaken. It had been talked about a lot, by some of the finest minds who ever lived, and Tim thought it might be true. But nobody had ever conducted a scientific investigation to see whether all these philosophers were right.

This realization is what launched him on a project that he was going to pursue for the next twenty-five years. It led him to discover subtle evidence about why we feel the way we do, and why it is getting worse.

It all started in grad school, with a simple survey.

Tim came up with a way of measuring how much a person really values getting things and having money compared to other values, like spending time with their family or trying to make the world a better place. He called it the Aspiration Index, and it is pretty straightforward. You ask people how much they agree with statements such as “It is important to have expensive possessions” and how much they agree with very different statements such as “It is important to make the world a better place for others.” You can then calculate their values.

At the same time, you can ask people lots of other questions, and one of them is whether they are unhappy or if they are suffering (or have suffered) from depression or anxiety. Then, as a first step, you see if they match.

Tim’s first tentative piece of research was to give this survey to 316 students. When the results came back and were all calculated out, Tim was struck by the results: materialistic people, who think happiness comes from accumulating stuff and a superior status, had much higher levels of depression and anxiety.

This was, he knew, just a primitive first shot in the dark. So Tim’s next step was, as part of a larger study, to get a clinical psychologist to assess 140 eighteen-year-olds in depth, calculating where they were on the Aspiration Index and if they were depressed or anxious. When the results were added up, they were the same: the more the kids valued getting things and being seen to have things, the more likely they were to be suffering from depression and anxiety.

Was this something that happened only with young people? To find out, Tim measured one hundred citizens of Rochester in upstate New York, who came from a range of age groups and economic backgrounds. The result was the same.

But how could he figure out what was really happening, and why?

Tim’s next step was to conduct a more detailed study, to track how these values affect you over time. He got 192 students to keep a detailed mood diary in which, twice a day, they had to record how much they were feeling nine different emotions, such as happiness or anger, and how much they were experiencing any of nine physical symptoms, such as backache. When he calculated out the results, he found, again, higher depression among the materialistic students; but there was a result more important than that. It really did seem that materialistic people were having a worse time, day by day, on all sorts of fronts. They felt sicker, and they were angrier. “Something about a strong desire for materialistic pursuits,” he was starting to believe, “actually affected the participants’ day-to-day lives, and decreased the quality of their daily experience.” They experienced less joy, and more despair.

Why would this be? What could be happening here? Ever since the 1960s, psychologists have known that there are two different ways you can motivate yourself to get out of bed in the morning. The first are called intrinsic motives, they are the things you do purely because you value them in and of themselves, not because of anything you get out of them. When a kid plays, she’s acting totally on intrinsic motives, she’s doing it because it gives her joy. The other day, I asked my friend’s five-year-old son why he was playing. “Because I love it,” he said. Then he scrunched up his face and said “You’re silly!” and ran off, pretending to be Batman. These intrinsic motivations persist all through our lives, long after childhood.

At the same time, there’s a rival set of values, which are called extrinsic motives. They’re the things you do not because you actually want to do them, but because you’ll get something in return, whether it’s money, or admiration, or sex, or superior status. Joe, who you met two chapters ago, went to work every day in the paint shop for purely extrinsic reasons, he hated the job, but he needed to be able to pay the rent, buy the Oxy that would numb his way through the day, and have the car and clothes that he thought made people respect him. We all have some motives like that.

Imagine you play the piano. If you play it for yourself because you love it, then you are being driven to do it by intrinsic values. If you play in a dive bar you hate, just to make enough cash to ensure you don’t get thrown out of your apartment, then you are being driven to do it by extrinsic values.

These rival sets of values exist in all of us. Nobody is driven totally by one or the other.

Tim began to wonder if looking into this conflict more deeply could reveal something important. So he started to study a group of two hundred people in detail over time. He got them to lay out their goals for the future. He then figured out with them if these were extrinsic goals, like getting a promotion, or a bigger apartment, or intrinsic goals, like being a better friend or a more loving son or a better piano player. And then he got them to keep a detailed mood diary.

What he wanted to know was, Does achieving extrinsic goals make you happy? And how does that compare to achieving intrinsic goals?

The results, when he calculated them out were quite startling. People who achieved their extrinsic goals didn’t experience any increase in day-to-day happiness, none. They spent a huge amount of energy chasing these goals, but when they fulfilled them, they felt the same as they had at the start, Your promotion? Your fancy car? The new iPhone? The expensive necklace? They won’t improve your happiness even one inch.

But people who achieved their intrinsic goals did become significantly happier, and less depressed and anxious. You could track the movement. As they worked at it and felt they became (for example) a better friend, not because they wanted anything out of it but because they felt it was a good thing to do, they became more satisfied with life. Being a better dad? Dancing for the sheer joy of it? Helping another person, just because it’s the right thing to do? They do significantly boost your happiness.

Yet most of us, most of the time, spend our time chasing extrinsic goals, the very thing that will give us nothing. Our whole culture is set up to get us to think this way. Get the right grades. Get the best-paying job. Rise through the ranks. Display your earnings through clothes and cars. That’s how to make yourself feel good.

What Tim had discovered is that the message our culture is telling us about how to have a decent and satisfying life, virtually all the time, is not true. The more this was studied, the clearer it became! Twenty-two different studies have in the years since, found that the more materialistic and extrinsically motivated you become, the more depressed you will be. Twelve different studies found that the more materialistic and extrinsically motivated you become, the more anxious you will be. Similar studies, inspired by Tim’s work and using similar techniques, have now been carried out in Britain, Denmark, Germany, India, South Korea, Russia, Romania, Australia, and Canada-and the results, all over the world, keep coming back the same.

Just as we have shifted en masse from eating food to eating junk food, Tim has discovered, in effect, that we have shifted from having meaningful values to having junk values. All this mass-produced fried chicken looks like food, and it appeals to the part of us that evolved to need food; yet it doesn’t give us what we need from food, nutrition. Instead, it fills us with toxins.

In the same way, all these materialistic values, telling us to spend our way to happiness, look like real values; they appeal to the part of us that has evolved to need some basic principles to guide us through life; yet they don’t give us what we need from values, a path to a satisfying life. Instead, they fill us with psychological toxins. Junk food is distorting our bodies. Junk values are distorting our minds.

Materialism is KFC for the soul.

When Tim studied this in greater depth, he was able to identify at least four key reasons why junk values are making us feel so bad.

The first is that thinking extrinsically poisons your relationships with other people. He teamed up again with another professor, Richard Ryan, who had been an ally from the start, to study two hundred people in depth, and they found that the more materialistic you become, the shorter your relationships will be, and the worse their quality will be. If you value people for how they look, or how they impress other people, it’s easy to see that you’ll be happy to dump them if someone hotter or more impressive comes along. And at the same time, if all you’re interested in is the surface of another person, it’s easy to see why you’ll be less rewarding to be around, and they’ll be more likely to dump you, too. You will have fewer friends and connections, and they won’t last as long.

Their second finding relates to another change that happens as you become more driven by junk values. Let’s go back to the example of playing the piano. Every day, Tim spends at least half an hour playing the piano and singing, often with his kids. He does it for no reason except that he loves it, it makes him, on a good day, feel satisfied, and joyful. He feels his ego dissolve, and he is purely present in the moment. There’s strong scientific evidence that we all get most pleasure from what are called “flow states” like this, moments when we simply lose ourselves doing something we love and are carried along in the moment. They’re proof we can maintain the pure intrinsic motivation that a child feels when she is playing.

But when Tim studied highly materialistic people, he discovered they experience significantly fewer flow states than the rest of us. Why would that be?

He seems to have found an explanation. Imagine if, when Tim was playing the piano every day, he kept thinking: Am I the best piano player in Illinois? Are people going to applaud this performance? Am l going to get paid for this? How much? Suddenly his joy would shrivel up like a salted snail. Instead of his ego dissolving, his ego would be aggravated and jabbed and poked.

That is what your head starts to look like when you become more materialistic. If you are doing something not for itself but to achieve an effect, you can’t relax into the pleasure of a moment. You are constantly monitoring yourself. Your ego will shriek like an alarm you can’t shut off.

This leads to a third reason why junk values make you feel so bad. When you are extremely materialistic, Tim said to me, “you’ve always kind of got to be wondering about yourself, how are people judging you?” It forces you to “focus on other people’s opinions of you, and their praise of you, and then you’re kind of locked into having to worry what other people think about you, and if other people are going to give you those rewards that you want. That’s a heavy load to bear, instead of walking around doing what it is you’re interested in doing, or being around people who love you just for who you are.”

If “your self-esteem, your sense of self-worth, is contingent upon how much money you’ve got, or what your clothes are like, or how big your house is,” you are forced into constant external comparisons, Tim says. “There’s always somebody who’s got a nicer house or better clothes or more money.” Even if you’re the richest person in the world, how long will that last? Materialism leaves you constantly vulnerable to a world beyond your control.

And then, he says, there is a crucial fourth reason. It’s worth pausing on this one, because I think it’s the most important.

All of us have certain innate needs, to feel connected, to feel valued, to feel secure, to feel we make a difference in the world, to have autonomy, to feel we’re good at something. Materialistic people, he believes, are less happy, because they are chasing a way of life that does a bad job of meeting these needs.

What you really need are connections. But what you are told you need, in our culture, is stuff and a superior status, and in the gap between those two signals, from yourself and from society, depression and anxiety will grow as your real needs go unmet.

You have to picture all the values that guide why you do things in your life, Tim said, as being like a pie. “Each value” you have, he explained, “is like a slice of that pie. So you’ve got your spirituality slice, and your family slice, and your money slice, and your hedonism slice. We’ve all got all the slices.” When you become obsessed with materialism and status, that slice gets bigger. And “the bigger one slice gets, the smaller other slices have to get.” So if you become fixated on getting stuff and a superior status, the parts of the pie that care about tending to your relationships, or finding meaning, or making the world better have to shrink, to make way.

“On Friday at four, I can stay [in my office] and work more, or I can go home and play with my kids,” he told me. “I can’t do both. It’s one or the other. If my materialistic values are bigger, I’m going to stay and work. If my family values are bigger, I’m going to go home and play with my kids.” It’s not that materialistic people don’t care about their kids, but “as the materialistic values get bigger, other values are necessarily going to be crowded out,” he says, even if you tell yourself they won’t.

And the pressure, in our culture, runs overwhelmingly one way, spend more; work more. We live under a system, Tim says, that constantly “distracts us from what’s really good about life.” We are being propagandized to live in a way that doesn’t meet our basic psychological needs, so we are left with a permanent, puzzling sense of dissatisfaction.

For millennia, humans have talked about something called the Golden Rule. It’s the idea that you should do unto others as you would have them do unto you. Tim, I think, has discovered something we should call the I-Want-Golden-Things Rule. The more you think life is about having stuff and superiority and showing it off, the more unhappy, and the more depressed and anxious, you will be.

But why would human beings turn, so dramatically, to something that made us less happy and more depressed? Isn’t it implausible that we would do something so irrational? In the later phase of his research, Tim began to dig into the question.

Nobody’s values are totally fixed. Your level of junk values, Tim discovered by following people in his studies, can change over your lifetime. You can become more materialistic, and more unhappy; or you can become less materialistic, and less unhappy. So we shouldn’t be asking, Tim believes, “Who is materialistic?” We should be asking: “When are people materialistic?” Tim wanted to know: What causes the variation?

There’s an experiment, by a different group of social scientists, that gives us one early clue. In 1978, two Canadian social scientists got a bunch of four and five year old kids and divided them into two groups. The first group was shown no commercials. The second group was shown two commercials for a particular toy. Then they offered these four or five year old kids a choice. They told them: You have to choose, now, to play with one of these two boys here. You can play with this little boy who has the toy from the commercials, but we have to warn you, he’s not a nice boy. He’s mean. Or you can play with a boy who doesn’t have the toy, but who is really nice.

If they had seen the commercial for the toy, the kids mostly chose to play with the mean boy with the toy. If they hadn’t seen the commercial, they mostly chose to play with the nice boy who had no toys.

In other words, the advertisements led them to choose an inferior human connection over a superior human connection, because they’d been primed to think that a lump of plastic is what really matters.

Two commercials, just two, did that. Today, every person sees way more advertising messages than that in an average morning. More eighteen-month-olds can recognize the McDonald’s M than know their own surname. By the time an average child is thirty-six months old she aIready knows a hundred brand logos.

Tim suspected that advertising plays a key role in why we are, every day, choosing a value system that makes us feel worse. So with another social scientist named Jean Twenge he tracked the percentage of total US. national wealth that’s spent on advertising, from 1976 to 2003, and he discovered that the more money is spent on ads, the more materialistic teenagers become.

A few years ago, an advertising agency head named Nancy Shalek explained approvingly: “Advertising at its best is making peopie feel that without their product, you’re a loser. Kids are very sensitive to that. You open up emotionaI vulnerabilities, and it’s very easy to do with kids because they’re the most emotionally vulnerable.”

This sounds harsh, until you think through the logic. Imagine if I watched an ad and it told me, Johann, you’re fine how you are. You look good. You smell good. You’re likable. People want to be around you. You’ve got enough stuff now. You don’t need any more. Enjoy life.

That would, from the perspective of the advertising industry, be the worst ad in human history, because I wouldn’t want to go out shopping, or lunge at my laptop to spend, or do any of the other things that feed my junk values. It would make me want to pursue my intrinsic values, which involve a whole lot less spending, and a whole lot more happiness.

When they talk among themselves, advertising people have been admitting since the 1920s that their job is to make people feel inadequate, and then offer their product as the solution to the sense of inadequacy they have created. Ads are the ultimate frenemy, they’re always saying: Oh babe, I want you to look/smell/feel great; it makes me so sad that at the moment you’re ugly/ stinking/miserable; here’s this thing that will make you into the person you and I really want you to be. Oh, did I mention you have to pay a few bucks? I just want you to be the person you deserve to be. Isn’t that worth a few dollars? You’re worth it.

This logic radiates out through the culture, and we start to impose it on each other, even when ads aren’t there. Why did I, as a child, crave Nike air-pumps, even though I was as likely to play basketball as I was to go to the moon? It was partly because of the ads, but mostly because the ads created a group dynamic among everyone I knew. It created a marker of status, that we then policed. As adults, we do the same, only in slightly more subtle ways.

This system trains us, Tim says, to feel “there’s never enough. When you’re focused on money and status and possessions, consumer society is always telling you more, more, more, more. Capitalism is always telling you more, more, more. Your boss is telling you work more, work more, work more. You internalize that and you think: Oh, I’ve got to work more, because my self depends on my status and my achievement. You internalize that. It’s a kind of form of internalized oppression.”

He believes it also explains why junk values lead to such an increase in anxiety. “You’re always thinking: Are they going to reward me? Does the person love me for who I am, or for my handbag? Am I going to be able to climb the ladder of success?” he said. You are hollow, and exist only in other people’s reflections. “That’s going to be anxiety-provoking.”

We are all vulnerable to this, he believes. “The way I understand the intrinsic values,” Tim told me, is that they “are a fundamental part of what we are as humans, but they’re fragile. It’s easy to distract us from them. You give people social models of consumerism and they move in an extrinsic way.” The desire to find meaningful intrinsic values is “there, it’s a powerful part of who we are, but it’s not hard to distract us.” And we have an economic system built around doing precisely that.

As I sat with Tim, discussing all this for hours, I kept thinking of a middle-class married couple who live in a nice semidetached house in the suburbs in Edgware, where we grew up. They are close to me; I have known them all my life; I love them.

If you peeked through their window, you’d think they have everything you need for happiness, each other, two kids, a good home, all the consumer goods we’re told to buy. Both of them work really hard at jobs they have little interest in, so that they can earn money, and with the money they earn, they buy the things that we have learned from television will make us happy, clothes and cars, gadgets and status symbols. They display these things to people they know on social media, and they get lots of likes and comments like “OMG, so jealous!” After the brief buzz that comes from displaying their goods, they usually find they become dissatisfied and down again. They are puzzled by this, and they often assume it’s because they didn’t buy the right thing. So they work harder, and they buy more goods, display them through their devices, feel the buzz, and then slump back to where they started.

They both seem to me to be depressed. They alternate between being blank, or angry, or engaging in compulsive behaviors. She had a drug problem for a long time, although not anymore; he gambles online at least two hours a day. They are furious a lot of the time, at each other, at their children, at their colleagues, and, diffusely, at the world, at anyone else on the road when they are driving, for example, who they scream and swear at. They have a sense of anxiety they can’t shake off, and they often attach it to things outside them, she obsessively monitors where her teenage son is at any moment, and is afraid all the time that he will be a victim of crime or terrorism.

This couple has no vocabulary to understand why they feel so bad. They are doing what the culture has been priming them to do since we were infants, they are working hard and buying the right things, the expensive things. They are every advertising slogan made flesh.

Like the kids in the sandbox, they have been primed to lunge for objects and ignore the prospect of interaction with the people around them.

I see now they aren’t just suffering from the absence of something, such as meaningful work, or community. They are also suffering from the presence of something, an incorrect set of values telling them to seek happiness in all the wrong places, and to ignore the potential human connections that are right in front of them.

When Tim discovered all these facts, it didn’t just guide his scientific work. He began to move toward a life that made it possible for him to live consistent with his own findings, to go back, in a sense, to something more like the beach he had discovered joyfully in Florida as a kid. “You’ve got to pull yourself out of the materialistic environments, the environments that are reinforcing the materialistic values,” he says, because they cripple your internal satisfactions. And then, he says, to make that sustainable, you have to “replace them with actions that are going to provide those intrinsic satisfactions, and encourage those intrinsic goals.”

So, with his wife and his two sons, he moved to a farmhouse on ten acres of land in Illinois, where they live with a donkey and a herd of goats. They have a small TV in the basement, but it isn’t connected to any stations or to cable, it’s just to watch old movies on sometimes. They only recently got the Internet (against his protestations), and they don’t use it much. He works part time, and so does his wife, “so we could spend more time with our kids, and be in the garden more and do volunteer work and do activism work and I could write more”, all the things that give them intrinsic satisfaction. “We play a lot of games. We play a lot of music. We have a lot of family conversations.” They sing together.

Where they live in western Illinois is “not the most exciting place in the world,” Tim says, “but I have ten acres of land, I have a twelve-minute commute with one flashing light and three stop signs on my way to my office, and we afford that on one [combined full-time] salary.”

I ask him if he had withdrawal symptoms from the materialistic world we were both immersed in for so long. “Never,” he says right away. “People ask me that: “Don’t you miss this? Don’t you wish you had that?” No, I don’t, because I am never exposed to the messages telling me that I should want it. I don’t expose myself to those things, so no, I don’t have that.”

One of his proudest moments was when one of his sons came home one day and said: “Dad, some kids at school are making fun of my sneakers.” They were not a brand name, or shiny-new. “Oh, what’d you say to them?” Tim asked. His son explained he looked at them and said: “Why do you care?” He was nonplussed, he could see that what they valued was empty, and absurd.

By living without these polluting values, Tim has, he says, discovered a secret. This way of life is more pleasurable than materialism. “It’s more fun to play these games with your kids,” he told me. “It’s more fun to do the intrinsically motivated stuff than to go to work and do stuff you don’t necessarily want to do. It’s more fun to feel like people love you for who you are, instead of loving you because you gave them a big diamond ring.”

Most people know all this in their hearts, he believes. “At some level I really believe that most people know that intrinsic values are what’s going to give them a good life,” he told me. When you do surveys and ask people what’s most important in life, they almost always name personal growth and relationships as the top two. “But I think part of why people are depressed is that our society is not set up in order to help people live lifestyles, have jobs, participate in the economy, or participate in their neighborhoods” in ways that support their intrinsic values. The change Tim saw happening in Florida as a kid, when the beachfronts were transformed into shopping malls and people shifted their attention there, has happened to the whole culture.

Tim told me people can apply these insights to their own life, on their own, to some extent. “The first thing is for people to ask themselves, Am I setting up my life so I can have a chance of succeeding at my intrinsic values? Am I hanging out with the right people, who are going to make me feel loved, as opposed to making me feel like I made it? Those are hard choices sometimes.” But often, he says, you will hit up against a limit in our culture. You can make improvements, but often “the solutions to the problems that I’m interested in can’t be easily solved at the individual person level, or in the therapeutic consulting room, or by a pill.” They require something more, as I was going to explore later.

When I interviewed Tim, I felt he solved a mystery for me. I had been puzzled back in Philadelphia about why Joe didn’t leave the job he hated at the paint company and go become a fisherman in Florida, when he knew life in the Sunshine State would make him so much happier. It seemed like a metaphor for why so many of us stay in situations we know make us miserable.

I think I see why now. Joe is constantly bombarded with messages that he shouldn’t do the thing that his heart is telling him would make him feel calm and satisfied. The whole logic of our culture tells him to stay on the consumerist treadmill, to go shopping when he feels lousy, to chase junk values. He has been immersed in those messages since the day he was born. So he has been trained to distrust his own wisest instincts.

When I yelled after him “Go to Florida!” I was yelling into a hurricane of messages, and a whole value system, that is saying the exact opposite.

from

Lost Connections. Uncovering the Real Causes of Depression and the Unexpected Solutions

by Johann Hari

get it at Amazon.com

THIS TIME IS NO DIFFERENT. IMF’s dire warning on global economy – Liam Dann * Why a New Multilateralism Now? – David Lipton.

Merry Christmas and happy new financial crisis.

History suggests we are due for another financial crisis and right now the world is in no shape to cope with one.

With ingenuity and international cooperation, we can make the most of new technologies and new challenges, and create a shared and sustained prosperity.


With interest rates still low, central banks simply don’t have the firepower they did in 2008 to deal with a deep recession.

The official outlook for New Zealand’s economy remains solid with GDP growth expected to stay safely north of 2.5 per cent.

But these kind of forecasts will mean little if the world heads into a serious financial crisis.

NZ Herald

Why a New Multilateralism Now

David Lipton, IMF First Deputy Managing Director

Good morning.

Thank you for the introduction.

I appreciate the invitation to speak here today. This conference is tackling issues that have a great bearing on the stability of the world economy. Having just passed the 10th anniversary of the start of the Global Financial Crisis, and now looking forward, I’d like to address what I see as this morning’s key topic: the next financial crisis.

History suggests that an economic downturn lurks somewhere over the horizon. Many are already speculating as to exactly when, where, and why it might arise. While we can’t know all that, we ought to be focusing right now on how to forestall its arrival and how to limit it to a “garden variety” recession when it arrives, meaning, how to avoid creating another systemic crisis. Over the past two years, the IMF has called on governments to put in place policies aimed at just that goal, as we have put it, “fix the roof while the sun shines.” But like many of you, I see storm clouds building, and fear the work on crisis prevention is incomplete.

Before asking what should be done, let’s analyze whether the international community has the wherewithal to respond to the next crisis, should it occur. And here I mean both individual countries, and the international organizations tasked to act as first responders. Should we be confident that the resources, policy instruments, and regulatory frameworks at our disposal will prove potent enough to counter and contain the next recession? Consider the main policy options.

Policy Options for the Next Recession

On monetary policy, much has been said about whether central banks will be able to respond to a deep or prolonged downturn. For example, past U.S. recessions have been met with 500 basis points or more of easing by the Fed. With policy rates so low at present in so many places, that response will not be available. Central banks would likely end up exploring ever more unconventional measures. But with their effectiveness uncertain, we ought to be concerned about the potency of monetary policy.

We read every day that for fiscal policy, the room for maneuver has been narrowing in many countries. Public debt has risen and, in many countries, deficits remain too high to stabilize or reduce debt. Now to be fair, we can presume that if the next slowdown creates unemployment and slack, multipliers will grow larger, likely restoring some potency to fiscal policy, even at high debt levels. But we should not expect governments to end up with the ample space to respond to a downturn that they had ten years ago. Moreover, with high sovereign debt levels, decisions to adopt stimulus may be a hard sell politically.

Given the enduring public resentments borne by the Global Financial Crisis, a recession deep enough to endanger the finances of homeowners or small businesses would likely lead to a strong political call to help relieve debt burdens. That could further stress already stretched public finances.

And if recession once again impairs banks, the recourse to bailouts is now limited in law, following financial regulatory reforms that call for bail-ins of owners and lenders. Those new systems for bail-ins remain underfunded and untested.

Finally, the impairment of key U.S. capital markets during the global financial crisis, which might have produced crippling spillovers across the globe, was robustly contained by unorthodox Fed action supported by Treasury backstop funding. That capacity is also unlikely to be readily available again.

The point is that national policy options and public financial resources may be much more constrained than in the past. The right lesson to take from that possibility is for each country to be much more careful to sustain growth, to limit vulnerabilities, and to prepare for whatever may come.

But the reality is that many countries are not pursuing policies that will bolster their growth in a sustainable fashion. The expansion actually has become less balanced across regions over the past year, and we are witnessing a buildup of vulnerabilities: higher sovereign and corporate debt, tighter financial conditions, incomplete reform efforts, and rising geopolitical tensions.

Five Key Policy Challenges

So, let me turn to five key challenges that could affect the next downturn, areas where governments face a choice to take proactive steps now, or not, and where inaction would probably make matters worse.

The first challenge is the simple and familiar admonition: “First, do no harm.” This is worthy advice for doctors and economic policymakers. Let me mention some examples.

In the case of U.S. fiscal policy over the past year, the combination of spending increases and tax cuts was intended to provide a shot of adrenalin to the U.S. economy and improve investment incentives. However, coming at a time when advanced recovery meant little need for stimulus, this choice runs the three risks of increasing the potential need for Fed tightening; raising deficits and public debt; and spending resources that might better be put aside to combat the next downturn.

Another example is the recent escalation of tariffs and trade tensions. Fortunately, the U.S. and China agreed in Buenos Aires to call a ceasefire. That was a positive development. There certainly are shortcomings in the global trading system, and countries experiencing disruption from trade have some legitimate concerns about a number of trade practices. But the only safe way to address these issues is through dialogue and cooperation.

The IMF has been advocating de-escalation and dialogue for some time. That is because the alternative is hard to contemplate. We estimate that if all of the tariffs that have been threatened are put in place, as much as three-quarters of a percent of global GDP would be lost by 2020. That would be a self-inflicted wound.

So it is vital that this ceasefire leads to a durable agreement that avoids an intensification or spread of tensions.

Now to the second challenge, which is closely tied to the trade issue: China’s emergence as an economic powerhouse. In many ways, this is one of the success stories of our era, showing that global integration can lead to rapid growth, poverty elimination, and new global supply chains lifting up other countries.

But as Winston Churchill once said of the U.S. during World War II, “the price of greatness is responsibility.”

China’s Global Role

Chinese policies that may have been globally inconsequential and thus acceptable when China joined the WTO and had a $1 trillion economy are now consequential to much of the world. That’s because China now is a globally integrated $13 trillion economy whose actions have global reverberations. If China is to continue to benefit from globalization and support the aspirations of developing countries, it will need to focus on how to limit adverse spillovers from its own policies and invest in ensuring that globalization can be sustainable.

Moreover, China would likely gain at home by addressing many of the policy issues that have been contentious, for example through stronger protections for intellectual property, which will benefit China as it becomes a world leader in technologies; reduced trade barriers, especially related to investment rules and government procurement procedures, which will produce cost-reducing and productivity enhancing competition that will benefit the Chinese people in the long run, and an acceleration of market-oriented economic reforms that will help China make more efficient use of scarce resources.

This notion of global responsibility applies to Europe as well, and this is the third challenge. Our forecasts show growth in the euro area and the UK falling short of previous projections, and modest potential growth going forward.

The future of the European economy will be shaped by the way the EU addresses its architectural and macroeconomic challenges and by Brexit. The recent EMU agreement on reforms is welcome. Going forward, the Euro area would gain by pushing further to shore up its institutional foundations.

The absence of a common fiscal policy limits Europe’s ability to share risks and respond to shocks that can radiate through its financial system. And crisis response will be constrained because too much power remains vested in national regulators and supervisors at the expense of an integrated approach across the continent.

All of this prevents Europe from playing a global role commensurate with the size and importance of the euro area economy.

The Task for Emerging Markets

The fourth challenge is in the emerging markets. For all of their extraordinary dynamism, we have seen a divergence among emerging markets over the past year: between those who have not shored up their defenses against shocks, including preparation for the normalization of interest rates in the advanced economies; and those that have taken advantage of the global recovery to address their underlying vulnerabilities.

Capital outflows over the past several months have shown how markets are judging the perceived weaknesses in individual countries. If global conditions become more complicated, these outflows could increase and become more volatile.

The fifth and final challenge is the topic you will take up this afternoon: the role of multilateral institutions.

We know that these institutions have played a crucial role in keeping the global economy on track. In the nearly 75 years since the IMF was set up, our world has undergone multiple transformations, from post-war reconstruction and the Bretton Woods system of fixed exchange rates to the era of flexible rates; the rise of emerging economies; the collapse of the Soviet Union and transition to market economies; as well as a series of financial crises: the Mexican debt crisis, the Asian Crisis, and the Global Financial Crisis.

At each stage, we at the IMF have been called upon to evolve and even remake ourselves.

Now, we see a rising tide of doubt about globalization and discontent with multilateralism in some advanced economies. Just as with the IMF, it is fair for the international community to ask for modernization in its institutions and organizations, to seek reforms to ensure that institutions serve effectively their core purposes.

This applies to groupings such as the G20, as well as international organizations.

So, it was heartening to see the G20 Leaders to call for reform of the WTO when they came together in Buenos Aires. This reform initiative, which has the potential to modernize the global trading system and restore support for cooperative approaches, should now go forward.

The policy challenges we face are clear. As I have suggested, governments have their work cut out for them and may have to contend with less potent policy tools. It is essential they do what they can now to address vulnerabilities and avoid actions that exacerbate the next downturn.

The Multilateral Response

But we should prepare for the possibility that weaker national tools may mean limited effectiveness, and thus may result in greater reliance on multilateral responses and on the global financial safety net.

The IMF’s lending capacity was increased during the global financial crisis to about one trillion dollars – a forceful response from the membership at a time of dire need. One lesson from that crisis was that the IMF went into it under-resourced; we should try to avoid that next time.

From that point of view it was encouraging that the G20 in Buenos Aires underlined its continued commitment to strengthen the safety net, with a strong and adequately financed IMF at its center. It is important that the leaders pledged to conclude the next discussion of our funding, the quota review, next year.

But the stakes are bigger than any one decision about IMF funding. IMF Managing Director Christine Lagarde has called for a “new multilateralism,” one that is dedicated to improving the lives of all this world’s citizens. That ensures that the economic benefits of globalization are shared much more broadly. That focuses on governments and institutions that are both accountable and working together for the common good. And that can take on the many transnational challenges that no one government alone, not even a few governments working together, can handle: climate change, cyber-crime, massive refugee flows, failures of governance, and corruption.

Working together, we will be better able to prevent a damaging downturn in the coming years and a dystopian future in the coming decades. With ingenuity and international cooperation, we can make the most of new technologies and new challenges, and create a shared and sustained prosperity.

Thank you.

Manifesto For The Democratisation Of Europe –  Thomas Piketty and Antoine Vauchez.

A concrete plan to democratise European institutions and policies, with a view to bringing more fiscal and social justice.

Europe will only reconnect with its citizens if it proves it has the ability to bring about genuine European solidarity, by having the main beneficiaries of the globalization process fairly contribute to the financing of the public goods Europe desperately needs.

In a critical moment for Europe, this Manifesto proposes to escape immobilism and abstract discussions by putting on the table a concrete plan to democratise both European institutions and policies, with a view to bringing more fiscal and social justice and to effectively address Europe’s environmental and migration emergencies.

The new European governance that has consolidated over the past decade in the wake of the financial crisis is not only opaque and unaccountable as epitomized by the Eurogroup; it is also ideologically biased towards economic policies with an almost exclusive focus on financial and budgetary objectives. Unsurprisingly, Europe has proved unable to take up the challenges with which it is confronted: growing inequalities across the continent, the acceleration of global warming, the influx of refugees, structural public under-investment (most notably in universities and research), tax fraud and evasion…

Our proposal empowers those member states that wish to address the current political and social crisis of the European project by proposing a budget of long-term investments in public assets of a European scale with a view to fighting social inequalities at EU level, and to securing the long-term viability of a genuine political model of social, fair and sustainable development in Europe.

Financing of the Budget is based on fiscal solidarity through the creation of four European taxes (on high incomes, on wealth, on carbon emissions and a harmonized corporate profits’ tax). To date, European integration has primarily benefited the most powerful and most mobile economic and financial agents: major multinationals, households with high incomes and large assets. Europe will only reconnect with its citizens if it proves it has the ability to bring about genuine European solidarity, by having the main beneficiaries of the globalization process fairly contribute to the financing of the public goods Europe desperately needs.

Such policies are virtually impossible in the current institutional framework, in particular because of the veto right of each country preventing any common fiscal policy. The Treaty for the democratization of Europe (T-Dem) sets the stage for a renewed democratic framework where these new economic policies, in particular the Budget, would not only be possible but also legitimate.

By creating a European Assembly in charge of deliberating and voting upon this Budget, member states can put themselves in a position to tax fairly the most prosperous actors and thus to finance the proposed common budget. With its mixed composition, including national and European members of Parliament, the European Assembly would also have the legitmacy to act as a counter-balance to the ever-growing impact of Europe’s economic governance on national social pacts.

Manifesto For The Democratization Of Europe

We, European citizens, from different backgrounds and countries, are today launching this appeal for the in-depth transformation of the European institutions and policies. This Manifesto contains concrete proposals, in particular a project for a Democratization Treaty and a Budget Project which can be adopted and applied as it stands by the countries who so wish, with no single country being able to block those who want to advance. It can be signed on-line (www.tdem.eu) by all European citizens who identify with it. It can be amended and improved by any political movement.

Following Brexit and the election of anti-European governments at the head of several member countries, it is no longer possible to continue as before. We cannot simply wait for the next departures, or further dismantling without making fundamental changes to present-day Europe.

Today, our continent is caught between political movements whose programme is confined to hunting down foreigners and refugees, a programme which they have now begun to put into action, on one hand. On the other, we have parties which claim to be European but which in reality continue to consider that hard core liberalism and the spread of competition to all (States, firms, territories and individuals) are enough to define a political project. They in no way recognise that it is precisely this lack of social ambition which leads to the feeling of abandonment.

There are some social and political movements which do attempt to end this fatal dialogue by moving in the direction of a new political, social and environmental foundation for Europe. After a decade of economic crisis there is no lack of these specifically European critical situations: structural under- investment in the public sector, particularly in the fields of training and research, a rise in social inequality, acceleration of global warming and a crisis in the reception of migrants and refugees. But these movements often have difficulty in formulating an alternative project, and in describing precisely how they would like to organise the Europe of the future and the decision-making infrastructure specific to it.

We, European citizens, by publishing this Manifesto, Treaty and Budget, are making specific proposals publicly available to all. They are not perfect, but they do have the merit of existing. The public can access them and improve them. They are based on a simple conviction. Europe must build an original model to ensure the fair and lasting social development of its citizens. The only way to convince them is to abandon vague and theoretical promises. If Europe wants to restore solidarity with its citizens it can only do so by providing concrete proof that it is capable of establishing cooperation between Europeans and by making those who have gained from globalisation contribute to the financing of the public sector goods which are cruelly lacking in Europe today. This means making large firms contribute more than small and medium businesses, and the richest taxpayers paying more than poorer taxpayers. This is not the case today.

Our proposals are based on the creation of a Budget for democratization which would be debated and voted by a sovereign European Assembly. This will at last enable Europe to equip itself with a public institution which is both capable of dealing with crises in Europe immediately and of producing a set of fundamental public and social goods and services in the framework of a lasting and solidarity-based economy. In this way, the promise made as far back as the Treaty of Rome of ‘harmonisation of living and working conditions’ will finally become meaningful.

This Budget, if the European Assembly so desires, will be financed by four major European taxes, the tangible markers of this European solidarity. These will apply to the profits of major firms, the top incomes (over 200,000 Euros per annum), the highest wealth owners (over 1 million Euros) and the carbon emissions (with a minimum price of 30 Euros per tonne). If it is fixed at 4% of GDP, as we propose, this budget could finance research, training and the European universities, an ambitious investment programme to transform our model of economic growth, the financing of the reception and integration of migrants and the support of those involved in operating the transformation. It could also give some budgetary leeway to member States to reduce the regressive taxation which weighs on salaries or consumption.

The issue here is not one of creating a ‘Transfer payments Europe’ which would endeavour to take money from the ‘virtuous’ countries to give it to those who are less so. The project for a Treaty of Democratization (www.tdem.eu) states this explicitly by limiting the gap between expenditure deducted and income paid by a country to a threshold of 0.1% of its GDP. The real issue is elsewhere: it is primarily a question of reducing the inequality within the different countries and of investing in the future of all Europeans, beginning of course with the youngest amongst them, with no single country having preference.

Because we must act quickly but we must also get Europe out of the present technocratic impasse, we propose the creation of a European Assembly. This will enable these new European taxes to be debated and voted as also the budget for democratization. This European Assembly can be created without changing the existing European treaties.

This European Assembly would of course have to communicate with the present decision-making institutions (in particular the Eurogroup in which the Ministers for Finance in the Euro zone meet informally every month). But, in cases of disagreement, the Assembly would have the final word. If not, its capacity to be a locus for a new transnational, political space where parties, social movements and NGOs would finally be able to express themselves, would be compromised. Equally its actual effectiveness, since the issue is one of finally extricating Europe from the eternal inertia of inter-governmental negotiations, would be at stake. We should bear in mind that the rule of fiscal unanimity in force in the European Union has for years blocked the adoption of any European tax and sustains the eternal evasion into fiscal dumping by the rich and most mobile, a practice which continues to this day despite all the speeches. This will go on if other decision-making rules are not set up.

Given that this European Assembly will have the ability to adopt taxes and to enter the very core of the democratic, fiscal and social compact of Member states, it is important to truly involve national and European parliamentarians. By granting national elected members a central role, the national, parliamentary elections will de facto be transformed into European elections. National elected members will no longer be able to simply shift responsibility on to Brussels and will have no other option than to explain to the voters the projects and budgets which they intend to defend in the European Assembly. By bringing together the national and European parliamentarians in one single Assembly, habits of co- governance will be created which at the moment only exist between heads of state and ministers of finance.

This is why we propose, in the Democratization Treaty available on-line (www.tdem.eu), that 80% of the members of the European Assembly should be from members of the national parliaments of the countries which sign the Treaty (in proportion to the population of the countries and the political groups), and 20% from the present European parliament (in proportion to the political groups). This choice merits further discussion. In particular, our project could also function with a lower proportion of national parliamentarians (for instance 50%). But in our opinion, an excessive reduction of this proportion might detract from the legitimacy of the European Assembly in involving all European citizens in the direction of a new social and fiscal pact, and conflicts of democratic legitimacy between national and European elections could rapidly undermine the project.

We now have to act quickly. While it would be desirable for all the European Union countries to join in this project without delay, and while it would be preferable that the four largest countries in the Euro zone (which together represent over 70% of the GNP and the population in the zone) adopt it at the outset, the project in its totality has been designed for it to be legally and economically adopted and applied by any sub-set of countries who wish to do so. This point is important because it enables countries and political movements who so desire to demonstrate their willingness to make very specific progress by adopting this project, or an improved version, right now. We call on every man and woman to assume his or her responsibilities and participate in a detailed and constructive discussion for the future of Europe.

Drafted by the following seven authors:

Manon Bouju, économiste

Lucas Chancel, vice-président du World Inquality Lab, Paris School of Economics

Anne-Laure Delatte, economiste, CNRS Research fellow

Stephanie Hennette-Vauchez, juriste, professeure à l’Université Paris Nanterre

Thomas Piketty, economiste, professeur à la Paris School of Economics et à l’Ecole des hautes études en sciences sociales

Guillaume Sacriste, politiste, maître de conférence à l’Université Paris 1-Sorbonne

Antoine Vauchez, politiste, CNRS Research professor, Université Paris 1-Sorbonne

and signed by scores of others

Social Europe

Manifesto for the democratisation of Europe

Download complete Manifesto PDF

DEPRESSION, THE CHEMICAL IMBALANCE MYTH – Johann Hari * THE EMPEROR’S NEW DRUGS – Irving Kirsch.

There is a problem with what everyone knows about antidepressant drugs. It isn’t true. The whole idea of mental distress being caused simply by a chemical imbalance is “a myth,”, sold to us by the drug companies.

In the United States, 40 percent of the regulators’ wages are paid by the drug companies, and in Britain, it’s 100 percent. The rules they have written are designed to make it extraordinarily easy to get a drug approved.

“There was never any basis for it, ever. It was just marketing copy. At the time the drugs came out in the early 1990s, you couldn’t have got any decent expert to go on a platform and say, ‘Look, there’s a lowering of serotonin in the brains of people who are depressed’ There wasn’t ever any evidence for it.” It hasn’t been discredited, because “it didn’t ever get ‘credited.” We don’t know what a “chemically balanced” brain would look like. The effects of these drugs on depression itself are in reality tiny. No matter what chemical you tinker with, you get the same outcome. Antidepressants are little more than active placebos, drugs with very little specific therapeutic benefit, but with serious side effects.

What do the people taking these different drugs actually have in common? Only one thing: the belief that the drugs work, because you believe you are being looked after and offered a solution. Clever marketing over solid empirical evidence.

The serotonin theory “is a lie. I don’t think we should dress it up and say, ‘Oh, well, maybe there’s evidence to support that.’ There isn’t.” Most people on these drugs, after an initial kick, remain depressed or anxious. The belief that antidepressants can cure depression chemically is simply wrong.

The year after I swallowed my first antidepressant, Tipper Gore, the wife of Vice President Al Gore, explained to the newspaper USA Today why she had recently become depressed. “It was definitely a clinical depression, one that I was going to have to have help to overcome,” she said. “What I learned about is your brain needs a certain amount of serotonin and when you run out of that, it’s like running out of gas.” Tens of millions of people, including me, were being told the same thing.

When Irving Kirsch discovered that these serotonin boosting drugs were not having the effects that everyone was being sold, complete/nonfiltered FDA drug company study/research records show that the effects of these drugs on depression itself are in reality tiny, he began, to his surprise, to ask an even more basic question.

What’s the evidence, he began to wonder, that depression is caused primarily by an imbalance of serotonin, or any other chemical, in the brain? Where did it come from?

The serotonin story began, Irving learned, quite by accident in a tuberculosis ward in New York City in the clammy summer of 1952, when some patients began to dance uncontrollably down a hospital corridor. A new drug named Marsilid had come along that doctors thought might help TB patients. It turned out it didn’t have much effect on TB, but the doctors noticed it did something else entirely. They could hardly miss it. It made the patients gleefully, joyfully euphoric, some began to dance frenetically.

So it wasn’t long before somebody decided, perfectly logically, to try to give it to depressed people, and it seemed to have a similar effect on them, for a short time. Not long after that, other drugs came along that seemed to have similar effects (also for short periods), ones named Ipronid and Imipramine. So what, people started to ask, could these new drugs have in common? And whatever it was, could it hold the key to unlocking depression?

Nobody really knew where to look, and so for a decade the question hung in the air, tantalizing researchers. And then in 1965, a British doctor called Alec Coppen came up with a theory. What if, he asked, all these drugs were increasing levels of serotonin in the brain? If that were true, it would suggest that depression might be caused by low levels of serotonin.

“It’s hard to overstate just how far out on a limb these scientists were climbing,” Dr. Gary Greenberg, who has written the history of this period, explains. “They really had no idea what serotonin was doing in the brain.” To be fair to the scientists who first put forward the idea, he says, they put it forward tentatively, as a suggestion. One of them said it was “at best a reductionist simplification,” and said it couldn’t be shown to be true “on the basis of data currently available.”

But a few years later, in the 1970s, it was finally possible to start testing these theories. It was discovered that you can give people a chemical brew that lowers their serotonin levels. So if this theory was right, if low serotonin caused depression, what should happen? After taking this brew, people should become depressed. So they tried it. They gave people a drug to lower their serotonin levels and watched to see what would happen. And, unless they had already been taking powerful drugs they didn’t become depressed. In fact, in the vast majority of patients, it didn’t affect their mood at all.

I went to see one of the first scientists to study these new antidepressants in Britain, Professor David Healy, in his clinic in Bangor, a town in the north of Wales. He has written the most detailed history of antidepressants we have. When it comes to the idea that depression is caused by low serotonin, he told me: “There was never any basis for it, ever. It was just marketing copy. At the time the drugs came out in the early 1990s, you couldn’t have got any decent expert to go on a platform and say, ‘Look, there’s a lowering of serotonin in the brains of people who are depressed’ There wasn’t ever any evidence for it.” It hasn’t been discredited, he said, because “it didn’t ever get ‘credited,’ in a sense. There wasn’t ever a point in time when 50 percent of the field actually believed it.” In the biggest study of serotonin’s effects on humans, it found no direct relationships with depression. Professor Andrew Skull of Princeton has said attributing depression to low serotonin is “deeply misleading and unscientific.“

It had been useful in only one sense. When the drug companies wanted to sell antidepressants to people like me and Tipper Gore, it was a great metaphor. It’s easy to grasp, and it gives you the impression that what antidepressants do is restore you to a natural state, the kind of balance that everyone else enjoys.

Irving learned that once serotonin was abandoned by scientists (but certainly not by drug company PR teams) as an explanation for depression and anxiety, there was a shift in scientific research. Okay, they said: if it’s not low serotonin that’s causing depression and anxiety, then it must be the lack of some other chemical. It was still taken for granted that these problems are caused by a chemical imbalance in the brain, and antidepressants work by correcting that chemical imbalance. If one chemical turns out not to be the psychological killer, they must start searching for another one.

But Irving began to ask an awkward question. If depression and anxiety are caused by a chemical imbalance, and antidepressants work by fixing that imbalance, then you have to account for something odd that he kept finding. Antidepressant drugs that increase serotonin in the brain have the same modest effect, in clinical trials, as drugs that reduce serotonin in the brain. And they have the same effect as drugs that increase another chemical, norepinephrine. And they have the same effect as drugs that increase another chemical, dopamine. In other words, no matter what chemical you tinker with, you get the same outcome.

So Irving asked: What do the people taking these different drugs actually have in common? Only, he found, one thing: the belief that the drugs work. It works, Irving believes, largely for the same reason that John Haygarth’s wand worked: because you believe you are being looked after and offered a solution.

After twenty years researching this at the highest level, Irving has come to believe that the notion depression is caused by a chemical imbalance is just “an accident of history,” produced by scientists initially misreading what they were seeing, and then drug companies selling that misperception to the world to cash in.

And so, Irving says, the primary explanation for depression offered in our culture starts to fall apart. The idea you feel terrible because of a “chemical imbalance” was built on a series of mistakes and errors. It has come as close to being proved wrong, he told me, as you ever get in science. It’s lying broken on the floor, like a neurochemical Humpty Dumpty with a very sad smile.

I had traveled a long way with Irving on his journey but I stopped there, startled. Could this really be true? I am trained in the social sciences, which is the kind of evidence that I’ll be discussing in the rest of this book. I’m not trained in the kind of science he is a specialist in. I wondered if I was misunderstanding him, or if he was a scientific outlier. So I read all that I could, and I got as many other scientists to explain it to me as possible. “There’s no evidence that there’s a chemical imbalance” in depressed or anxious people’s brains, Professor Joanna Moncrieff, one of the leading experts on this question-explained to me bluntly in her office at the University College of London. The term doesn’t really make any sense, she said: we don’t know what a “chemically balanced” brain would look like. People are told that drugs like antidepressants restore a natural balance to your brain, she said, but it’s not true-they create an artificial state. The whole idea of mental distress being caused simply by a chemical imbalance is “a myth,” she has come to believe, sold to us by the drug companies.

The clinical psychologist Dr. Lucy Johnstone was more blunt still. “Almost everything you were told was bullshit,” she said to me over coffee. The serotonin theory “is a lie. I don’t think we should dress it up and say, ‘Oh, well, maybe there’s evidence to support that.’ There isn’t.”

Yet it seemed wildly implausible to me that something so huge, one of the most popular drugs in the world, taken by so many people all around me, could be so wrong. Obviously, there are protections against this happening: huge hurdles of scientific testing that have to take place before a drug gets to our bathroom cabinets. I felt as if I had just landed in a flight from JFK to LAX, only to be told that the plane had been flown by a monkey the whole way. Surely there are procedures in place to stop something like this from happening? How could these drugs have gotten through the procedures in place, if they were really as limited as this deeper research suggested?

I discussed this with one of the leading scientists in this field, Professor John Ioannidis, who the Atlantic Monthly has said “may be one of the most influential scientists alive.” He says it is not surprising that the drug companies could simply override the evidence and get the drugs to market anyway, because in fact it happens all the time. He talked me through how these antidepressants got from the development stage to my mouth.

It works like this: “The companies are often running their own trials on their own products,” he said. That means they set up the clinical trial, and they get to decide who gets to see any results. So “they are judging their own products. They’re involving all these poor researchers who have no other source of funding, and who have little control over how the results will be written up and presented.” Once the scientific evidence is gathered, it’s not even the scientists who write it up much of the time. “Typically, it’s the company people who write up the published scientific reports.”

This evidence then goes to the regulators, whose job is to decide whether to allow the drug onto the market. But in the United States, 40 percent of the regulators’ wages are paid by the drug companies, and in Britain, it’s 100 percent. When a society is trying to figure out which drug is safe to put on the market, there are meant to be two teams: the drug company making the case for it, and a referee working for us, the public, figuring out if it properly works. But Professor Ioannidis was telling me that in this match, the referee is paid by the drug company team, and that team almost always wins.

The rules they have written are designed to make it extraordinarily easy to get a drug approved. All you have to do is produce two trials, any time, anywhere in the world, that suggest some positive effect of the drug. If there are two, and there is some effect, that’s enough. So you could have a situation in which there are one thousand scientific trials, and 998 find the drug doesn’t work at all, and two find there is a tiny effect, and that means the drug will be making its way to your local pharmacy.

“I think that this is a field that is seriously sick,” Professor Ioannidis told me. “The field is just sick and bought and corrupted, and I can’t describe it otherwise.” I asked him how it made him feel to have learned all of this. “It’s depressing,” he said. That’s ironic, I replied. “But it’s not depressing,” he responded, “to the severe extent that I would take SSRIs [antidepressants].”

I tried to laugh, but it caught in my throat.

Some people said to Irving, so what? Okay, so say it’s a placebo effect. Whatever the reason, people still feel better. Why break the spell? He explained: the evidence from the clinical trials suggests that the antidepressant effects are largely a placebo, but the side effects are mostly the result of the chemicals themselves, and they can be very severe.

“Of course,” Irving says, there’s “weight gain.” I massively ballooned, and saw the weight fall off almost as soon as I stopped. “We know that SSRIs [the new type of antidepressants] in particular contribute to sexual dysfunction, and the rates for most SSRIs are around 75 percent of treatment-engendered sexual dysfunction,” he continued. Though it’s painful to talk about, this rang true for me, too. In the years I was taking Paxil, I found my genitals were a lot less sensitive, and it took a really long time to ejaculate. This made sex painful and it reduced the pleasure I took from it. It was only when I stopped taking the drug and I started having more pleasurable sex again that I remembered regular sex is one of the best natural antidepressants in the world.

“In young people, these chemical antidepressants increase the risk of suicide. There’s a new Swedish study showing that it increases the risk of violent criminal behavior,” Irving continued. “In older people it increases the risk of death from all causes, increases the risk of stroke. In everybody, it increases the risk of type 2 diabetes. In pregnant women, it increases the risk of miscarriage and of having children born with autism or physical deformities. So all of these things are known.” And if you start experiencing these effects, it can be hard to stop, about 20 percent of people experience serious withdrawal symptoms.

So, he says, “if you want to use something to get its placebo effect, at least use something that’s safe.” We could be giving people the herb St. John’s Wort, Irving says, and we’d have all the positive placebo effects and none of these drawbacks. Although, of course, St. John’s Wort isn’t patented by the drug companies, so nobody would be making much profit off it.

By this time, Irving was starting, he told me softly, to feel “guilty” for having pushed those pills for all those years.

In 1802, John Haygarth revealed the true story of the wands to the public. Some people are really recovering from their pain for a time, he explained, but it’s not because of the power in the wands. It’s because of the power in their minds. It was a placebo effect, and it likely wouldn’t last, because it wasn’t solving the underlying problem.

This message angered almost everyone? Some felt duped by the people who had sold the expensive wands in the first place, but many more felt furious with Haygarth himself, and said he was clearly talking rubbish. “The intelligence excited great commotions, accompanied by threats and abuse,” he wrote. “A counterdeclaration was to be signed by a great number of very respectable persons”, including some leading scientists of the day, explaining that the wand worked, and its powers were physical, and real.

Since Irving published his early results, and as he has built on them over the years, the reaction has been similar. Nobody denies that the drug companies’ own data, submitted to the FDA, shows that antidepressants have only a really small effect over and above placebo. Nobody denies that my own drug company admitted privately that the drug I was given, Paxil, was not going to work for people like me, and they had to make a payout in court for their deception.

But some scientists, a considerable number, do dispute many of Kirsch’s wider arguments. I wanted to study carefully what they say. I hoped the old story could still, somehow, be saved. I turned to a man who, more than anyone else alive, successfully sold antidepressants to the wider public, and he did it because he believed it: he never took a cent from the drug companies.

In the 1990s, Dr. Peter Kramer was watching as patient after patient walked into his therapy office in Rhode Island, transformed before his eyes after they were given the new antidepressant drugs. It’s not just that they seemed to have improved; they became, he argued, “better than well”, they had more resilience and energy than the average person. The book he wrote about this, Listening to Prozac, became the bestselling book ever about antidepressants. I read it soon after I started taking the drugs. I was sure the process Peter described so compellingly was happening to me. I wrote about it, and I made his case to the public in articles and interviews.

So when Irving started to present his evidence, Peter, by then a professor at Brown Medical School, was horrified. He started taking apart Irving’s critique of antidepressants at length, in public, both in books and in a series of charged public debates.

His first argument is that Irving is not giving antidepressants enough time. The clinical trials he has analyzed, almost all the ones submitted to the regulator, typically last for four to eight weeks. But that isn’t enough. It takes longer for these drugs to have a real effect.

This seemed to me to be an important objection. Irving thought so, too. So he looked to see if there were any drug trials that had lasted longer, to find their results. It turns out there were two, and in the first, the placebo did the same as the drug, and in the second, the placebo did better.

Peter then pointed to another mistake he believed Irving had made. The antidepressant trials that Irving is looking at lump together two groups: moderately depressed people and severely depressed people. Maybe these drugs don’t work much for moderately depressed people, Peter concedes, but they do work for severely depressed people. He’s seen it. So when Irving adds up an average for everyone, lumping together the mildly depressed and the severely depressed, the effect of the drugs looks small, but that’s only because he’s diluting the real effect, as surely as Coke will lose its flavor if you mix it with pints and pints of water.

Again, Irving thought this was a potentially important point, and one he was keen to understand, so he went back over the studies he had drawn his data from. He discovered that, with a single exception, he had looked only at studies of people classed as having very severe depression.

This then led Peter to turn to his most powerful argument. It’s the heart of his case against Irving and for antidepressants.

In 2012, Peter went to watch some clinical trials being conducted, in a medical center that looked like a beautiful glass cube, and gazed out over expensive houses.

When the company there wants to conduct trials into antidepressants, they have two headaches. They have to recruit volunteers who will swallow potentially dangerous pills over a sustained period of time, but they are restricted by law to paying only small amounts: between $40 and $75. At the same time, they have to find people who have very specific mental health disorders, for example, if you are doing a trial for depression, they have to have only depression and no other complicating factors. Given all that, it’s pretty difficult for them to find anyone who will take part, so they often turn to quite desperate people, and they have to offer other things to tempt them. Peter watched as poor people were bused in from across the city to be offered a gorgeous buffet of care they’d never normally receive at home, therapy, a whole community of people who’d listen to them, a warm place to be during the day, medication, and money that could double their poverty-level income.

As he watched this, he was struck by something. The people who turn up at this center have a strong incentive to pretend to have any condition they happen to be studying there, and the for-profit companies conducting the clinical trials have a strong incentive to pretend to believe them. Peter looked on as both sides seemed to be effectively bullshitting each other. When he saw people being asked to rate how well the drugs had worked, he thought they were often clearly just giving the interviewer whatever answer they wanted.

So Peter concluded that the results from clinical trials of antidepressants, all the data we have, are meaningless. That means Irving is building his conclusion that their effect is very small (at best) on a heap of garbage, Peter declared. The trials themselves are fraudulent.

It’s a devastating point, and Peter has proved it quite powerfully. But it puzzled Irving when he heard it, and it puzzled me. The leading scientific defender of antidepressants, Peter Kramer, is making the case for them by saying that the scientific evidence for them is junk.

When I spoke to Peter, I told him that if he is right (and I think he is), then that’s not a case for the drugs. It’s a case against them. It means that, by law, they should never have been brought to market.

When I started to ask about this, in a friendly tone Peter became quite irritable, and said even bad trials can yield usable results. He soon changed the subject. Given that he puts so much weight on what he’s seen with his own eyes, I asked Peter what he would say to the people who claimed that John Haygarth’s wand worked, because they, too, were just believing what they saw with their own eyes. He said that in cases like that, “the collection of experts isn’t as expert or as numerous as what we’re talking about here. I mean, this would be [an] orders-of-magnitude bigger scandal if these were [like] just bones wrapped in cloth.”

Shortly after, he said: “I think I want to cut off this conversation.”

Even Peter Kramer had one note of caution to offer about these drugs. He stressed to me that the evidence he has seen only makes the case for prescribing antidepressants for six to twenty weeks. Beyond that, he said, “I think that the evidence is thinner, and my dedication to the arguments is less as you get to long-term use. I mean, does anyone really know about what fourteen years of use does in terms of harm and benefit? I think the answer is we don’t really know.” I felt anxious as he said that, I had already told him that I used the drugs for almost that long. Perhaps because he sensed my anxiety, he added: “Although I do think we’ve been reasonably lucky. People like you come off and function.”

Very few scientists now defend the idea that depression is simply caused by low levels of serotonin, but the debate about whether chemical antidepressants work for some other reason we don’t fully understand, is still ongoing. There is no scientific consensus. Many distinguished scientists agree with Irving Kirsch; many agree with Peter Kramer. I wasn’t sure what to take away from all of this, until Irving led me to one last piece of evidence. I think it tells us the most important fact we need to know about chemical antidepressants.

In the late 1990s, a group of scientists wanted to test the effects of the new SSRI antidepressants in a situation that wasn’t just a lab, or a clinical trial. They wanted to look at what happens in a more everyday situation, so they set up something called the Star-D Trial. It was pretty simple. A normal patient goes to the doctor and explains he’s depressed. The doctor talks through the options with him, and if they both agree, he starts taking an antidepressant. At this point, the scientists conducting the trial start to monitor the patient. If the antidepressant doesn’t work for him, he’s given another one. If that one doesn’t work, he’s given another one, and on and on until he gets one that feels as though it works. This is how it works for most of us out there in the real world: a majority of people who get prescribed antidepressants try more than one, or try more than one dosage, until they find the effect they’re looking for.

And what the trial found is that the drugs worked. Some 67 percent of patients did feel better, just like I did in those first months.

But then they found something else. Within a year, half of the patients were fully depressed again. Only one in three of the people who stayed on the pills had a lasting, proper recovery from their depression. (And even that exaggerates the effect, since we know many of those people would have recovered naturally without the pills.)

It seemed like my story, played out line by line. I felt better at first; the effect wore off; I tried increasing the dose, and then that wore off, too. When I realized that antidepressants weren’t working for me any more, that no matter how much I jacked up the dose, the sadness would still seep back through, I assumed there was something wrong with me.

Now I was reading the Star-D Trial’s results, and I realized I was normal. My experience was straight from the textbook: far from being an outlier, I had the typical antidepressant experience.

This evidence has been followed up several times since, and the proportion of people on antidepressants who continue to be depressed is found to be between 65 and 80 percent.

To me, this seems like the most crucial piece of evidence about antidepressants of all: most people on these drugs, after an initial kick, remain depressed or anxious.

I want to stress, some reputable scientists still believe that these drugs genuinely work for a minority of people who take them, due to a real chemical effect. It’s possible. Chemical antidepressants may well be a partial solution for a minority of depressed and anxious people, I certainly don’t want to take away anything that’s giving relief to anyone. If you feel helped by them, and the positives outweigh the side effects, you should carry on. (And if you are going to stop taking them, then it’s essential that you don’t do it overnight, because you can experience severe physical withdrawal symptoms and a great deal of panic as a result. I gradually reduced my dose very slowly, over six months, in consultation with my doctor, to prevent this from happening.)

But it is impossible, in the face of this evidence, to say they are enough, for a big majority of depressed and anxious people.

I couldn’t deny it any longer: for the vast majority we clearly needed to find a different story about what is making us feel this way, and a different set of solutions. But what, asked myself, bewildered, could they be?

The Emperor’s New Drugs

Irving Kirsch

Everyone knows that antidepressant drugs are miracles of modern medicine. Professor Irving Kirsch knew this as well as anyone. But, as he discovered during his research, there is a problem with what everyone knows about antidepressant drugs. It isn’t true.

How did antidepressant drugs gain their reputation as a magic bullet for depression? And why has it taken so long for the story to become public? Answering these questions takes us to the point where the lines between clinical research and marketing disappear altogether.

Using the Freedom of Information Act, Kirsch accessed clinical trials that were withheld, by drug companies, from the public and from the doctors who prescribe antidepressants. What he found, and what he documents here, promises to bring revolutionary change to the way our society perceives, and consumes, antidepressants.

The Emperor’s New Drugs exposes what we have failed to see before: depression is not caused by a chemical imbalance in the brain; antidepressants are significantly more dangerous than other forms of treatment and are only marginally more effective than placebos; and, there are other ways to combat depression, treatments that don’t only include the empty promise of the antidepressant prescription.

This is not a book about alternative medicine and its outlandish claims. This is a book about fantasy and wishful thinking in the heart of clinical medicine, about the seductions of myth, and the final stubbornness of facts.

Irving Kirsch is a lecturer in medicine at the Harvard Medical School and a professor of psychology at Plymouth University, as well as professor emeritus of psychology at the University of Hull, and the University of Connecticut. He has published eight books and numerous scientific articles on placebo effects, antidepressant medication, hypnosis, and suggestion. His work has appeared in Science, Science News, New Scientist, New York Times, Newsweek, and BBC Focus and many other leading magazines, newspapers, and television documentaries.

Like most people, I used to think that antidepressants worked. As a clinical psychologist, I referred depressed psychotherapy clients to psychiatric colleagues for the prescription of medication, believing that it might help. Sometimes the antidepressant seemed to work; sometimes it did not. When it did work, I assumed it was the active ingredient in the antidepressant that was helping my clients cope with their psychological condition.

According to drug companies, more than 80 per cent of depressed patients can be treated successfully by antidepressants. Claims like this made these medications one of the most widely prescribed class of prescription drugs in the world, with global sales that make it a $19-billion-a-year industry. Newspaper and magazine articles heralded antidepressants as miracle drugs that had changed the lives of millions of people. Depression, we were told, is an illness a disease of the brain that can be cured by medication. I was not so sure that depression was really an illness, but I did believe that the drugs worked and that they could be a helpful adjunct to psychotherapy for very severely depressed clients. That is why I referred these clients to psychiatrists who could prescribe antidepressants that the clients could take while continuing in psychotherapy to work on the psychological issues that had made them depressed.

But was it really the drug they were taking that made my clients feel better? Perhaps I should have suspected that the improvement they reported might not have been a drug effect. People obtain considerable benefits from many medications, but they also can experience symptom improvement just by knowing they are being treated. This is called the placebo effect. As a researcher at the University of Connecticut, I had been studying placebo effects for many years. I was well aware of the power of belief to alleviate depression, and I understood that this was an important part of any treatment, be it psychological or pharmacological. But I also believed that antidepressant drugs added something substantial over and beyond the placebo effect.

As I wrote in my first book, ‘comparisons of antidepressive medication with placebo pills indicate that the former has a greater effect, the existing data suggest a pharmacologically specific effect of imipramine on depression’. As a researcher, I trusted the data as it had been presented in the published literature. I believed that antidepressants like imipramine were highly effective drugs, and I referred to this as ‘the established superiority of imipramine over placebo treatment’.

When I began the research that I describe in this book, I was not particularly interested in investigating the effects of antidepressants. But I was definitely interested in investigating placebo effects wherever I could find them, and it seemed to me that depression was a perfect place to look. Why did I expect to find a large placebo effect in the treatment of depression? If you ask depressed people to tell you what the most depressing thing in their lives is, many answer that it is their depression. Clinical depression is a debilitating condition. People with severe depression feel unbearably sad and anxious, at times to the point of considering suicide as a way to relieve the burden. They may be racked with feelings of worthlessness and guilt. Many suffer from insomnia, whereas others sleep too much and find it difficult to get out of bed in the morning. Some have difficulty concentrating and have lost interest in all of the activities that previously brought pleasure and meaning into their lives. Worst of all, they feel hopeless about ever recovering from this terrible state, and this sense of hopelessness may lead them to feel that life is not worth living. In short, depression is depressing. John Teasdale, a leading researcher on depression at Oxford and Cambridge universities, labelled this phenomenon ‘depression about depression’ and claimed that effective treatments for depression work at least in part by altering the sense of hopelessness that comes from being depressed about one’s own depression?!

Whereas hopelessness is a central feature of depression, hope lies at the core of the placebo effect. Placebos instil hope in patients by promising them relief from their distress. Genuine medical treatments also instil hope, and this is the placebo component of their effectiveness.

When the promise of relief instils hope, it counters a fundamental attribute of depression. Indeed, it is difficult to imagine any treatment successfully treating depression without reducing the sense of hopelessness that depressed people feel. Conversely, any treatment that reduces hopelessness must also assuage depression. So a convincing placebo ought to relieve depression.

It was with that in mind that one of my postgraduate students, Guy Sapirstein, and I set out to investigate the placebo effect in depression, an investigation that I describe in the first chapter of this book, and that produced the first of a series of surprises that transformed my views about antidepressants and their role in the treatment of depression. In this book I invite you to share this journey in which I moved from acceptance to dissent, and finally to a thorough rejection of the conventional view of antidepressants.

The drug companies claimed and still maintain that the effectiveness of antidepressants has been proven in published clinical trials showing that the drugs are substantially better than placebos (dummy pills with no active ingredients at all). But the data that Sapirstein and I examined told a very different story. Although many depressed patients improve when given medication, so do many who are given a placebo, and the difference between the drug response and the placebo response is not all that great.

What the published studies really indicate is that most of the improvement shown by depressed people when they take antidepressants is due to the placebo effect.

Our finding that most of the effects of antidepressants could be explained as a placebo effect was only the first of a number of surprises that changed my views about antidepressants. Following up on this research, I learned that the published clinical trials we had analysed were not the only studies assessing the effectiveness of antidepressants. I discovered that approximately 40 per cent of the clinical trials conducted had been withheld from publication by the drug companies that had sponsored them. By and large, these were studies that had failed to show a significant benefit from taking the actual drug. When we analysed all of the data, those that had been published and those that had been suppressed my colleagues and I were led to the inescapable conclusion that antidepressants are little more than active placebos, drugs with very little specific therapeutic benefit, but with serious side effects. I describe these analyses and the reaction to them in Chapters 3 and 4.

How can this be? Before a new drug is put on the market, it is subjected to rigorous testing. The drug companies sponsor expensive clinical trials, in which some patients are given medication and others are given placebos. The drug is considered effective only if patients given the real drug improve significantly more than patients given the placebos. Reports of these trials are then sent out to medical journals, where they are subjected to rigorous peer review before they are published. They are also sent to regulatory agencies, like the Food and Drug Administration (FDA) in the US, the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK and the European Medicine Agency (EMEA) in the EU. These regulatory agencies carefully review the data on safety and effectiveness, before deciding whether to approve the drugs for marketing. So there must be substantial evidence backing the effectiveness of any medication that has reached the market.

And yet I remain convinced that antidepressant drugs are not effective treatments and that the idea of depression as a chemical imbalance in the brain is a myth. When I began to write this book, my claim was more modest. I believed that the clinical effectiveness of antidepressants had not been proven for most of the millions of patients to whom they are prescribed, but I also acknowledged that they might be beneficial to at least a subset of depressed patients. During the process of putting all of the data together, those that I had analysed over the years and newer data that have just recently seen the light of day, I realized that the situation was even worse than I thought.

The belief that antidepressants can cure depression chemically is simply wrong.

In this book I will share with you the process by which I came to this conclusion and the scientific evidence on which it is based. This includes evidence that was known to the pharmaceutical companies and to regulatory agencies, but that was intentionally withheld from prescribing physicians, their patients and even from the National Institute for Health and Clinical Excellence (NICE) when it was drawing up treatment guidelines for the National Health Service (NHS).

My colleagues and I obtained some of these hidden data by using the Freedom of Information Act in the US. We analysed the data and submitted the results for peer review to medical and psychological journals, where they were then published. Our analyses have become the focus of a national and international debate, in which many doctors have changed their prescribing habits and others have reacted with anger and incredulity.

My intention in this book is to present the data in a plain and straightforward way, so that you will be able to decide for yourself whether my conclusions about antidepressants are justified.

The conventional view of depression is that it is caused by a chemical imbalance in the brain. The basis for this idea was the belief that antidepressant drugs were effective treatments. Our analysis showing that most if not all of the effects of these medications are really placebo effects challenges this widespread view of depression. In Chapter 4 I examine the chemical-imbalance theory. You may be surprised to learn that it is actually a rather controversial theory and that there is not much scientific evidence to support it. While writing this chapter I came to an even stronger conclusion. It is not just that there is not much supportive evidence; rather, there is a ton of data indicating that the chemical-imbalance theory is simply wrong.

The chemical effect of antidepressant drugs may be small or even non-existent, but these medications do produce a powerful placebo effect. In Chapters 5 and 6 I examine the placebo effect itself. I look at the myriad of effects that placebos have been shown to have and explore the theories of how these effects are produced. I explain how placebos are able to produce substantial relief from depression, almost as much as that produced by medication, and the implications that this has for the treatment of depression.

Finally, in Chapter 7, I describe some of the alternatives to medication for the treatment of depression and assess the evidence for their effectiveness. One of my aims is to provide essential scientifically grounded information for making informed choices between the various treatment options that are available.

Much of what I write in this book will seem controversial, but it is all thoroughly grounded on scientific evidence, evidence that I describe in detail in this book. Furthermore, as controversial as my conclusions seem, there has been a growing acceptance of them. NICE has acknowledged the failure of antidepressant treatment to provide clinically meaningful benefits to most depressed patients; the UK government has instituted plans for providing alternative treatments; and neuroscientists have noted the inability of the chemical-imbalance theory to explain depression. We seem to be on the cusp of a revolution in the way we understand and treat depression.

Learning the facts behind the myths about antidepressants has been, for me, a journey of discovery. It was a journey filled with shocks and surprises, surprises about how drugs are tested and how they are approved, what doctors are told and what is kept hidden from them, what regulatory agencies know and what they don’t want you to know, and the myth of depression as a brain disease. I would like to share that journey with you. Perhaps you will find it as surprising and shocking as I did. It is my hope that making this information public will foster changes in the way new drugs are tested and approved in the future, in the public availability of the data and in the treatment of depression.

1

Listening to Prozac, but Hearing Placebo

In 1995 Guy Sapirstein and I set out to assess the placebo effect in the treatment of depression. Instead of doing a brand-new study, we decided to pool the results of previous studies in which placebos had been used to treat depression and analyse them together. What we did is called a meta-analysis, and it is a common technique for making sense of the data when a large number of studies have been done to answer a particular question. It was once considered somewhat controversial, but meta-analyses are now common features in all of the leading medical journals. Indeed, it is hard to see how one could interpret the results of large numbers of studies without the aid of a meta-anaiysis.

In doing our meta-analysis, it was not enough to find studies in which depressed patients had been given placebos. We also needed to find studies in which depression had been tracked in patients who were not given any treatment at all. This was to make sure that any effect we found was really due to the administration of the placebo. To better understand the reason for this, imagine that you are investigating a new remedy for colds. If the patients are given the new medicine, they get better, if they are given placebos, they also get better. Seeing these data, you might be tempted to think that the improvement was a placebo effect. But people recover from colds even if you give them nothing at all. So when the patients in our imaginary study took a dummy pill and their colds got better, the improvement may have had nothing to do with the placebo effect. It might simply have been due to the passage of time and the fact that colds are short-lasting illnesses.

Spontaneous improvement is not limited to colds. It can also happen when people are depressed. Because people sometimes recover from bouts of depression with no treatment at all, seeing that a person has become less depressed after taking a placebo does not mean that the person has experienced a placebo effect. The improvement could have been due to any of a number of other factors. For example, people can get better because of positive changes in life circumstances, such as finding a job after a period of unemployment or meeting a new romantic partner. Improvement can also be facilitated by the loving support of friends and family. Sometimes a good friend can function as a surrogate therapist. In fact, a very influential book on psychotherapy bore the title Psychotherapy: The Purchase of Friendship. The author did not claim that psychotherapy was merely friendship, but the title does make the point that it can be very therapeutic to have a friend who is empathic and knows how to listen.

The point is that without comparing the effect of placebos against rates of spontaneous recovery, it is impossible to assess the placebo effect. Just as we have to control for the placebo effect to evaluate the effect of a drug, so too we have to control for the passage of time when assessing the placebo effect. The drug effect is the difference between what happens when people are given the active drug and what happens when they are given the placebo. Analogously, the placebo effect is the difference between what happens when people are given placebos and what happens when they are not treated at all.

It is rare for a study to focus on the placebo effect or on the effect of the simple passage of time, for that matter. So where were we to find our placebo data and no-treatment data? We found our placebo data in clinical studies of antidepressants, and our no-treatment data in clinical studies of psychotherapy. It is common to have no-treatment or wait-list control groups in studies of the effects of psychotherapy. These groups consist of patients who are not given any treatment at all during the course of the study, although they may be placed on a wait list and given treatment after the research is concluded.

For the purpose of our research, Sapirstein and I were not particularly interested in the effects of the antidepressants or psychotherapy. What we were interested in was the placebo effect. But since we had the treatment data to hand, we looked at them as well. And, as it turned out, it was the comparison of drug and placebo that proved to be the most interesting part of our study.

All told, we analysed 38 clinical trials involving more than 3,000 depressed patients. We looked at the average improvement during the course of the study in each of the four types of groups: drug, placebo, psychotherapy and no-treatment. I am going to use a graph here (Figure 1.1) to show what the data tell us. Although the text will have a couple more such charts, I am going to keep them to a minimum. But this is one that I think we need, to make the point clearly. What the graph shows is that there was substantial improvement in both the drug and psychotherapy groups. People got better when given either form of treatment, and the difference between the two was not significant. People also got better when given placebos, and here too the improvement was remarkably large, although not as great as the improvement following drugs or psychotherapy. In contrast, the patients who had not been given any treatment at all showed relatively little improvement.

The first thing to notice in this graph is the difference in improvement between patients given placebos and patients not given any treatment at all. This difference shows that most of the improvement in the placebo groups was produced by the fact that they had been given placebos. The reduction in depression that people experienced was not just caused by the passage of time, the natural course of depression or any of the other factors that might produce an improvement in untreated patients. It was a placebo effect. and it was powerful.

Figure 1.1. Average improvement on drug, psychotherapy, placebo and no treatment. ‘lmprovement’ refers to the reduction of symptoms on scales used to measure depression. The numbers are called ‘effect sizes’. They are commonly used when the results of different studies are pooled together. Typically, effect sizes of 0.5 are considered moderate, whereas effect sizes of 0.8 are considered large. So the graph shows that antidepressants, psychotherapy and placebos produce large changes in the symptoms of depression, but there was only a relatively small average improvement in people who were not given any treatment at all.
.

One thing to learn from these data is that doing nothing is not the best way to respond to depression. People should not just wait to recover spontaneously from clinical depression, nor should they be expected just to snap out of it. There may be some improvement that is associated with the simple passage of time, but compared to doing nothing at all, treatment even if it is just placebo treatment provides substantial benefit.

Sapirstein and I were not surprised to find that there was a powerful placebo effect in the treatment of depression. Actually, we were quite pleased. That was our hypothesis and our reason for doing the study. What did surprise us, however, was how small the difference was between the response to the drug and the response to the placebo. That difference is the drug effect. Although the drug effect in the published clinical trials that we had analysed was statistically significant, it was much smaller than we had anticipated. Much of the therapeutic response to the drug was due to the placebo effect.

The relatively small size of the drug effect was the first of a series of surprises that the antidepressant data had in store for us.

One way to understand the size of the drug effect is to think about it as only a part of the improvement that patients experience when taking medication. Part of the improvement might be spontaneous that is, it might have occurred without any treatment at all and part may be a placebo effect. What is left over after you subtract spontaneous improvement and the placebo effect is the drug effect. You can see in Figure 1.1 that improvement in patients who had been given a placebo was about 75 per cent of the response to the real medication. That means that only 25 per cent of the benefit of antidepressant treatment was really due to the chemical effect of the drug. It also means that 50 per cent of the improvement was a placebo effect. In other words, the placebo effect was twice as large as the drug effect.

The drug effect seemed rather small to us, considering that these medications had been heralded as a revolution in the treatment of depression, blockbuster drugs that have been prescribed to hundreds of millions of patients, with annual sales totalling billions of pounds: Sapirstein and I must have done something wrong in either collecting or analysing the data. But what? We spent months trying to figure it out.

ARE ALL DRUGS CREATED EQUAL? DOUBLEBLIND OR DOUBLE-TALK

One thing that occurred to us, when considering how surprisingly small the drug effect was in the clinical trials we had analysed, was that a number of different medications had been assessed in those studies. Perhaps some of them were effective, whereas others were not. If this were the case, we had underestimated the benefits of effective drugs by lumping them together with ineffective medications. So before we sent our paper out for review, we went back to the data and examined the type of drugs that had been administered in each of the clinical trials in our meta-analysis.

We found that some of these trials had assessed tricyclic antidepressants, an older type of medication that was the most commonly used antidepressant in the 1960s and 1970s. In other trials, the focus was on selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), the first of the ‘new-generation’ drugs that replaced tricyclics as the top-selling type of antidepressant. And there were other types of antidepressants investigated in these trials as well. When we reanalysed the data, examining the drug effect and the placebo effect for each type of medication separately, we found that the diversity of drugs had not affected the outcome of our analysis. In fact, the data were remarkably consistent much more so than is usually the case when one analyses different groups of data. Not only did all of these medications produce the same degree of improvement in depression, but also, in each case, only 25 per cent of the improvement was due to the effect of the drug. The rest could be explained by the passage of time and the placebo effect.

The lack of difference we found between one class of antidepressants and another is now a rather frequent finding in antidepressant research. The newer antidepressants (SSRIs, for example) are no more effective than the older medications. Their advantage is that their side effects are less troubling, so that patients are more likely to stay on them rather than discontinue treatment. Still, the consistency of the size of the drug effect was surprising. It was not just that the percentages were close; they were virtually identical. They ranged from 24 to 26 per cent. At the time I thought, ‘What a nice coincidence! It will look great in a PowerPoint slide when I am invited to speak on this topic.’ But since then I have been struck by similar instances in which the consistency of the data is remarkable, and it is part of what has transformed me from a doubter to a disbeliever. I will note similar consistencies as we encounter them in this book.

The consistency of the effects of different types of antidepressants meant that we had not underestimated the antidepressant drug effect by lumping together the effects of more effective and less effective drugs. But our re-examination of the data in our meta-analysis held another surprise for us. Some of the medications we had analysed were not antidepressants at all, even though they had been evaluated for their effects on depression. One was a barbiturate, a depressant that had been used as a sleeping aid, before being replaced by less dangerous medications. Another was a benzodiazepine a sedative that has largely replaced the more dangerous barbiturates. Yet another was a synthetic thyroid hormone that had been given to depressed patients who did not have a thyroid disorder. Although none of these drugs are considered antidepressants, their effects on depression were every bit as great as those of antidepressants and significantly better than placebos. Joanna Moncrieff, a psychiatrist at University College London, has since listed other drugs that have been shown to be as effective as medications for depression. These include antipsychotic drugs, stimulants and herbal remedies. Opiates are also better than placebos, but I have not seen them compared to antidepressants.

If sedatives, barbiturates, antipsychotic drugs, stimulants, opiates and thyroid medications all outperform inert placebos in the treatment of depression, does this mean that any active drug can function as an antidepressant? Apparently not. In September 1998 the pharmaceutical company Merck announced the discovery of a novel antidepressant with a completely different mode of action than other medications for depression. This new drug, which they later marketed under the trade name Emend for the prevention of nausea and vomiting due to chemotherapy, seemed to show considerable promise as an antidepressant in early clinical trials. Four months later the company announced its decision to pull the plug on the drug as a treatment for depression. The reason? It could not find a significant benefit for the active drug over placebos in subsequent clinical trials.

This was unfortunate for a number of reasons. One is that the announcement caused a 5 per cent drop in the value of the company’s stock. Another is that the drug had an important advantage over current antidepressants, it produced substantially fewer side effects. The relative lack of side effects had been one reason for the enthusiasm about Merck’s new antidepressant. However, it may also have been the reason for its subsequent failure in controlled clinical trials. It seems that easily noticeable side effects are needed to show antidepressant benefit for an active drug compared to a placebo.

. . .

from

THE EMPEROR’S NEW DRUGS

by Irving Kirsch

get it at Amazon.com

LET’S MAKE THE HUMAN FOOTPRINT EVEN BIGGER. U.S. billionaires are fuelling the hard-right cause in Britain – George Monbiot * DARK MONEY. The Billionaires Behind the Rise of the Radical Right – Jane Mayer.

“A stunning record of corporate malfeasance.”

Dark money is among the greatest current threats to democracy. It means money spent below the public radar, that seeks to change political outcomes. It enables very rich people and corporations to influence politics without showing their hands.

Despite having been elected as a populist outsider, Trump put together a transition team that was crawling with the kinds of corporate insiders he had vowed to disempower.

“This whole idea that he was an outsider and going to destroy the political establishment and drain the swamp were the lines of a conman, and guess what, he is being exposed as just that.”

Among the world’s biggest political spenders are Charles and David Koch, co-owners of Koch Industries, a vast private conglomerate of oil pipelines and refineries, chemicals, timber and paper companies, commodity trading firms and cattle ranches. If their two fortunes were rolled into one, Charles David Koch, with $120bn, would be the richest man on Earth.

In a rare public statement, in an essay published in 1978, Charles Koch explained his objective. “Our movement must destroy the prevalent statist paradigm.” As Jane Mayer records in her book Dark Money, the Kochs’ ideology, lower taxes and looser regulations, and their business interests “dovetailed so seamlessly it was difficult to distinguish one from the other”. Over the years, she notes, “the company developed a stunning record of corporate malfeasance”. Koch Industries paid massive fines for oil spills, illegal benzene emissions and ammonia pollution. In 1999, a jury found that Koch Industries had knowingly used a corroded pipeline to carry butane, which caused an explosion in which two people died. Company Town, a film released last year, tells the story of local people’s long fight against pollution from a huge paper mill owned by the Koch Brothers.

They have poured hundreds of millions of dollars into a network of academic departments, thinktanks, journals and movements. And they appear to have been remarkably successful.

The Koch network has helped secure massive tax cuts, the smashing of trade unions and the dismantling of environmental legislation.

But their hands, for the most part, remain invisible. A Republican consultant who has worked for Charles and David Koch told Mayer that “to call them under the radar is an understatement. They are underground.”

. . . The Guardian

DARK MONEY. The History of the Billionaires Behind the Rise of the Radical Right

Jane Mayer

“We must make our choice. We may have democracy, or we may have wealth concentrated in the hands of a few, but we can’t have both.” Louis Brandeis

Election night 2016 was a stunning political upset, auguring a new political order in almost every respect. Donald Trump, a billionaire businessman with no experience in elected office, running on a promise to upend the status quo, defeated Hillary Clinton, the designated heir to Barack Obama’s Democratic presidency. Trump’s triumph defied the predictions of almost every pundit and pollster. It rocked the political establishments in both parties, and sent shock waves around the globe. Markets trembled before recovering their equilibrium. The political world seemed to shift on its axis, spinning toward an unknown and unpredictable future.

Although Trump ran as a self-proclaimed outsider against what he portrayed as entrenched and corrupt political elites, there was an unexpectedly familiar representative of this moneyed class at his victory party in Manhattan. Standing with a jubilant smile amid the throng of revelers at the Hilton hotel in midtown Manhattan was David Koch.

During the presidential primaries, Trump had mocked his Republican rivals as “puppets” for flocking to the secretive fundraising sessions sponsored by David Koch and his brother Charles, co-owners of the second-largest private company in the United States, the Kansas-based energy and manufacturing conglomerate Koch Industries. Affronted, the Koch brothers, whose political spending had made their name almost shorthand for special-interest clout, withheld their financial support from Trump. As a result, the story line adopted by many in the media was that the Koch brothers in particular, and big political donors in general, were no longer a major factor in American politics. Trump had, after all, defeated far bigger-spending rivals, including Clinton.

It might be nice to think the era of big money in American politics is over, but a closer look reveals a far more complicated and far less reassuring reality.

Trump had indeed campaigned by attacking the big donors, corporate lobbyists, and political action committees that have come to dominate American politics as “very corrupt.” In doing so, he fed into a national, bipartisan outpouring of disgust at the growing extent to which campaigns have become little more than relentless pursuits of obscene amounts of cash. To the surprise of many, Trump and Bernie Sanders, the left-wing insurgent who challenged Clinton in the Democratic primaries, seemed to transform big political money from an advantage into a liability. Trump nicknamed Clinton “Crooked Hillary,” claiming that she was “100% owned by her donors.” By Election Day, the public’s trust in her was in tatters.

Improbably, Trump, a New York businessman who had global financial interests and who spent some $66 million of his own fortune to get elected, ran against Wall Street. He successfully positioned himself as pristine because he was a billionaire in his own right, rather than one beholden to other billionaires. In a tweet less than a month before the election, Trump promised, “I will Make Our Government Honest Again believe me. But first I’m going to have to #DrainTheSwamp.” His DrainTheSwamp hashtag became a rallying cry for supporters riled by the growing economic inequality in the country and intent on ending corruption in Washington, which they blamed for putting the interests of the rich and powerful over their own.

Yet as Ann Ravel, a Democratic member of the Federal Election Commission who had championed reform of political money for years, observed just days after Trump’s election, instead “the alligators are multiplying.”

Despite having been elected as a populist outsider, Trump put together a transition team that was crawling with the kinds of corporate insiders he had vowed to disempower. Especially prominent among them were lobbyists and political operatives who had financial ties to the Kochs. This was perhaps unexpected, because the Kochs had continued to express their distaste for Trump throughout the campaign. Charles Koch called himself a libertarian. He supported open immigration and tree trade both of which benefited his vast multinational corporation. He had denounced Trump’s plans to bar Muslim immigrants as “monstrous” and “frightening.”

Yet there were signs of a rapprochement. The chair of Trump’s transition team, Vice President elect Mike Pence, had been Charles Koch’s first choice for the presidency in 2012 and a major recipient of Koch campaign contributions. David Koch had personally donated $300,000 to Pence’s campaigns in the four years before Trump chose Pence as his running mate. Pence, who in the past had shared the Kochs’ enthusiasm for privatizing Social Security and denying the reality of climate change, had been a featured guest at a fund-raiser that David Koch hosted for about seventy of the Republican Party’s biggest political donors at his Palm Beach, Florida, mansion in the spring of 2016. He had also been slated to speak at the Kochs’ donor summit in August 2016, but canceled after joining the Republican ticket.

Meanwhile, Pence’s senior adviser in the sensitive task of managing Trump’s transition to power was Marc Short, who just a few months earlier had actually run the Kochs’ secretive donor club, Freedom Partners. This was the same elite group whose meetings Trump had ridiculed during the campaign.

The Kochs’ influence was also evident in the transition team members that Trump picked in the areas of energy and the environment, which were crucial to Koch Industries’ bottom line. For policy and personnel advice regarding the Department of Energy, an early chart of the transition team showed that Trump chose Michael McKenna, the president of the lobbying firm MWR Strategies, whose clients included Koch Industries. McKenna also had ties to the American Energy Alliance, a tax-exempt nonprofit that advocated for corporate-friendly energy policies, to which the Kochs’ donor group, Freedom Partners, had given $1.5 million in 2012. The group, which didn’t disclose its revenue sources, was a textbook example of the way secret spending by billion-dollar private interests aimed to manipulate public opinion.

Another lobbyist for Koch Industries, Michael Catanzaro, a partner at the lobbying firm CGCN Group, headed “energy independence” for Trump’s transition team and was mentioned as a possible White House energy czar. Meanwhile, Harold Hamm, a charter member of the Kochs’ donor circle, who became a billionaire by founding Continental Resources, an Oklahoma-based shale-oil company known for its enormously lucrative “fracking” operation, was reportedly advising Trump on energy issues and under consideration for a cabinet post, possibly energy secretary.

To the alarm of the scientific community, Trump chose Myron Ebell, an outspoken climate change skeptic, to head his transition team for the Environmental Protection Agency (EPA). Ebell too had Koch money ties. He worked at a Washington think tank, the Competitive Enterprise Institute. It didn’t disclose its funding sources, but in the past, it had been bankrolled by fossil fuel interests, including the Kochs. His stridently antiregulatory views meshed perfectly with theirs. The Kochs had long been at war with the EPA, which had ranked Koch Industries one of only three companies in America that was simultaneously a top ten polluter of air, water, and climate.

Joining Ebell on the transition team was David Schnare, a selfdescribed “free-market environmentalist” who had accused the EPA of having “blood on its hands.” Schnare worked for a think tank affiliated with the State Policy Network, which was also funded in part by the Kochs. He was reviled in environmental circles for hounding the climate scientist Michael Mann with onerous public records requests until the Virginia Supreme Court ordered him to desist in 2014. The Union of Concerned Scientists had described these actions against climate scientists as “harassment.”

Thus, less than a week after having been elected on a wave of populist anger, Trump appeared set to fulfill many of the special interests’ fondest dreams, including the deregulatory schemes of the Kochs. He promised to “get rid of” the EPA in “almost every form” and to withdraw from the 2015 international climate accord in Paris, and against the overwhelming scientific evidence to the contrary, he called climate change “a hoax”. The Trump transition had a selfimposed ethics code barring lobbyists from shaping the rules and staffing the departments in which they had financial interests, but in the early stages, at least, these commonsense strictures appeared to have been sidestepped.

Experts in government ethics were aghast. “If you have people on the transition team with deep financial ties to the industries to be regulated, it raises questions about whether they are serving the public interest or their own interests,” warned Norman Eisen, who devised the Obama administration’s conflict-of-interest rules. “Let’s face it, in the Beltway nexus of corporations and dark money, lobbyists are the delivery mechanism for speciaI-interest influence.” Peter Wehner, who served in the administrations of Ronald Reagan and both presidents Bush, told the New York Times, “This whole idea that he was an outsider and going to destroy the political establishment and drain the swamp were the lines of a conman, and guess what, he is being exposed as just that.”

The Kochs’ influence reached greater heights with Trump’s nomination of Mike Pompeo, a Republican congressman from Kansas, to direct the CIA. Pompeo was the single largest recipient of Koch campaign funds in Congress. The Kochs had also been investors, and partners, in Pompeo’s business ventures prior to his entry into politics. In fact, as Burdett Loomis, a University of Kansas professor of political science, noted, the future CIA director’s nickname was “the congressman from Koch.”

Helping to guide the transition team in these fateful choices was Rebekah Mercer, the daughter of Robert Mercer, the wealthy New York hedge fund manager who “out-Koched the Kochs” in 2014, as Bloomberg News put it, giving more money to their political club than even they had.

Clearly the reports of the Kochs’ political death in 2016 were exaggerated. While they had refrained from backing a presidential candidate, the tentacles of the “Kochtopus,” as their sprawling political machine was known, were already encircling the Trump administration before it had even officially taken power.

Many had counted the Kochs out after their refusal to back a presidential candidate. Their initial 2015 plan called for their donor group to spend an astounding budget of $889 million in order to purchase the presidency. But they sat out the primaries, as they had in the past, and then found their plan rudely upended when Trump emerged as the nominee. He was the only major Republican presidential candidate whom they opposed. Sidelined, they continued to withhold their support.

But while the media fixated on the extraordinary presidential race, the Kochs and their network of right-wing political patrons quietly spent more money than ever on the three-pronged influence-buying approach they had mastered during the previous forty years. They combined corporate lobbying, politically tinged nonprofit spending, and “down ballot” campaign contributions in state and local races, where their money bought a bigger bang for the buck.

Far from shutting their wallets, they simply downgraded their budget to $750 million and directed several hundred million dollars of it to races beneath the presidential level. Few noticed, but in 2016 Koch Industries and Freedom Partners poured huge sums into at least nineteen Senate, forty-two House, and four gubernatorial races as well as countless lesser ones all over the country.

They also mobilized what a 2016 study by two Harvard University scholars, Theda Skocpol and Alexander Hertel-Fernandez, described as an unprecedented and unparalleled permanent, private political machine. In fact, amazingly, in 2016 the Kochs’ private network of political groups had a bigger payroll than the Republican National Committee. The Koch network had 1,600 paid staffers in thirty-five states and boasted that its operation covered 80 percent of the population. This marked a huge escalation from just a few years earlier. As recently as 2012, the Kochs’ primary political advocacy group, Americans for Prosperity, had a paid staff of only 450.

The Kochs ran their political operation centrally like a private business, with divisions devoted to various constituency groups, such as Hispanics, veterans, and young voters. One of their top people explained that their aim during the 2016 election had been to target five million voters in eight states with key Senate races. In the past, labor unions probably provided the closest parallel to this kind of private political organizing, but they of course represented the dues of millions of members. In comparison, the Koch network was sponsored by just four hundred or so of the richest people in the country. It was for this reason that the Harvard scholars who studied it said that the Koch network was “like nothing we’ve ever seen.”

Irrespective of Trump, the Kochs and their fellow mega-donors succeeded in their chief political objective in 2016, which was to keep both houses of Congress under conservative Republican control, ensuring that they could continue to advance their corporate agenda. They succeeded in their secondary goal, too, which was to further crush the Democratic Party by continuing the nationwide sweep of state legislatures and local offices that they had begun in 2010. By controlling statehouses, they could dominate not just legislation but also the gerrymandering of congressional districts, in hopes of securing their grip on the House of Representatives for years to come.

Many of the races they backed were too minor to merit press attention. In Texas alone, they supported candidates in seventy-four different races, reaching all the way down to a county court commissioner. Thanks in no small part to huge quantities of targeted money spent by the Kochs and their allied donors, the Democratic Party lost both houses of Congress, fourteen governorships, and thirty state legislatures, comprising more than nine hundred seats, during Obama’s presidency. By the time the votes were tallied in the 2016 election, Republicans controlled thirty-two state legislatures, while Democrats controlled only thirteen. Five others were split. This imbalance posed a huge problem for Democrats not only in the present but for the future, because state legislatures serve as incubators for rising leaders.

The Kochs might have disavowed Trump, but in several important respects he was their natural heir and the unintended consequence of the extraordinary political movement they had underwritten since the 1970s. For forty years, they had vilified the very idea of government. They had propagated that message through the countless think tanks, academic programs, front groups, ad campaigns, legal organizations, lobbyists, and candidates they supported. It was hard not to believe that this had helped set the table for the takeover of the world’s most powerful country by a man who made his inexperience and antipathy toward governing among his top selling points.

Charles Koch’s mentor, the quasi-anarchist Robert LeFevre, had taught the Kochs that “government is a disease masquerading as its own cure.” Their extreme opposition to the expansions of the federal government that had taken place during the Progressive Era, the New Deal era, the Great Society, and Obama’s presidency had helped to convince voters that Washington was corrupt and broken and that, when it came to governing, knowing nothing was preferable to expertise. Charles Koch had referred to himself as a “radical,” and in Trump he got the radical solution he had helped to spawn.

The Kochs had also primed America for Trump by pouring gasoline on the fires lit by the antitax Tea Party movement starting in 2009. Charles Koch decried Trump’s toxic rhetoric in 2016, and David Koch complained to the Financial Times that “you’d think we could have more influence” after spending hundreds of millions of dollars on American politics. But in fact, the influence of the Kochs and their fellow big donors was manifest in Trump’s use of incendiary and irresponsibly divisive rhetoric. Only a few years ago, it was they who were sponsoring the hate.

In the 1960s, Charles Koch had funded the all-white private Freedom School in Colorado, whose head had told the New York Times that the admittance of black students might present housing problems because some students were segregationists. That was long ago, and his views, like those of many others, could well have changed. But in a 2011 interview with the Weekly Standard, David Koch echoed specious claims, made by the conservative gadfly Dinesh D’Souza, that Obama was somehow African rather than American in his outlook. He claimed that Obama, who was born in America and abandoned by his Kenyan father as a toddler, nonetheless derived his “radical” views from his African heritage.

The effort to attack Obama, not as a legitimate and democratically elected American political opponent, but as an alien threat to the country’s survival, was very much in evidence at a summit that the Kochs’ political organization Americans for Prosperity hosted in Austin, Texas, during the summer of 2010. Between Tea Party training sessions, operatives working for the Kochs gave an award to a blogger who had described Obama as the “cokehead-inchief” and asserted that he suffered from “demonic possession (aka schizophrenia, etc.).” The Kochs and other members of the Republican donor class might have disowned the vile language of the 2016 campaign, but six years earlier they were honoring it with trophies.

The same incendiary style characterized the big donors’ fight against the Affordable Care Act. Rather than respectfully debating Obama’s health-care plan as a policy issue, the Kochs and their allied donors poured cash into a dark-money group called the Center to Protect Patient Rights, which mounted a guerrilla war of fearmongering and vitriol. Television ads sponsored by the group featured the false claim that Obama’s plan was “a government takeover” of health care, which PolitiFact named “the Lie of the Year” in 2010. Meanwhile, a spin-off of Americans for Prosperity organized anti-Obamacare rallies at which protesters unfurled banners depicting corpses from Dachau, implying that Obama’s policies would result in mass murder.

Koch operatives also purposefully sabotaged the democratic process by planting screaming protesters in town hall meetings at which congressmen met with constituents that year. In short, during the Obama years, the Kochs radicalized and organized an unruly movement of malcontents, over which by 2016 they had lost control. “We are partly responsible,” one former employee in the Kochs’ political operation admitted to Politico a month before Trump was elected. “We invested a lot in training and arming a grassroots army that was not controllable.”

In other ways, too, the Kochs and their allied big donors became victims of their own success in 2016. They inadvertently laid the groundwork for Trump’s rise by too thoroughly capturing the Republican Party with their cash. Their narrowly self-serving policy priorities were at odds with those of the vast majority of voters. Yet virtually every Republican presidential candidate other than Trump pledged fealty to the donors’ wish lists as they jockeyed for their support. The candidates promised to cut taxes for those in the highest brackets, preserve Wall Street loopholes, tolerate the off-shoring of manufacturing jobs and profits, and downgrade or privatize middleclass entitlement programs, including Social Security. Free trade was barely debated. These positions faithfully reflected the agenda of the wealthy donors, but studies showed that they were increasingly out of step with the broad base of not just Democratic but also Republican voters, many of whom had been left behind economically and socially for decades, particularly acutely since the 2008 financial crash. Trump, who could afford to forgo the billionaires’ backing and ignore their policy priorities, saw the opening and seized it.

Whether Trump would fulfill his supporters’ hopes and break free from the self-serving elites whose money had captured the Republican Party prior to his unorthodox election remained to be seen. The early signs were not promising. Not only was Trump’s early transition team swarming with corporate lobbyists, including those who had worked for the Kochs, but Trump’s inaugural committee featured several members of the Kochs’ billion-dollar donor club, too. Neither Diane Hendricks, a building-supply company owner whose $3.6 billion fortune made her the wealthiest woman in Wisconsin, nor billionaire Sheldon Adelson, founding chairman and chief executive of the Las Vegas Sands Corporation casino empire, signaled a break from politics as usual.

Inaugurals had long been underwritten by rich donors, so perhaps reading too much into this was unfair. But Trump’s tax proposals, to the extent that they could be gleaned, were if anything even more of a bait and switch. While he had garnered bluecollar support by promising to stick it to the elites who “are getting away with murder,” his proposals, according to economic experts, threatened instead to enshrine a permanent aristocracy in America. He appeared poised to repeal the estate tax, presenting a windfall to heirs of estates worth $10.9 million or more. There had been fewer than five thousand estates of this size in 2015. He also had plans to abolish the gift tax, which put the brakes on inherited wealth. Capital gains taxes and income taxes for top earners were headed toward the chopping block, too. Charles and David Koch, who together were worth some $84.5 billion, stood to benefit to an extent that dwarfed earlier administrations, as did many other billionaires. As the headline on Yahoo Finance proclaimed on the day after the election, “Trump’s Win Is a ‘Grand Slam’ for Wall Street Banks.”

The fact of the matter was that while Trump might have been elected by those he described as “the forgotten” men, he would have to deal with a Republican Party that had been shaped substantially by the billionaires of the radical Right. He would have to work with a vice president once funded by the Kochs and a Congress dominated by members who owed their political careers to the Kochs. Further, he would have to face a private political machine organized in practically every state, ready to attack any deviation from their agenda. No one could predict what Trump would do. Nor could they predict how much longer the Kochs, by then in their eighties, would stay active. But one thing was certain. The Kochs’ dark money, which they had directed their successors to keep spending long after they had passed away, would continue to exert disproportionate influence over American politics for years to come.

November 2016 Washington, D.C.

from

DARK MONEY. The Hidden History of the Billionaires Behind the Rise of the Radical Right

by Jane Mayer

get it at Amazon.com

Also on TPPA = CRISIS

DEMOCRACY IN CHAINS: THE DEEP HISTORY OF THE RADICAL RIGHT’S STEALTH PLAN FOR AMERICA – NANCY MACLEAN

PUBLIC CHOICE THEORY. THE IDEA THAT CLIMATE SCIENTISTS ARE IN IT FOR THE CASH HAS DEEP IDEOLOGICAL ROOTS – GRAHAM READFEARN

ANGER CORRODES THE VESSEL THAT CONTAINS IT. Self Compassion and Anger in Relationships – Kristin Neff and Christopher Germer.

Our deepest need as human beings is the need to be loved. Our brains communicate emotions to one another, regardless of how carefully we chose our words.

Much of our relationship suffering is unnecessary and can be prevented by cultivating a loving relationship with ourselves. Cultivating self-compassion is one of the best things we can do for our relationship interactions.

Anger has a way of popping up around disconnection and can sometimes linger for years, long after the relationship has ended.

Sometimes we turn the anger against ourselves in the form of harsh self-criticism, which is a surefire way to become depressed. And if we get stuck in angry rumination, who did what to whom and what they deserve for it, we live with an agitated state of mind and may end up getting angry at others for no apparent reason.

“Anger corrodes the vessel that contains it.”

To have the type of close, connected relationships we really want with others, we first need to feel close and connected to ourselves. Cultivating self-compassion is far from selfish.

Much of our suffering arises in relationship with others. As Sartre famously wrote, “Hell is other people.” The good news is that much of our relationship suffering is unnecessary and can be prevented by cultivating a loving relationship with ourselves.

There are at least two types of relational pain. One is the pain of connection, when those we care about are suffering.

The other type is the pain of disconnection, when we experience loss or rejection and feel hurt, angry, or alone.

Our capacity for emotional resonance means that emotions are contagious. This is especially true in intimate relationships. If you are irritated with your partner but try to hide it, for instance, your partner will often pick up on your irritation. He might say, “Are you angry at me?” Even if you deny it, your partner will feel the irritation; it will affect his mood, leading to an irritated tone of voice. You will feel this, in turn, and become even more irritated, and your responses will have a harsher tone, and on it goes. This is because our brains would have been communicating emotions to one another regardless of how carefully we chose our words.

In social interactions, there can be a downward spiral of negative emotions, when one person has a negative attitude, the other person becomes even more negative, and so on. This means that other people are partly responsible for our state of mind, but we are also partly responsible for their state of mind. The good news is that emotional contagion gives us more power than we realize to change the emotional tenor of our relationships. Self-compassion can interrupt a downward spiral and start an upward spiral instead.

Compassion is actually a positive emotion and activates the reward centers of our brain, even though it arises in the presence of suffering. A very useful way to change the direction of a negative relationship interaction, therefore, is to have compassion for the pain we’re feeling in the moment. The positive feelings of compassion we have for ourselves will also be felt by others, manifested in our tone and subtle facial expressions, and help to interrupt the negative cycle, in this way cultivating self-compassion is one of the best things we can do for our relationship interactions as well as for ourselves.

Not surprisingly, research shows that self-compassionate people have happier and more satisfying romantic relationships. In one study, for instance, individuals with higher levels of self-compassion were described by their partners as being more accepting and nonjudgmental than those who lacked self-compassion. Rather than trying to change their partners, self-compassionate people tended to respect their opinions and consider their point of view. They were also described as being more caring, connected, affectionate, intimate, and willing to talk over relationship problems than those who lacked self-compassion. At the same time, self-compassionate people were described as giving their partners more freedom and autonomy in their relationships. They tended to encourage partners to make their own decisions and to follow their own interests. In contrast, people who lacked self-compassion were described as being more critical and controlling of their partners. They were also described as being more self-centered, inflexibly wanting everything their own way.

Steve met Sheila in college, and after 15 years of marriage he still loved her dearly. He hated to admit this to himself, but she was also starting to drive him crazy. Sheila was terribly insecure and constantly needed Steve to reassure her of his love and affection. Wasn’t sticking around for 15 years enough? If he didn’t tell her “I love you ” every day, she would start to worry, and if a few days went by she got into a proper sulk. He felt controlled by her need for reassurance and resented the fact that she didn’t honor his own need to express himself authentically. Thair relationship was starting to suffer.

To have the type of close, connected relationships we really want with others, we first need to feel close and connected to ourselves. By being supportive toward ourselves in times of struggle, we gain the emotional resources needed to care for our significant others. When we meet our own needs for love and acceptance, we can place fewer demands on our partners, allowing them to be more fully themselves. Cultivating self-compassion is far from selfish.

It gives us the resilience we need to build and sustain happy and healthy relationships in our lives.

Over time Sheila was able to see how her constant need for reassurance from Steve was driving him away. She realized that she had become a black hole and that Steve would never be able to fully satisfy her insecurity by giving her “enough” love. It would never be enough. So Sheila started a practice of journaling at night to give herself the love and affection she craved. She would write the type of tender words to herself that she was hoping to hear from Steve, like “I love you sweetheart. I won’t ever leave you.” Then, first thing in the morning, she would read what she had written and let it soak in. She began giving herself the reassurance she was desperately seeking from Steve and let him off the hook. It wasn’t quite as nice, she had to admit, but she liked the fact that she wasn’t so dependent. As the pressure eased, Steve started to be more naturally expressive in their relationship, and they became closer. The more secure she felt in her own self-acceptanee, the more she was able to accept his love as it was, not just how she wanted it to be. Ironically, by meeting her own needs she became less self-focused and started to feel an independence that was new and delicious.

Self-Compassion and Anger in Relationships

Another type of relational pain is disconnection, which occurs whenever there is a loss or rupture in a relationship. Anger is a common reaction to disconnection. We might get angry when we feel rejected or dismissed, but also when disconnection is unavoidable, such as when someone dies. The reaction may not be rational, but it still happens. Anger has a way of popping up around disconnection and can sometimes linger for years, long after the relationship has ended.

Although anger gets a bad rap, it isn’t necessarily bad. Like all emotions, anger has positive functions. For instance, anger can give us information that someone has overstepped our boundaries or hurt us in some way, and it may be a powerful signal that something needs to change. Anger can also provide us with the energy and determination to protect ourselves in the face of threat, take action to stop harmful behavior, or end a toxic relationship.

While anger in and of itself is not a problem, we often have an unhealthy relationship with anger. For instance, we may not allow ourselves to feel our anger and suppress it instead. This can be especially true for women, who are taught to be “nice,” i.e., not angry. When we try to stuff down our anger, it can lead to anxiety, emotional constriction, or numbness. Sometimes we turn the anger against ourselves in the form of harsh self-criticism, which is a surefire way to become depressed. And if we get stuck in angry rumination, who did what to whom and what they deserve for it, we live with an agitated state of mind and may end up getting angry at others for no apparent reason.

Nate was an electrician who lived in Chicago. He had split from his wife, Lila, over five years ago, but he still got enraged every time he thought about her. It turns out that Lila had an affair with a close friend of theirs, someone they often socialized with, and that this went on behind his back for almost a year. As soon as Nate found out about it, he was seething with anger. He somehow managed to refrain from calling her every name in the book, but he was sick to his stomach whenever he thought about what had happened. He filed for divorce almost immediately, thank goodness they didn’t have children, so the process was relatively quick and easy. Although he hadn’t had any contact with Lila for several years, his anger never really subsided. And the trauma of the affair kept Nate from forming new relationships because he had such a hard time trusting anyone.

If we continually harden our emotions in an attempt to protect ourselves against those we’re angry at, over time we may develop bitterness and resentment. Anger, bitterness, and resentment are “hard feelings.” Hard feelings are resistant to change and often stick with us long past the time when they are useful. (How many of us are still angry at someone we are unlikely to ever see again?) Furthermore, chronic anger causes chronic stress, which is bad for all the systems of the body, cardiovascular, endocrine, nervous, even the reproductive system. As the saying goes, “Anger corrodes the vessel that contains it.” Or “Anger is the poison we drink to kill another person.” When anger is no longer helpful to us, the most compassionate thing we can do is change our relationship to it, especially by applying the resources of mindfulness and self compassion.

How? The first step is to identify the soft feelings behind the hard feelings of anger. Often anger is protecting more tender, sensitive emotions, such as feeling hurt, scared, unloved, alone, or vulnerable. When we peel back the outer layer of anger to see what is underneath, we are often surprised by the fullness and complexity of our feelings. Hard feelings are difficult to work with directly because they are typically defensive and outward focused. When we identify our soft feelings, however, we turn inward and can begin the transformation process.

To truly heal, however, we need to peel back the layers even further and discover the unmet needs that are giving rise to our soft feelings. Unmet needs are universal human needs, those experiences that are core to any human being. The Center for Nonviolent Communication offers a comprehensive list of needs at http://www.cm/cnrg/ training/needs inventory. Some examples are the need to be safe, connected, validated, heard, included, autonomous, and respected. And our deepest need as human beings is the need to be loved.

By having the courage to turn toward and experience our authentic feelings and needs, we can begin to have insight into what is really going on for us. Once we contact the pain and respond with self-compassion, things can start to transform on a deep level. We can use self-compassion to meet our needs directly.

Self-compassion in response to unmet needs means that we can begin to give ourselves what we have yearned to receive from others, perhaps for many years. We can be our own source of support, respect, love, validation, or safety. Of course, we need relationships and connection with others. We aren’t automatons. But when others are unable to meet our needs, for whatever reason, and have harmed us in the process, we can recover by holding the hurt, the soft feelings, in a compassionate embrace and fill the hole in our hearts with loving, connected presence.

Nate worked hard at transforming his anger because he realized it was holding him back. He had tried catharsis to get it out, punching pillows, yelling at the top of his lungs but it didn’t work. Eventually Nate signed up for an MSC course because a friend was very enthusiastic about it and said it would reduce his stress.

When Nate came to the part of the MSC course that focused on transforming anger by meeting his unmet needs, he felt nervous but did it anyway. It was easy to get in touch with his anger, and even the hurt behind it, and feel it in his body. The toughest part was identifying his unmet need. Certainly Nate felt betrayed and unloved, but that wasn’t what seemed to be holding him back. Nate stuck with the exercise, and finally the unmet need revealed itself, and his whole body relaxed. Respect!

Nate came from a hardworking hlue-collar family, and his parents were still happily married after 30 years. He tried to do everything right in his own marriage, to the best of his ability, and he took his vows very seriously. Honesty and respect were core values for Nate. Knowing that Lila would never give him the respect he needed, it was too late for that, he took the plunge and tried to give it to himself. “I respect you,” he told himself. At first it felt silly and empty and hollow. So he paused and tried to say the words as if they were true. He thought about how much he had sacrificed to get his master electrician’s certification and open a business, the long hours he had put in to pay the mortgage and build a savings account. “I respect you,” he repeated, over and over, though it still just sounded like words. Then he thought of how honest and hardworking he had tried to be in his marriage, even though that wasn’t enough for Lila.

Very, very slowly, Nate started to take it in. Finally he put his hand on his heart and said it like he really meant it: “I respect you.” He started to tear up, because he actually felt it. Once he did, the anger at his wife started to melt away. He began to see her unmet needs, different from his, for more closeness and affection. Not that what Lila did was okay, but Nate realized that her behavior had nothing to do with his worth or value as a person. He couldn’t rely on any outside person, even one who was reliable and faithful, to give him the respect he needed. It had to come from within.

Self-Compassion and Forgiveness

When someone has harmed us and we still feel anger and bitterness, sometimes the most compassionate thing to do is to forgive. Forgiveness involves letting go of anger at someone who has caused us harm. But forgiveness must involve grieving before letting go. The central point of forgiveness practice is that we cannot forgive others without first opening to the hurt that we have experienced. Similarly, to forgive ourselves, we must first open to the pain, remorse, and guilt of hurting others.

Forgiveness doesn’t mean condoning bad behavior or resuming a relationship that causes harm. If we are being harmed in a relationship, we need to protect ourselves before we can forgive. If we are harming another in a relationship, we cannot forgive ourselves if we are using this as an excuse for acting badly. We must first stop the behavior, then acknowledge and take responsibility for the harm we have caused.

At the same time, it’s helpful to remember that the harm done is usually the product of a universe of interacting causes and conditions stretching back through time. We have partly inherited our temperament from our parents and grandparents, and our actions are shaped by our early childhood history, culture, health status, current events, and so forth. Therefore, we don’t have complete control over precisely what we say and do from one moment to the next.

Sometimes we cause pain in life without intending it, and we may still feel sorry about causing such pain. An example is when we move across the country to start a new life, leaving friends and family behind, or when we can’t give our elderly parents the attention they need because of our work situation. This kind of pain is not the fault of anyone, but it can still be acknowledged and healed with self compassion.

The capacity to forgive requires keen awareness of our common humanity. We are all imperfect human beings whose actions stem from a web of interdependent conditions that are much larger than ourselves. In other words, we don’t have to take our mistakes so personally.

Paradoxically, this understanding helps us take more responsibility for our actions because we feel more emotionally secure. One research study asked participants to recall a recent action they felt guilty about, such as cheating on an exam, lying to a romantic partner, saying something harmful, that still made them feel bad about themselves when they thought about it. The researchers found that participants who were helped to be self-compassionate about their transgression reported being more motivated to apologize for the harm done, and more committed to not repeating the behavior, than those who were not helped to be selfcompassionate.

Anneka really struggled to forgive herself after getting super angry at her friend and coworker Hilde, whom she told to f-off. Anneka had been under a tremendous amount of pressure at work to secure a contract with new clients and was all set to close the deal at a dinner that they were hosting. The clients were pretty conservative, and Anneka knew she had to be on time and look appropriate for them to trust her. Hilde was supposed to pick her up for the dinner, but she wasn’t there at the appointed time. Frantic, Anneka called her. “Where are you?” Hilde had completely forgotten about the event. “Oh, I ’m so sorry,” she offered lamely. Anneka dropped the f bomb, said a few more unpleasant things, then hung up and called a taxi. Immediately after ward, Anneka felt terrible. This was her friend! Hilde hadn’t done anything purposefully harmful, she simply forgot, and Anneka has been too busy to remind her. The truth was that Anneka was so anxious about closing the deal that she lost perspective and ouerreacted.

There are five steps to forgiveness:

1. Opening to pain, being present with the distress of what happened.

2. Self Compassion, allowing our hearts to melt with sympathy for the pain, no matter what caused it.

3. Wisdom, beginning to recognize that the situation wasn’t entirely personal, but was the consequence of many interdependent causes and conditions.

4. Intention to forgive. “May I begin to forgive myself [another] for what I [he/she] did, wittingly or unwittingly, to have caused them [me] pain.”

5. Responsibility to protect, committing ourselves to not repeat the same mistake; to stay out of harm’s way, to the best of our ability.

At first Anneka harshly berated herself for her behavior, but she knew that heating up on herself wouldn’t help anyone. Instead, Anneka needed to forgive herself for having made a mistake, just as everyone makes mistakes.

Anneka had learned the five steps to forgiveness from her MSC course, so she knew what to do. First, she had to accept the pain she had caused Hilde. This was really tough for Anneka, especially since she didn’t get the contract she was hoping for. Her mind wanted to pin all the blame on Hilde. It was Hilde’s fault! But Anneka knew the truth. There was no excuse for talking to Hilde that way. It was wrong.

Anneka allowed herself to feel in her bones what it must have been like for Hilde to hear those words, from someone she considered a friend. That took some courage because Anneka felt so bad about it. Then Anneka gave herself compassion for the pain of hurting someone she loved. “Everyone makes mistakes. I’m so sorry you wounded your friend in this manner. I know you deeply regret it.” Giving herself compassion provided a bit of perspective, and Anneka was able to acknowledge the incredible stress she was under. The circumstances brought out the worst in her. Then Anneka tried to forgive herself, at least in a preliminary way, for her behavior. “May I begin to forgive myself for the pain I unwittingly inflicted on my dear friend Hilde.” Anneka also made a commitment to take at least one deep breath before speaking when she felt angry. Anneka knew this might take some time because she didn’t always know when she felt angry, but she was determined to try to be less reactive when under stress.

The central point of forgiveness is first opening to the hurt that we experienced or caused to others. Timing is very important because we are naturally ambivalent about feeling the guilt of hurting others or making ourselves vulnerable to being hurt again. As the saying goes, first we need to “give up all hope of a better past.”

Embracing the Good

One of the biggest benefits of self compassion is that it doesn’t just help you cope with negative emotions, it actively generates positive emotions. When we embrace ourselves and our experience with loving, connected presence, it feels good. It doesn’t feel good in a saccharine way, nor does it resist or avoid what feels bad. Rather, self compassion allows us to have the full range of experience, the bitter and the sweet.

Typically, however, we tend to focus much more on what’s wrong than on what’s right in our lives. For example, when you get an annual review at work, what do you remember the most, the points of praise or criticism? Or if you go shopping at the mall and interact with five polite salespeople and one rude one, which is most likely to stick in your mind?

The psychological term for this is negativity bias. Rick Hanson says the brain is like “Velcro for bad experiences and Teflon for good ones.” Evolutionarily speaking, the reason we have a negativity bias is that our ancestors who fretted and worried at the end of the day, wondering where that pack of hyenas was yesterday and where it might be hanging out tomorrow, were more likely to survive than our ancestors who kicked back and relaxed. This is evolutionarily adaptive when we face physical danger. However, since most of the dangers we face nowadays are threats to our sense of self, it is self-compassionate to correct the negativity bias because it distorts reality.

We need to intentionally recognize and absorb positive experiences to develop more realistic, balanced awareness that is not skewed toward the negative. This requires some training, just like mindfulness and self-compassion require training. Furthermore, since compassion training includes opening to pain, we may need the energy boost of focusing on positive experience to support our compassion practice.

Focusing on the positive also has important benefits. Barbara Fredrickson, who developed the “broaden and build” theory, posits that the evolutionary purpose of positive emotions is to broaden attention. In other words, when people feel safe and content, they become curious and start exploring their environment, noticing opportunities for food, shelter, or rest. This allows us to take advantage of opportunities that would otherwise go unnoticed.

“When one door of happiness closes, another opens, but often we look so long at the closed door that we do not see the one that has been opened for us.” Helen Keller

Recently there has been a movement in psychology that focuses on finding the most effective ways to help people cultivate positive emotions, and two powerful practices that have been identified are savoring and gratitude.

Savoring

Savoring involves noticing and appreciating the positive aspects of life, taking them in, letting them linger, and then letting them go. It is more than pleasure, savoring involves mindful awareness of the experience of pleasure. In other words, being aware that something good is happening while it’s happening.

Given our natural tendency to skip over what’s right and focus on what’s wrong, we need to plut a little extra effort into paying attention to what gives us pleasure. Luckily, savoring is simple practice, noticing the tart and juicy taste of a fresh apple, a gentle cool breeze on your cheek, the warm smile of your coworker, the hand of your partner gently holding your own. Research suggests that simply taking the time to notice and linger with these sorts of positive experiences can greatly increase our happiness.

Gratitude

Gratitude involves recognizing, acknowledging, and being grateful for the good things in our lives. If we just focus on what we want but don’t have, we’ll remain in a negative state of mind. But when we focus on what we do have, and give thanks for it, we radically reframe our experience.

Whereas savoring is primarily an experiential practice, gratitude is a wisdom practice. Wisdom refers to understanding how everything arises interdependently, The confluence of factors required for even a simple event to occur is mind boggling and can inspire an attitude of awe and reverence. Gratitude involves recognizing the myriad people and events that contribute to the good in our lives. As an MSC participant once remarked, “The texture of wisdom is gratitude.”

Gratitude can be aimed at the big things in life, like our health and family, but the effect of gratitude may be even more powerful when it is aimed at small things, such as when the bus arrives on time or the air conditioning is working on a hot summer day. Research shows that gratitude is also strongly linked to happiness. As the philosopher Mark Nepo wrote: “One key to knowing joy is to be easily pleased.”

The meditation teacher James Baraz tells this wonderful story about the power of gratitude in his book Awakening Joy, which we’ve adapted here by permission.

One year I was visiting my then eighty-nine-year-old mother and brought along a magazine with an article on the beneficial effects of gratitude. As we ate dinner I told her about some of the findings. She said she was impressed by the reports but admitted she had a lifetime habit of looking at the glass half empty. “I know I ’m very fortunate and have so many things to be thankful for, but little things just set me off” She said she wished she could change the habit but had doubts whether that was possible. “I’m just more used to seeing what’s going wrong,” she concluded.

“You know, Mom, the key to gratitude is really in the way we frame a situation,” I began. “For instance, suppose all of a sudden your television isn’t getting good reception.”

“That’s a scenario I can relate to, ” she agreed with a knowing smile.

“One way to describe your experience would be to say, ‘This is so annoying I could scream.” Or you could say, ‘This is so annoying. . . and my life is really very blessed. She agreed that could make a big difference.

“But I don’t think I can remember to do that,” she sighed.

So together we made up a gratitude game to remind her. Each time she complained about something, I would simply say “and . . . ,” to which she would respond “and my life is very blessed.” I was elated to see that she was willing to try it out. Although it had started as just a fun game, after a while it began to have some real impact. Her mood grew brighter as our weeks became filled with gratitude. To my delight and amazement, my mother has continued doing the practice, and the change has been revolutionary.

Self-Appreciation

Most people recognize the importance of expressing gratitude and appreciation toward others. But what about ourselves? That one doesn’t come so easily.

The negativity bias is especially strong toward ourselves. Self appreciation not only feels unnatural it can feel downright wrong. Because our tendency is to focus on our inadequacies rather than appreciate our strengths, we often have a skewed perspective of who we are. Think about it, When you receive a compliment, do you take it in, or does it bounce off you almost immediately? We usually feel uncomfortable just thinking about our good qualities. The counterargument immediately arises: “I’m not always that way” or “I have a lot of bad qualities too.” Again, this reaction demonstrates the negativity bias because when we receive unpleasant feedback, our first thoughts are not typically “Yes, but I’m not aiways that way” or “Are you aware of all my good qualities?”

Many of us are actually afraid to acknowledge our own goodness. Some common reasons given for this are:

– I don’t want to alienate my friends by being arrogant.

– My good qualities are not a problem that needs to be fixed, so I don’t need to focus on them.

– I’m afraid I would be putting myself on a pedestal, only to fall off.

– It will make me feel superior and separate from others.

Of course, there is a big difference between simply acknowledging what’s true, that we have good as well as not so good qualities, and saying that we’re perfect or better than others. It’s important to appreciate our strengths as well as have compassion for our weaknesses so that we embrace the whole of ourselves, exactly as we are.

We can apply the three components of selfcompassion, self kindness, common humanity, and mindfulness, to our positive qualities as well as our negative ones. These three factors together allow us to appreciate ourselves in a healthy and balanced way.

Self Appreciation

Self Kindness: Part of being kind to ourselves involves expressing appreciation for our good qualities, just as we would do with a good friend.

Common Humanity: When we remember that having good qualities is part of being human, we can acknowledge our strengths without feeling isolated or better than others.

Mindfulness: To appreciate ourselves, we need to pay attention to our good qualities rather than taking them for granted.

It’s important to recognize that the practice of self appreciation is not selfish or self centered. Rather, it simply recognizes that good qualities are part of being human, Although some children may have been raised with the belief that humility means not recognizing their accomplishments, that approach can harm children‘s self-concept and get in the way of knowing themselves properly. Self-appreciation is a way to correct our negativity bias toward ourselves and see ourselves more clearly as a whole person. Self-appreciation also provides the emotional resilience and selfconfidence needed to give to others.

The best selling author and spiritual teacher Marianne Williamson writes, “We are all meant to shine, as children do. . . . And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.”

Wisdom and gratitude are central to selfappreciation as well. These qualities help us to see our good qualities in a broader context. When we appreciate ourselves, we’re also appreciating the causes, conditions, and people, including friends, parents, and teachers, who helped us develop those good qualities in the first place. This means we don’t need to take our own good qualities so personally!

Alice grew up in a stern Protestant family where humility and self effacement were the expected norm. When she was eight years old and came home with a trophy for winning her third-grade spelling bee, she remembers, her mother just raised her eyebrows and said, “Now don’t you be getting too big for your britches.” Every time Alice accomplished anything she felt she had to downplay it or else receive the disapproval of her family.

Later on in life, Alice started dating a man named Theo who thought she was beautiful and kind and smart and wonderful and liked to tell her so. Alice would not only cringe with embarrassment; Theo’s comments made her anxious. What if Theo finds out I’m not perfect? What happens if I let him down? She would continually push aside his comments when he said something nice, leaving Theo feeling perplexed and on the other side of an invisible wall.

Alice was becoming adept at self-compassion, especially the capacity to see her personal inadequacies as part of common humanity. Self-appreciation made sense to Alice, primarily conceptually, but she knew she had a way to go. First Alice made a mental note of everything good that she did during the day, a moment of kindness, a success, a small accomplishment. Then she tried to say something appreciative about it, such as “That was well done, Alice.” When Alice spoke to herself like this, she felt like she was violating an invisible contract from childhood and it made her uneasy, but she persisted. “I’m not saying I’m better than anyone else or that I’m perfect I’m simply acknowledging that this too is true.”

Eventually Alice made a commitment to take in and savor the heartfelt compliments Theo gave her. Theo was so delighted by this turn of events that he bought her a bracelet that said on the inside, I may not be perfect, but parts of me are excellent!

from

The Mindful Self-Compassion Workbook. A proven way to accept yourself, build inner strength, and thrive

by Kristin Neff, PhD and Christopher Germer, PhD

get it at Amazon.com

Also on TPPA = CRISIS

HOW TO ACCEPT YOURSELF, BUILD INNER STRENGTH, AND THRIVE. THE MINDFUL SELF-COMPASSION WORKBOOK – KRISTIN NEFF AND CHRISTOPHER GERMER

TED TALK. SELF-COMPASSION VS SELF-ESTEEM – DR KRISTIN NEFF

CFT: FOCUSING ON COMPASSION IN NEXT GENERATION CBT DENNIS TIRCH PH.D * COMPASSION FOCUSED THERAPY FOR DUMMIES – MARY WELFORD * COMPASSION FOCUSED THERAPY – PAUL GILBERT

THE MINDFUL PATH TO SELF-COMPASSION. FREEING YOURSELF FROM DESTRUCTIVE THOUGHTS AND EMOTIONS – CHRISTOPHER K. GERMER PhD

THE SELF ACCEPTANCE PROJECT. HOW TO BE KIND & COMPASSIONATE TOWARD YOURSELF IN ANY SITUATION – TAMI SIMON

HOW TO ACCEPT YOURSELF, BUILD INNER STRENGTH, AND THRIVE. The Mindful Self-Compassion Workbook – Kristin Neff and Christopher Germer.

“Be kind to yourself in the midst of suffering.”

Western culture places great emphasis on being kind to our friends, family, and neighbors who are struggling. Not so when it comes to ourselves.

Are you kinder to others than you are to yourself? More than a thousand research studies show the benefits of being a supportive friend to yourself, especially in times of need.

In the blink of an eye we can go from “I don’t like this feeling” to “I don’t want this feeling” to “I shouldn’t have this feeling” to “Something is wrong with me for having this feeling” to “I’m bad!”

The seeds of self-compassion already lie within you, learn how you can uncover this powerful inner resource and transform your life.

Self-compassion is the perfect alternative to self-esteem because it offers a sense of self-worth that doesn’t require being perfect or better than others.

This science-based workbook offers a step-by-step approach to breaking free of harsh self-judgments and impossible standards in order to cultivate emotional well-being. The book is based on the authors’ groundbreaking eight-week Mindful Self-Compassion (MSC) program, which has helped tens of thousands of people worldwide. It is packed with guided meditations (with audio downloads); informal practices to do anytime, anywhere; exercises; and vivid stories of people using the techniques to address relationship stress, weight and body image issues, health concerns, anxiety, and other common problems.

Kristin Neff, PhD, is Associate Professor of Human Development and Culture at the University of Texas at Austin and a pioneer in the field of self-compassion research.

Christopher Germer, PhD, has a private practice in mindfulnessand compassionbased psychotherapy in Arlington, Massachusetts, and is a part-time Lecturer on Psychiatry at Harvard Medical School/Cambridge Health Alliance. He is a founding faculty member of the Institute for Meditation and Psychotherapy and of the Center for Mindfulness and Compassion.

Introduction:

How To Approach This Workbook

“Our task is not to seek for love, but merely to seek and find all the barriers within yourself that you have built against it.” Rumi

We have all built barriers to love. We’ve had to in order to protect ourselves from the harsh realities of living a human life. But there is another way to feel safe and protected. When we are mindful of our struggles, and respond to ourselves with compassion, kindness, and support in times of difficulty, things start to change. We can learn to embrace ourselves and our lives, despite inner and outer imperfections, and provide ourselves with the strength needed to thrive.

An explosion of research into self-compassion over the last decade has shown its benefits for well-being. Individuals who are more self-compassionate tend to have greater happiness, life satisfaction, and motivation, better relationships and physical health, and less anxiety and depression. They also have the resilience needed to cope with stressful life events such as divorce, health crises, academic failure, even combat trauma.

When we struggle, however, when we suffer, fail, or feel inadequate, it’s hard to be mindful toward what’s occurring; we’d rather scream and beat our fists on the table. Not only do we not like what’s happening, we think there is something wrong with us because it’s happening. In the blink of an eye we can go from “I don’t like this feeling” to “I don’t want this feeling” to “I shouldn’t have this feeling” to “Something is wrong with me for having this feeling” to “I’m bad!”

That’s where self-compassion comes in. Sometimes we need to comfort and soothe ourselves for how hard it is to be a human being before we can relate to our lives in a more mindful way.

Self-compassion emerges from the heart of mindfulness when we meet suffering in our lives. Mindfulness invites us to open to suffering with loving, spacious awareness. Self-compassion adds, “be kind to yourself in the midst of suffering.” Together, mindfulness and self-compassion form a state of warmhearted, connected presence during difficult moments in our lives.

MINDFUL SELF-COMPASSION

Mindful Self-Compassion (MSC) was the first training program specifically designed to enhance a person’s self-compassion. Mindfulness-based training programs such as mindfulness-based stress reduction and mindfulness-based cognitive therapy also increase self-compassion, but they do so more implicitly, as a welcome byproduct of mindfulness. MSC was created as a way to explicitly teach the general public the skills needed to be self-compassionate in daily life. MSC is an eight-week course where trained teachers lead a group of 8 to 25 participants through the program for 234 hours each week, plus a half-day meditation retreat. Research indicates that the program produces long-lasting increases in self-compassion and mindfulness, reduces anxiety and depression, enhances overall well-being, and even stabilizes glucose levels among people with diabetes.

The idea for MSC started back in 2008 when the authors met at a meditation retreat for scientists. One of us (Kristin) is a developmental psychologist and pioneering researcher into self-compassion. The other (Chris) is a clinical psychologist who has been at the forefront of integrating mindfulness into psychotherapy since the mid-1990s. We were sharing a ride to the airport after the retreat and realized we could combine our skills to create a program to teach self-compassion.

I (Kristin) first came across the idea of self-compassion in 1997 during my last year of graduate school, when, basically, my life was a mess. I had just gotten through a messy divorce and was under incredible stress at school. I thought I would learn to practice Buddhist meditation to help me deal with my stress. To my great surprise the woman leading the meditation class talked about how important it was to develop self-compassion. Although I knew that Buddhists talked a lot about the importance of compassion for others, I never considered that having compassion for myself might be just as important. My initial reaction was “What? You mean I’m allowed to be kind to myself? Isn’t that selfish?” But I was so desperate for some peace of mind I gave it a try. Soon I realized how helpful self-compassion could be. I learned to be a good, supportive friend to myself when I struggled. When I started to be kinder to and less judgmental of myself, my life transformed.

After receiving my PhD, I did two years of postdoctoral training with a leading self-esteem researcher and began to learn about some of the downsides of the self-esteem movement.

Though it’s beneficial to feel good about ourselves, the need to be “special and above average” was being shown to lead to narcissism, constant comparisons with others, ego-defensive anger, prejudice, and so on.

The other limitation of self-esteem is that it tends to be contingent, it’s there for us in times of success but often deserts us in times of failure, precisely when we need it most!

I realized that self-compassion was the perfect alternative to self-esteem because it offered a sense of self-worth that didn’t require being perfect or better than others.

After getting a job as an assistant professor at the University of Texas at Austin, I decided to conduct research on self-compassion. At that point, no one had studied selfcompassion from an academic perspective, so I tried to define what self-compassion is and created a scale to measure it, which started what is now an avalanche of selfcompassion research.

The reason I really know self-compassion works, however, is because I’ve seen the benefits of it in my personal life. My son, Rowan, was diagnosed with autism in 2007, and it was the most challenging experience I had ever faced. I don’t know how I would have gotten through it if it weren’t for my self-compassion practice. I remember the day I got the diagnosis, I was actually on my way to a meditation retreat. I had told my husband that I would cancel the retreat so we could process, and he said, “No, go to your retreat and do that self-compassion thing, then come back and help me.”

So while I was on retreat, I flooded myself with compassion. I allowed myself to feel whatever I was feeling without judgment, even feelings I thought I “shouldn’t” be having. Feelings of disappointment, even of irrational shame. How could I possibly feel this about the person I love most in the world? But I knew I had to open my heart and let it all in. I let in the sadness, the grief, the fear. And fairly soon I realized I had the stability to hold it, that the resource of self-compassion would not only get me through, but would help me be the best, most unconditionally loving parent to Rowan I could be. And what a difference it made!

Because of the intense sensory issues experienced by children with autism, they are prone to violent tantrums. The only thing you can do as a parent is to try to keep your child safe and wait until the storm passes. When my son screamed and flailed away in the grocery store for no discernible reason, and strangers gave me nasty looks because they thought I wasn’t disciplining my child properly, I would practice self-compassion. I would comfort myself for feeling confused, ashamed, stressed, and helpless, providing myself the emotional support I desperately needed in the moment. Self-compassion helped me steer clear of anger and self-pity, allowing me to remain patient and loving toward Rowan despite the feelings of stress and despair that would inevitably arise. I’m not saying that I didn’t have times when I lost it. I had many. But I could rebound from my missteps much more quickly with self-compassion and refocus on supporting and loving Rowan.

I (Chris) also learned self-compassion primarily for personal reasons. I had been practicing meditation since the late ’70s, became a clinical psychologist in the early ’80s, and joined a study group on mindfulness and psychotherapy. This dual passion for mindfulness and therapy eventually led to the publication of Mindfulness and Psychotherapy.

As mindfulness became more popular, I was being asked to do more public speaking. The problem, however, was that I suffered from terrible public speaking anxiety. Despite maintaining a regular practice of meditation my whole adult life and trying every clinical trick in the book to manage anxiety, before any public talk my heart would pound, my hands began to sweat, and I found it impossible to think clearly. The breaking point came when I was scheduled to speak at an upcoming Harvard Medical School conference that I helped to organize. (I still tried to expose myself to every possible speaking opportunity.) I’d been safely tucked in the shadows of the medical school as a clinical instructor but now I’d have to give a speech and expose my shameful secret to all my esteemed colleagues.

Around that time, a very experienced meditation teacher advised me to shift the focus of my meditation to loving-kindness, and to simply repeat phrases such as “May I be safe,” “May I be happy,” “May I be healthy,” “May I live with ease.” So I gave it a try. In spite of all the years I’d been meditating and reflecting on my inner life as a psychologist, I’d never spoken to myself in a tender, comforting way. Right off the bat, I started to feel better and my mind also became clearer. I adopted loving-kindness as my primary meditation practice.

Whenever anxiety arose as I anticipated the upcoming conference, I just said the loving-kindness phrases to myself, day after day, week after week. I didn’t do this particularly to calm down, but simply because there was nothing else I could do. Eventually, however, the day of the conference arrived. When I was called to the podium to speak, the typical dread rose up in the usual way. But this time there was something new, a faint background whisper saying, “May you be safe. May you be happy . . .” In that moment, for the first time, something rose up and took the place of fear, self-compassion.

Upon later reflection, I realized that I was unable to mindfully accept my anxiety because public speaking anxiety isn’t an anxiety disorder after all, it’s a shame disorder, and the shame was just too overwhelming to bear. Imagine being unable to speak about the topic of mindfulness due to anxiety! I felt like a fraud, incompetent, and a bit stupid. What I discovered on that fateful day was that sometimes, especially when we’re engulfed in intense emotions like shame, we need to hold ourselves before we can hold our moment-to-moment experience. I had begun to learn self-compassion, and saw its power firsthand.

In 2009, I published The Mindful Path to Self-Compassion in an effort to share what I had learned, especially in terms of how self-compassion helped the clients I saw in clinical practice. The following year, Kristin published Self-Compassion, which told her personal story, reviewed the theory and research on self-compassion, and provided many techniques for enhancing self-compassion.

Together we held the first public MSC program in 2010. Since then we, along with a worldwide community of fellow teachers and practitioners, have devoted a tremendous amount of time and energy to developing MSC and making it safe, enjoyable, and effective for just about everyone. The benefits of the program have been supported in multiple research studies, and to date tens of thousands of people have taken MSC around the globe.

HOW TO USE THIS WORKBOOK

Most of the MSC curriculum is contained in this workbook, in an easy-to-use format that will help you start to be more self-compassionate right away. Some people who use this workbook will be currently taking an MSC course, some may want to refresh what they previously learned, but for many people this will be their first experience with MSC.

This workbook is designed to also be a stand-alone pathway for you to learn the skills you need to be more self-compassionate in daily life. It follows the general structure of the MSC course, with the chapters organized in a carefully sequenced manner so the skills build upon one another. Each chapter provides basic information about a topic followed by practices and exercises that allow you to experience the concepts firsthand.

Most of the chapters also contain illustrations of the personal experiences of participants in the MSC course, to help you know how the practices may play out in your life. These are composite illustrations that don’t compromise the privacy of any particular participant, and the names are not real. In this book, we also alternate between masculine and feminine pronouns when referring to a single individual. We have made this choice to promote ease of reading as our language continues to evolve and not out of disrespect toward readers who identify with other personal pronouns. We sincerely hope that all will feel included.

We recommend that you go through the chapters in order, giving the time needed in between to do the practices a few times. A rough guideline would be to practice about 30 minutes a day and to do about one or two chapters per week. Go at your own pace, however. If you feel you need to go more slowly or spend extra time on a particular topic, please do so. Make the program your own. If you are interested in taking the MSC course in person from a trained MSC teacher, you can find a program near you at http://www.centerformsc.org. Online training is also available. For professionals who want to learn more about the theory, research, and practice of MSC, including how to teach self-compassion to clients, we recommend reading the MSC professional training manual, to be published by The Guilford Press in 2019.

The ideas and practices in this workbook are largely based on scientific research (notes at the back of the book point to the relevant research). However, they are also based on our experience teaching thousands of people how to be more selfcompassionate. The MSC program is itself an organic entity, continuing to evolve as we and our participants learn and grow together.

Also, while MSC isn’t therapy, it’s very therapeutic, it will help you access the resource of self-compassion to meet and transform difficulties that inevitably emerge as we live our lives. However, the practice of self-compassion can sometimes activate old wounds, so if you have a history of trauma or are currently having mental health challenges, we recommend that you complete this workbook under the supervision of a therapist.

Tips for Practice

As you go through this workbook, it’s important to keep some points in mind to get the most out of it.

– MSC is an adventure that will take you into uncharted territory, and unexpected experiences will arise. See if you can approach this workbook as an experiment in self-discovery and self-transformation. You will be working in the laboratory of your own experience, see what happens.

– While you will be learning numerous techniques and principles of mindfulness and self-compassion, feel free to tailor and adapt them in a way that works for you. The goal is for you to become your own best teacher.

– Know that tough spots will show up as you learn to turn toward your struggles in a new way. You are likely to get in touch with difficult emotions or painful self-judgments. Fortunately, this book is about building the emotional resources, skills, strengths, and capacities to deal with these difficulties.

– While self-compassion work can be challenging, the goal is to find a way to practice that’s pleasant and easy. Ideally, every moment of self-compassion involves less stress, less striving, and less work, not more.

– It is good to be a “slow learner.” Some people defeat the purpose of self compassion training by pushing themselves too hard to become self compassionate. Allow yourself to go at your own pace.

– The workbook itself is a training ground for self-compassion. The way you approach this course should be self-compassionate. In other words, the means and ends are the same.

– It is important to allow yourself to go through a process of opening and closing as you work through this book. just as our lungs expand and contract, our hearts and minds also naturally open and close. It is self-compassionate to allow ourselves to close when needed and to open up again when that naturally happens. Signs of opening might be laughter, tears, or more vivid thoughts and sensations. Signs of closing might be distraction, sleepiness, annoyance, numbness, or self-criticism.

– See if you can find the right balance between opening and closing. Just like a faucet in the shower has a range of water flow between off and full force that you can control, you can also regulate the degree of openness you experience. Your needs will vary: sometimes you may not be in the right space to do a particular practice, and other times it will be exactly what you need. Please take responsibitty for your own emotional safety, and don’t push yourself through something if it doesn’t feel right in the moment. You can always come back to it later, or do the practice with the help and guidance of a trusted friend or therapist.

1. What is Self-Compassion?

Selt-compassion involves treating yourself the way you would treat a friend who is having a hard time, even if your friend blew it or is feeling inadequate, or is just facing a tough life challenge. Western culture places great emphasis on being kind to our friends, family, and neighbors who are struggling. Not so when it comes to ourselves. Self-compassion is a practice in which we learn to be a good friend to ourselves when we need it most, to become an inner ally rather than an inner enemy. But typically we don’t treat ourselves as well as we treat our friends.

The golden rule says “Do unto others as you would have them do unto you.” However, you probably don’t want to do unto others as you do unto yourself! Imagine that your best friend calls you after she just got dumped by her partner, and this is how the conversation goes.

“Hey,” you say, picking up the phone. “How are you?”

“Terrible,” she says, choking back tears. “You know that guy Michael I’ve been dating? Well, he’s the first man I’ve been really excited about since my divorce. Last night he told me that I was putting too much pressure on him and that he just wants to be friends. I’m devastated.”

You sigh and say, “Well, to be perfectly honest, it’s probably because you’re old, ugly, and boring, not to mention needy and dependent. And you’re at least 20 pounds overweight. I’d just give up now, because there’s really no hope of finding anyone who will ever love you. I mean, frankly you don’t deserve it!”

Would you ever talk this way to someone you cared about? Of course not. But strangely, this is precisely the type of thing we say to ourselves in such situations, or worse. With self-compassion, we learn to speak to ourselves like a good friend. “I’m so sorry. Are you okay? You must be so upset. Remember I’m here for you and I deeply appreciate you. Is there anything I can do to help?”

Although a simple way to think about self-compassion is treating yourself as you would treat a good friend, the more complete definition involves three core elements that we bring to bear when we are in pain: self-kindness, common humanity, and mindfulness.

Self-Kindness. When we make a mistake or fail in some way, we are more likely to beat ourselves up than put a supportive arm around our own shoulder. Think of all the generous, caring people you know who constantly tear themselves down (this may even be you). Self-kindness counters this tendency so that we are as caring toward ourselves as we are toward others. Rather than being harshly critical when noticing personal shortcomings, we are supportive and encouraging and aim to protect ourselves from harm. Instead of attacking and berating ourselves for being inadequate, we offer ourselves warmth and unconditional acceptance. Similarly, when external life circumstances are challenging and feel too difficult to bear, we actively soothe and comfort ourselves.

Theresa was excited. “I did it! I can’t believe I did it! I was at an office party last week and blurted out something inappropriate to a coworker. Instead of doing my usual thing of calling myself terrible names, I tried to be kind and understanding. I told myself, ‘Oh well, it’s not the end of the world. I meant well even if it didn’t come out in the best way.”

Common Humanity. A sense of interconnectedness is central to self-compassion. It’s recognizing that all humans are flawed works-in-progress, that everyone fails, makes mistakes, and experiences hardship in life. Self-compassion honors the unavoidable fact that life entails suffering, for everyone, without exception. While this may seem obvious, it’s so easy to forget. We fall into the trap of believing that . . .

from

The Mindful Self-Compassion Workbook. A proven way to accept yourself, build inner strength, and thrive

by Kristin Neff, PhD and Christopher Germer, PhD

get it at Amazon.com

Also on TPPA = CRISIS

TED TALK. SELF-COMPASSION VS SELF-ESTEEM – DR KRISTIN NEFF

CFT: FOCUSING ON COMPASSION IN NEXT GENERATION CBT DENNIS TIRCH PH.D * COMPASSION FOCUSED THERAPY FOR DUMMIES – MARY WELFORD * COMPASSION FOCUSED THERAPY – PAUL GILBERT

THE MINDFUL PATH TO SELF-COMPASSION. FREEING YOURSELF FROM DESTRUCTIVE THOUGHTS AND EMOTIONS – CHRISTOPHER K. GERMER PhD

THE SELF ACCEPTANCE PROJECT. HOW TO BE KIND & COMPASSIONATE TOWARD YOURSELF IN ANY SITUATION – TAMI SIMON

MIGRAINE AND DEPRESSION: It’s All The Same Brain – Gale Scott * Migraine May Permanently Change Brain Structure – American Academy of Neurology * Migraine: Multiple Processes, Complex Pathophysiology – Rami Burstein, Rodrigo Noseda, and David Borsook.

The symptoms that accompany migraine suggest that multiple neuronal systems function abnormally. Neuroimaging studies show that brain networks, brain morphology, and brain chemistry are altered in episodic and chronic migraineurs. As a consequence of the disease itself or its genetic underpinnings, the migraine brain is altered structurally and functionally.

Migraine tends to run in families and as such is considered a genetic disorder. Genetic predisposition to migraine resides in multiple susceptible gene variants, many of which encode proteins that participate in the regulation of glutamate neurotransmission and proper formation of synaptic plasticity.

Migraine is a leading cause of suicide, an indisputable proof of the severity of the distress that the disease may inflict on the individual. 40% of migraine patients are also depressed.

Migraine and Depression: It’s All The Same Brain

Gale Scott

When a patient suffers from both migraines and depression or other psychiatric comorbidities, physicians have to treat both. It’s a common situation, since 40% of migraine patients are also depressed. Anxiety is even more prevalent in these patients. An estimated 50% of migraine patients are anxious whether with generalized anxiety, phobias, panic attacks. or other forms of anxiety, said Mia Minen, MD Director of Headache Services at NYU Langoni Medical Center.

Health care costs in treating these co-morbid patients are 1.5 times higher than for migraine patients without accompanying psychiatric disorders.

But sorting out whether one problem is causing the other is not always easy, she said in a recent interview at NYU Langone. “it’s really interesting, which came first,” she said, “We really don’t know.”

There may be a bidirectional relationship with depression. Anxiety may precede migraines, then depression may follow.

Fortunately, she said, the question of which problem came first doesn’t really matter that much.

“It’s all one brain, one organ, and some of the same neurotransmitters are implicated in both disorders.” Serotonin is affected in migraine just as it is in depression and anxiety, she said. Dopamine and norepinephrine are also related both to migraines and psychiatric comorbidities.

“So it’s really one organ that’s controlling all these things,” Minen said.

The first step in treatment is having patients keep a headache diary to track the intensity and frequency and what they take when they feel it coming on.

For a mild migraine that might be ibuprofen or another over-the-counter pain killer.

If the migraine is moderately severe there are 7 migraine-specifuc medications that are effective, she said. There are oral, nasal, and injectable forms of triptans a family of tryptamine-based drugs. “We sometimes tell patients to combine the triptan with Naprosyn,” she said.

If triptans are contraindicated because the patient has other health problems, there are still more pharmaceutical options.

Those include some classes of beta blockers, antiseizure medications, and tricyclic antidepressants at low doses.

The drug regimen may vary with the particular comorbidity. For instance, for migraines with anxiety, venlafaxine might work. If patients have sleep disturbances, amitriptyline might be effective. “Lack of sleep is also a trigger for migraine,” she noted.

The toughest co-morbidity to treat in patients with migraine is finding a regimen that works for patients who are taking a lot of psychiatric medications, like SSRIs and antipsychotics.

For older patients with migraines plus cardiovascular disease, drug choices are also limited.

Botox injections seem promising, but Minen is cautious. “It’s a great treatment for patients with chronic migraines but they have to have failed 2 or 3 medications before they qualify for Botox.” Treatment involves 31 injections over the forehead, the back of the head and the neck. Relief lasts about 3 months, she said.

In addition to pharmaceutical treatment, there are cognitive behavior approaches that can work, like biofeedback and progressive muscle relaxation therapy.

Opioids are not the treatment of choice, she said. They have not been shown to be effective, Minen said and reduce the body’s ability to respond to triptans.

“For chronic migraine, studies don’t show opioids enable patients to return to work; there is no objective study showing they work,” and their uses raises other problems. Patients used to taking opioids who go to an emergency room and request them may find themselves suspected of drugseeking behavior. “It’s hard for doctors and patients,” she said, when patients ask for opioids “It puts doctors in a predicament.”

New drugs are on the horizon, she said. “Calcitonin gene related peptide antagonists look good,” and unlike triptans are not contraindicated for people at risk of strokes or heart attacks.

For now, said Minen, treating migraine and comorbidities “is more an art than a science,” she said, “But a large majority of patients do get better.”

Migraine May Permanently Change Brain Structure

American Academy of Neurology

Migraine may have longlasting effects on the brain’s structure, according to a study published in the August 28, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“Traditionally, migraine has been considered a benign disorder without long-term consequences for the brain,” said study author Messoud Ashina, MD, PhD, with the University of Copenhagen in Denmark. “Our review and meta-analysis study suggests that the disorder may permanently alter brain structure in multiple ways.”

The study found that migraine raised the risk of brain lesions, white matter abnormalities and altered brain volume compared to people without the disorder. The association was even stronger in those with migraine with aura.

Migraine with aura
A common type of migraine featuring additional neurological symptoms. Aura is a term used to describe a neurological symptom of migraine, most commonly visual disturbances.
People who experience ‘migraine with aura’ will have many or all the symptoms of a ‘migraine without aura‘ and additional neurological symptoms which develop over a 5 to 20 minute period and last less than an hour.
Visual disturbances can include: blind spots in the field of eyesight, coloured spots, sparkles or stars, flashing lights before the eyes, tunnel vision, zig zag lines, temporary blindness.
Other symptoms include: numbness or tingling, pins and needles in the arms and legs, weakness on one side of the body, dizziness, a feeling of spinning (vertigo).
Speech and hearing can be affected and some people have reported memory changes, feelings of fear and confusion and, more rarely, partial paralysis or fainting.
These neurological symptoms usually happen before a headache, which could be mild, or no headache may follow.

For the meta-analysis, researchers reviewed six population-based studies and 13 clinic-based studies to see whether people who experienced migraine or migraine with aura had an increased risk of brain lesions, silent abnormalities or brain volume changes on MRI brain scans compared to those without the conditions.

The results showed that migraine with aura increased the risk of white matter brain lesions by 68 percent and migraine with no aura increased the risk by 34 percent, compared to those without migraine. The risk for infarct-like abnormalities increased by 44 percent for those without aura. Brain volume changes were more common in people with migraine and migraine with aura than those with no migraines.

“Migraine affects about 10 to 15 percent of the general population and can cause a substantial personal, occupational and social burden,” said Ashina. “We hope that through more study, we can clarify the association of brain structure changes to attack frequency and length of the disease. We also want to find out how these lesions may influence brain function.”

The study was supported by the Lundbeck Foundation and the Novo Nordisk Foundation.

To learn more about migraine, please visit American Academy of Neurology.

Migraine: Multiple Processes, Complex Pathophysiology

Rami Burstein (1,3), Rodrigo Noseda (1,3) and David Borsook (2,3)
1 – Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston
2 – Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital
3 – Harvard Medical School

Migraine is a common, multifactorial, disabling, recurrent, hereditary neurovascular headache disorder. It usually strikes sufferers a few times per year in childhood and then progresses to a few times per week in adulthood, particularly in females. Attacks often begin with warning signs (prodromes) and aura (transient focal neurological symptoms) whose origin is thought to involve the hypothalamus, brainstem, and cortex.

Once the headache develops, it typically throbs, intensifies with an increase in intracranial pressure, and presents itself in association with nausea, vomiting, and abnormal sensitivity to light, noise, and smell. It can also be accompanied by abnormal skin sensitivity (anodynia) and muscle tenderness.

Collectively, the symptoms that accompany migraine from the prodromal stage through the headache phase suggest that multiple neuronal systems function abnormally.

As a consequence of the disease itself or its genetic underpinnings, the migraine brain is altered structurally and functionally. These molecular, anatomical, and functional abnormalities provide a neuronal substrate for an extreme sensitivity to fluctuations in homeostasis, a decreased ability to adapt, and the recurrence of headache.

Homeostasis is the state of steady internal conditions maintained by living things.

Advances in understanding the genetic predisposition to migraine, and the discovery of multiple susceptible gene variants (many of which encode proteins that participate in the regulation of glutamate neurotransmission and proper formation of synaptic plasticity) define the most compelling hypothesis for the generalized neuronal hyperexcitability and the anatomical alterations seen in the migraine brain.

Regarding the headache pain itself, attempts to understand its unique qualities point to activation of the trigeminovascular pathway as a prerequisite for explaining why the pain is restricted to the head, often affecting the periorhital area and the eye, and intensities when intracranial pressure increases.

Introduction

Migraine is a recurrent headache disorder affecting 15% of the population during the formative and most productive periods of their lives, between the ages of 22 and 55 years. It frequently starts in childhood, particularly around puberty, and affects women more than men.

It tends to run in families and as such is considered a genetic disorder.

In some cases, the headache begins with no warning signs and ends with sleep. In other cases, the headache may be preceded by a prodromal phase that includes fatigue; euphoria; depression; irritability; food cravings; constipation; neck stiffness; increased yawning; and/or abnormal sensitivity to light, sound, and smell and an aura phase that includes a variety of focal cortically mediated neurological symptoms that appear just before and/or during the headache phase. Symptoms of migraine aura develop gradually, feature exeitatory and inhibitory phases, and resolve completely. Positive (gain of function) and negative (loss of function) symptoms may present as scintillating lights and scotomas when affecting the visual cortex; paresthesia, and numbness of the face and hands when affecting the somatosensory cortex; tremor and unilateral muscle weakness when affecting the motor cortex or basal ganglia; and difficulty saying words (aphasia) when affecting the speech area.

The pursuant headache is commonly unilateral, pulsating, aggravated by routine physical activity, and can last a few hours to a few days (Headache Classification Committee of the International Headache Society, 2013). As the headache progresses, it may be accompanied by a variety of autonomic symptoms (nausea, vomiting, nasallsinus congestion, rhinorrhea, lacrimation, ptosis, yawning, frequent urination, and diarrhea), affective symptoms (depression and irritability), cognitive symptoms (attention deficit, difficulty finding words, transient amnesia, and reduced ability to navigate in familiar environments), and sensory symptoms (photophobia, phonophobia, osmophobia, muscle tenderness, and cutaneous allodynia).

The extent of these diverse symptoms suggests that migraine is more than a headache. It is now viewed as a complex neurological disorder that affects multiple cortical, subcortical, and brainstem areas that regulate autonomic, affective, cognitive, and sensory functions. As such, it is evident that the migraine brain differs from the non-migraine brain and that an effort to unravel the pathophysiology of migraine must expand beyond the simplistic view that there are “migraine generator” areas.

In studying migraine pathophysiology, we must consider how different neural networks interact with each other to allow migraine to commence with stressors such as insufficient sleep, skipping meals, stressful or post stressful periods, hormonal fluctuations, alcohol, certain foods, flickering lights, noise, or certain scents, and why migraine attacks are sometimes initiated by these triggers and sometimes not.

We must tackle the enigma of how attacks are resolved on their own or just weaken and become bearable by sleep, relaxation, food, and/or darkness. We must explore the mechanisms by which the frequency of episodic migraine increases over time (from monthly to weekly to daily), and why progression from episodic to chronic migraine is uncommon.

Disease mechanisms

In many cases, migraine attacks are likely to begin centrally, in brain areas capable of generating the classical neurological symptoms of prodromes and aura, whereas the headache phase begins with consequential activation of meningeal nociceptors at the origin of the trigeminovascular system.

A nociceptor is a sensory neuron that responds to damaging or potentially damaging stimuli by sending “possible threat” signals to the spinal cord and the brain. If the brain perceives the threat as credible, it creates the sensation of pain to direct attention to the body part, so the threat can hopefully be mitigated; this process is called nociception.
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The meninges are the three membranes that envelop the brain and spinal cord. In mammals, the meninges are the dura mater, the arachnoid mater, and the pia mater. Cerebrospinal fluid is located in the subarachnoid space between the arachnoid mater and the pia mater. The primary function of the meninges is to protect the central nervous system.

While some clues about how the occurrence of aura can activate nociceptors in the meninges exist, nothing is known about the mechanisms by which common prodromes initiate the headache phase or what sequence of events they trigger that results in activation of the meningeal nociceptors. A mechanistic search for a common denominator in migraine symptomatology and characteristics points heavily toward a genetic predisposition to generalized neuronal hyperexcitability. Mounting evidence for alterations in brain structure and function that are secondary to the repetitive state of headache can explain the progression of disease.

Prodromes

In the context of migraine, prodromes are symptoms that precede the headache by several hours. Examination of symptoms that are most commonly described by patients point to the potential involvement of the hypothalamus (fatigue, depression, irritability, food cravings, and yawning), brainstem (muscle tenderness and neck stiffness), cortex (abnormal sensitivity to light, sound, and smell), and limbic system (depression and anhedonia) in the prodromal phase of a migraine attack. Given that symptoms such as fatigue, yawning, food craving, and transient mood changes occur naturally in all humans, it is critical that we understand how their occurrence triggers a headache; whether the routine occurrence of these symptoms in migraineurs (i.e., when no headache develops) differs mechanistically from their occurrence before the onset of migraine; and why yawning, food craving, and fatigue do not trigger a migraine in healthy subjects.

Recently, much attention has been given to the hypothalamus because it plays a key role in many aspects of human circadian rhythms (wake sleep cycle, body temperature, food intake, and hormonal fluctuations) and in the continuous effort to maintain homeostasis. Because the migraine brain is extremely sensitive to deviations from homeostasis, it seems reasonable that hypothalamie neurons that regulate homeostasis and circadian cycles are at the origin of some of the migraine prodromes.

Unraveling the mechanisms by which hypothalamic and brainstem neurons can trigger a headache is central to our ability to develop therapies that can intercept the headache during the prodromal phase (i.e., before the headache begins. The ongoing effort to answer this question focuses on two very different possibilities (Fig. 1). The first suggests that hypothalamic neurons that respond to changes in physiological and emotional homeostasis can activate meningeal nociceptors by altering the balance between parasympathetic and sympathetic tone in the meninges toward the predominance of parasympathetic tone. Support for such a proposal is based on the following: (1) hypothalamic neurons are in a position to regulate the firing of preganglionic parasympathetic neurons in the superior salivatory nucleus (SSN) and sympathetic preganglionic neurons in the spinal intermediolateral nucleus. (2) the SSN can stimulate the release of acetylcholine, vasoactive intestinal peptide, and nitric oxide from meningeal terminals of postganglionic parasympathetic neurons in the Spheno palatine ganglion (SPG), leading to dilation of intracranial blood vessels, plasma protein extravasation, and local release of inflammatory molecules capable of activating pial and dural branches of meningeal nociceptors; (3) meningeal blood vessels are densely innervated by para sympathetic fibers. (4) activation of SSN neurons can modulate the activity of central trigeminovascular neurons in the spinal trigeminal nucleus. (5) activation of meningeal nociceptors appears to depend partially on enhanced activity in the SPG. (6) enhanced cranial parasympathetic tone during migraine is evident by lacrimation and nasal congestion, and, finally, (7) blockade of the sphenopalatine ganglion provides partial or complete relief of migraine pain.

The second proposal suggests that hypothalamic and brainstem neurons that regulate responses to deviation from physiological and emotional homeostasis can lower the threshold for the transmission of nociceptive trigeminovascular signals from the thalamus to the cortex, a critical step in establishing the headache experience. This proposal is based on understanding how the thalamus selects, amplifies, and prioritizes information it eventually transfers to the cortex, and how hypothalamic and brainstem nuclei regulate relay thalamocortical neurons. It is constructed from recent evidence that relay trigeminothalamic neurons in sensory thalamie nuclei receive direct input from hypothalamic neurons that contain dopamine, histamine, orexin, and melanin concentrating hormone (MCH), and brainstem neurons that contain noradrenaline and serotonin. In principle, each of these neuropeptides/neurotransmitters can shift the activity of thalamic neurons from burst to tonic mode if it is excitatory (dopamine, and high concentration of serotonin, noradrenaline, histamine, orexin, and from tonic to burst mode if it is inhibitory (MCH and low concentration of serotonin). The opposing factors that regulate the firing of relay trigeminovascular thalamic neurons provide an anatomical foundation for explaining why prodromes give rise to some migraine attacks but not to others, and why external (e.g., exposure to strong perfume) and internal conditions (e.g., skipping a meal and feeling hungry, sleeping too little and being tired, or simple stress) trigger migraine attacks so inconsistently.

In the context of migraine, the convergence of these hypothalamic and brainstem neurons on thalamic trigeminovascular neuruns can establish high and low set points for the allostatic load of the migraine brain. The allostatic load, defined as the amount of brain activity required to appropriately manage the level of emotional or physiological stress at any given time, can explain why external and internal conditions only trigger headache some of the times, when they coincide with the right circadian phase of cyclic rhythmicity of brainstem, and hypothalamic and thalamic neurons that preserve homeostasis.

Cortical spreading depression

Clinical and preclinical studies suggest that migraine aura is caused by cortical spreading depression (CSD), a slowly propagating wave of depolarization/excitation followed by hyperpolarization/inhibition in cortical neurons and glia. While specific processes that initiate CSD in humans are not known, mechanisms that invoke inflammatory molecules as a result of emotional or physiological stress, such as lack of sleep, may play a role. In the cortex, the initial membrane depolarization is associated with a large efflux of potassium; influx of sodium and calcium; release of glutamate, ATP, and hydrogen ions; neuronal swelling ; upregulation of genes involved in inflammatory processing; and a host of changes in cortical perfusion and enzymatic activity that include opening of the megachannel Panxl, activation of caspase-1, and a breakdown of the blood brain barrier.

Outside the brain, caspase-1 activation can initiate inflammation by releasing high mobility group protein B1 and interleukin-1 into the CSF, which then activates nuclear factor KB in astrocytes, with the consequential release of cyclooxygenase-2 and inducible nitric oxide swithase (iNOS) into the subarach noid space. The introduction into the meninges of these proinflammatory molecules, as well as calcitonin gene related peptide (CGRP) and nitric oxide, may be the link between aura and headache because the meninges are densely innervated by pain fibers whose activation distinguishes headaches of intracranial origin (e.g., migraine, meningitis, and subaraeh noid bleeds) from headaches of extracranial origin (e.g., tension type headache, cervicogenic headache, or headaches caused by mild trauma to the cranium).

Anatomy and physiology of the trigeminovascular pathway: from activation to sensitization

Anatomical description

The trigeminovascular pathway conveys nociceptive information from the meninges to the brain. The pathway originates in trigeminal ganglion neurons whose peripheral axons reach the pia, dura, and large cerebral arteries, and whose central axons reach the nociceptive dorsal horn laminae of the SpV. In the SpV, the nociceptors converge on neurons that receive additional input from the periorbital skin and pericranial muscles. The ascending axonal projections of trigeminovascular SpV neurons transmit monosynaptic nocieeptive signals to (1) brainstem nuclei, such as the ventro lateral periaqueductal gray, reticular for mation, superior salivatory, parabrachial, cuneiform, and the nucleus of the solitary tract; (2) hypothalamic nuclei, such as the anterior, lateral, perifornical, dorsome dial, suprachiasmatic, and supraoptic; and (3) basal ganglia nuclei, such as the caudate putamen, globus pallidus, and sub stantia innominata. These projections maybe critical for the initiation of nausea, vomiting, yawning, lacrimation, urination, loss of appetite, fatigue, anxiety, irritability, and depression by the headache itself.

Additional projections of trigeminovascular SpV neurons are found in the thalamic ventral posteromedial (VPM), posterior (PO), and parafascicular nuclei. Relay trigeminovascular thalamic neurons that project to the somatosensory, insular, motor, parietal association, retrosplenial, auditory, visual, and olfactory cortices are in a position to construct the specific nature of migraine pain (i.e., location, intensity, and quality) and many of the cortically mediated symptoms that distinguish between migraine headache and other pains. These include transient symptoms of motor clumsiness, difficulty focusing, amnesia, allodynia, phonophobia, photophobia, and osmophobia. Figure 2A illustrates the complexity of the trigeminovascular pathway.

Activation

Studies in animals show that CSD initiates delayed activation (Fig. 2D, 2B,C) and immediate activation (Fig. 2D) of peripheral and central trigeminovascular neurons in a fashion that resembles the classic delay and occasional immediate onset of headache after aura, and that systemic administration of the M type potassium channel opener KCNQ2/3 can prevent the CSD induced activation of the nociceptors.

These findings support the notion that the onset of the headache phase of migraine with aura coincides with the activation of meningeal nociceptors at the peripheral origin of the trigeminovascular pathway. Whereas the vascular, cellular, and molecular events involved in the activation of meningeal nocieeptors by CSD are not well under stood, a large body of data suggests that transient constriction and dilatation of pial arteries and the development of dural plasma protein extravasation, neurogenic inflammation, platelet aggregation, and mast cell degranulation, many of which may be driven by CSD dependent peripheral CGRP release, can introduce to the meninges proinflammatory molecules, such as histamine, bradykinin, serotonin, and prostaglandins (prostaglandin E2), and a high level of hydrogen ions thus altering the molecular environment in which meningeal nociceptors exist.

Sensitization

When activated in the altered molecular environment described above, peripheral trigeminovascular neurons become sensitized (their response threshold decreases and their response magnitude increases) and begin to respond to dura stimuli to which they showed minimal or no response at base line. When central trigeminovascular neurons in laminae I and V of SpV (Fig. 2F) and in the thalamic PO/VPM nuclei (Fig. 2G) become sensitized, their spontaneous activity increases, their receptive fields expand, and they begin to respond to innocuous mechanical and thermal stimulation of cephalic and extracephalic skin areas as if it were noxious. The human correlates of the electrophysiological measures of neuronal sensitization in animal studies are evident in contrast analysis of BOLD signals registered in MRI scans of the human trigeminal ganglion (Fig. 2H), spinal trigeminal nucleus (Fig. 2I), and the thalamus (Fig. 2J), all measured during migraine attacks.

The clinical manifestation of peripheral sensitization during migraine, which takes roughly 10 mins to develop, includes the perception of throbbing headache and the transient intensiflcation of headache while bending over or coughing, activities that momentarily increase intracranial pressure.

The clinical manifestation of sensitization of central trigeminovascular neurons in the SpV, which takes 30-60 min to develop and 120 min to reach full extent, include the development of cephalic allodynia signs such as scalp and muscle tenderness and hypersensitivity to touch. These signs are often recognized in patients reporting that they avoid wearing glasses, earrings, hats, or any other object that come in contact with the facial skin during migraine.

The clinical manifestation of thalamic sensitization during migraine, which takes 2-4 h to develop, also includes extracephalic allodynia signs that cause patients to remove tight clothing and jewelry, and avoid being touched, massaged, or hugged.

Evidence that triptans, 5HT agonists that disrupt communications between peripheral and central trigeminovascular neurons in the dorsal horn, are more effective in aborting migraine when administered early (i.e., before the development of central sensitization and allodynia) rather than late (i.e., after the development of allodynia) provides further support for the notion that meningeal nociceptors drive the initial phase of the headache. Further support for this concept was provided recently by studies showing that humanized monoclonal antihodies against CGRP, molecules that are too big to penetrate the bloodbrain barrier and act centrally (according to the companies that developed them), are effective in preventing migraine. Along this line, it was also reported that drugs that act on central trigeminovascular neurons, e.g., dihydroergotamine (DHE), are equally effective in reversing an already developed central sensitization a possible explanation for DHE effectiveness in aborting migraine after the failure of therapy with triptans.

Genetics and the hyperexcitable brain

Family history points to a genetic predisposition to migraine. A genetic association with migraine was first observed and defined in patients with familial hemiplegic migraine (FHM).

The three genes identified with FHM encode proteins that regulate glutamate availability in the synapse. FHM1 (CACNAIA) encodes the pore-forming a1 subunit of the P/Q type calcium channel; FHM2 (ATP1A2) encodes the 112 subunit of the Na+/K+ ATPase pump; and the FHM3 (SCNIA) encodes the a1 sub unit of the neuronal voltage gated Nav1.1 channel.

Collectively, these genes regulate transmitter release, glial ability to clear (reuptake) glutamate from the synapse, and the generation of action potentials.

Since these early findings, large genome wide association studies have identified 13 susceptibility gene variants for migraine with and without aura, three of which regulate glutaminergic neurotransmission (MTDH/AEG-1 downregulates glutamate transporter, LPRI modulates synaptic transmission through the NMDA receptor, and MEF-2D regulates the glutamatergic excitatory synapse), and two of which regulate synaptic development and plasticity (ASTN2 is involved in the structural development of cortical layers, and FHI5 regulates cAMP sensitive CREB proteins involved msynaptic plasticity).

These findings provide the most plausible explanation for the “generalized” neuronal hyperexcitability of the migraine brain.

In the context of migraine, increased activity in glutamalergic systems can lead to excessive occupation of the NMDA receptor, which in turn may amplify and reinforce pain transmission, and the development of allodynia and central sensitization. Network wise, wide spread neuronal hyperexcitability may also be driven by thalamocortical dysrhythmia, defective modulatory brainstem circuits that regulate excitability at multiple levels along the neuraxis; and inherently improper regulation/habituation of cortical, thalamic, and brainstem functions by limbic structures, such as the hypothalamus, amygdala, nucleus accumbens, caudate, putamen, and globus pallidus. Given that 2 of the 13 susceptibility genes regulate synaptic development and plasticity, it is reasonable to speculate that some of the networks mentioned above may not be properly wired to set a normal level of habituation throughout the brain, thus explaining the multi factorial nature of migraine. Along this line, it is also tempting to propose that at least some of the structural alterations seen in the migraine brain may be inherited and, as such, may be the “cause” of migraine, rather than being secondary to (i.e., being caused by) the repeated headache attacks. But this concept awaits evidence.

Structural and functional brain alterations

Brain alterations can be categorized into the following two processes: (1) alteration in brain function and (2) alterations in brain structure (Fig. 3). Functionally, a variety of imaging techniques used to measure relative activation in different brain areas in migraineurs (vs control subjects) revealed enhanced activation in the periaqueductal gray; red nucleus and substantia nigra; hypothalamus; posterior thalamus; cerebellum, insula, cingulate and prefrontal cortices, anterior temporal pole, and the hippocampus; and decreased activation in the somatosensory cortex, nucleus cuneiformis, caudate, putamen, and pallidum. All of these activity changes occurred in response to nonrepetitive stimuli, and in the cingulate and prefrontal cortex they occurred in response to repetitive stimuli.

Collectively, these studies support the concept that the migraine brain lacks the ability to habituate itself and consequently becomes hyperexcitable. It is a matter of debate, however, if such changes are unique to migraine headache. Evidence for nearly identical activation patterns in other pain conditions, such as lower back pain, neuropathic pain, Hbromyalgia, irritable bowel syndrome, and cardiac pain, raises the possibility that differences between somatic pain and migraine pain are not due to differences in central pain processing.

Anatomically, voxel based morphometry and diffusion sensor imaging studies in migraine patients (vs control subjects) have revealed thickening of the somatosensory cortex; increased gray matter density in the caudate; and gray matter volume loss in the superior temporal gyms, inferior frontal gyms, precentral gyms, anterior cingulate cortex, amygdala, parietal operculum, middle and inferior frontal gyrus, inferior frontal gyrus, and bilateral insula.

Changes in cortical and subcortical structures may also depend on the frequency of migraine attacks for a number of cortical and subcortical regions. As discussed above, it is unclear whether such changes are genetically predetermined or simply a result of the repetitive exposure to pain/stress. Favoring the latter are studies showing that similar gray matter changes occurring in patients experiencing other chronic pain conditions are reversible and that the magnitude of these changes can be correlated with the duration of disease.

Further complicating our ability to determine how the migraine brain differs from the brain of a patient experiencing other chronic pain conditions are anatomical findings showing decreased gray matter density in the prefrontal cortex, thalamus, posterior insula, secondary somatosensory cortex, precentral and posteentral gyms, hippocampus, and temporal pole of chronic back pain patients; anterior insula and orbitofrontal cortex of complex regional pain syndrome patients; and the insula, midanterior cingulate cortex, hippocampus and inferior temporal coxtex in osteoarthritis pa tients with chronic back pain.

Whereas some of the brain alterations seen in migraineurs depend on the sex of the patient, little can he said about the role played by the sex of patients who experience other pain conditions.

Treatments in development

Migraine therapy has two goals: to terminate acute attacks; and to prevent the next attack from happening. The latter can potentially prevent the progression from episodic to chronic state. Regarding the effort to terminate acute attacks, migraine represents one of the few pain conditions for which a specific drug (i.e., triptan) has been developed based on understanding the mechanisms of the disease. In contrast, the effort to prevent migraine from happening is likely to face a much larger challenge given that migraine can originate in an unknown number of brain areas (see above), and is associated with generalized functional and structural brain abnormalities.

A number of treatments that attract attention are briefly reviewed below.

Medications The most exciting drug currently under development is humanized monoclonal antibodies against CGRP. The development of these monoclonal antibodies are directed at both CGRP and its receptors. The concept is based on CGRP localization in the trigeminal ganglion and its relevance to migaine patho-physiology. In recent phase II randomized placebo-controlled trials, the neutralizing humanized monoclonal antibodies against CGRP administered by injection for the prevention of episodic migraine, showed promising results. Remarkably, a single injection may prevent or significantly reduce migraine attacks for 3 months.

Given our growing understanding of the importance of prodromes (likely representing abnormal sensitivity to the fluctuation in hypothalamically regulated homeostasis) and aura (likely representing the inherited conical hyperexcitability) in the pathophysiology of migraine, drugs that target ghrelin, leptin, and orexin receptors may be considered for therapeutic development which is based on their ability to restore proper hypothalamic control of stress, hyperphagia, adiposity, and sleep. All may be critical in reducing allostatic load and, consequently, in initiating the next migraine attack.

Brain modification

Neuroimaging studies showing that brain networks, brain morphology, and brain chemistry are altered in episodic and chronic migraineurs justify attempts to develop therapies that widely modify brain networks and their functions. Transcranial magnetic stimulation, which is thought to modify cortical hyperexcitability, is one such approach. Another approach for generalized brain modification is cognitive behavioral therapy.

Conclusions

Migraine is a common and undertreated disease. For those who suffer, it is a major cause of disability, including missing work or school, and it frequently has associated comorbidities such as anxiety and depression. To put this in context, it is a leading cause of suicide, an indisputable proof of the severity of the distress that the disease may inflict on the individual.

There is currently no objective diagnosis or treatment that is universally effective in aborting or preventing attacks. As an intermittent disorder, migraine represents a neurological condition wherein systems that continuously evaluate errors (error detection) frequently fail, thus adding to the allostatic load of the disease.

Given the enormous burden to society, there is an urgent imperative to focus on better understanding the neurobiology of the disease to enable the discovery of novel treatment approaches.

AN ANXIOUS PARADISE. Crisis in New Zealand mental health services as depression and anxiety soar – Eleanor Ainge Roy * World in mental health crisis of monumental suffering – Sarah Broseley.

System neglects ‘missing middle’ of the population who face common problems.
50-80% of New Zealanders experience mental distress or addiction challenges at some point in their lives, while each year one in five people experience mental illness or significant mental distress.

A landmark inquiry has found New Zealand’s mental health services are overwhelmed and geared towards crisis care rather than the wider population who are experiencing increasing rates of depression, trauma and substance abuse.

It has urged the government to widen provision of mental health care from 3% of the population in critical need to “the missing middle” – the 20% of the population who struggle with “common, disabling problems” such as anxiety.

New Zealand has one of the highest rates of suicide in the OECD, especially among young people. In 2017, 20,000 people tried to take their own life.

. . . The Guardian

Also on TPPA = CRISIS

World in mental health crisis of ‘monumental suffering’, say experts – Sarah Broseley.

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ANDAMAN ISLANDS. A SEXUALISED HEART OF DARKNESS – Ben Graham * A History of Our Relations With the Andamanese – Maurice Vidal Portman.

Creepy antics of British naval officer over 100 years ago had a profound impact on lost tribe.

“We cannot be said to have done anything more than increase their general terror of, and hostility to, all comers.

He indulged his passion for photography by kidnapping members of various tribes and posing them in mock-Greek homoerotic compositions.

During his 20 years in a sexualised heart of darkness, Portman measured and catalogued every inch of his prisoner’s bodies, with an obsessive focus on genitalia.”

A tribe has been thrust into the spotlight over a missionary’s death. But if it wasn’t for one man’s creepy acts more than a century ago, it might never have happened.

A horrific legacy of bizarre sexual photographs, kidnappings, death and disease at the order of a British naval officer more than a century ago has been thrown into the spotlight after the recent death of a Christian missionary.

John Allen Chau’s bow and arrow slaying at the hands of one of the world’s few remaining truly isolated tribes has polarised opinion around the world.

The 26-year-old was killed by Sentinelese tribesmen, desperate to keep him from setting foot on their remote island home off the coast of India.

And, while some Christians believe the American missionary was martyred doing what he was born to do, many also believe he put himself and others at unnecessary risk by trying to enter a hunter-gatherer community notoriously suspicious of outsiders.

But this debate may not have happened at all if it wasn’t for the actions of one man from Canada who sailed the world in an attempt to pacify Andamanese islanders, including the Sentinelese people, between 1879 and 1901 at the command of the British Royal Navy.

It became a bizarre obsession for Maurice Vidal Portman, a naval officer, and his colonial cronies whose attempts to “civilise” the tribes turned into vile series of kidnappings, death, disease, and disturbing photographs.

In one of his books, which is available to read for free online, Mr Portman describes how he and his men stumbled across the North Sentinel Island’s people more than a century ago.

He describes the first time one of his cronies, Mr Homfrey, saw the Sentinelese people on their remote island home.

“He did not land, but saw ten men on the beach who were naked, with long hair, and were shooting fish with bow and arrows,” he wrote.

The Sentinelese are one of the world’s last “uncontacted” tribes whose language and customs remain a mystery to outsiders.

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Other Andamanese islanders from a nearby island said their neighbours were “not friendly” to them due to an inter-island conflict many years ago.

This encounter and Mr Portman’s observation that the Sentinelese were different from nearby island cultures, in terms of weapons and dialect sparked a dark obsession.

“There is a tribe on North Senital Island, about which very little is known, though it is suspected to be quite a recent offshoot from the Little Andaman people, if indeed all communication between the two islands has actually ceased,” he writes later in the book.

He decided to pay the island a visit in January 1880 with his band of British, Indian, and Burmese convicts. The first trip went by without too much trouble, but a second visit just a few days later, was a disaster.

They ended up spooking the “timid” islanders, who reacted by aggressively driving him and his men away.

“This expedition was not a success …” he wrote. “We cannot be said to have done anything more than increase their general terror of, and hostility to, all comers.”

This was because Mr Portman and his crew came across a family in a thick forest, who were freaked out by the sudden appearance of the strange visitors. A Sentinelese man drew his bow and a mass scuffle broke out.

“We caught three unhurt and brought them on board,” Mr Portman wrote.

The kidnapped group was then taken to the South Andaman Island capital of Port Blair “in the interest of science”.

“They sickened rapidly, and the old man and his wife died, so the four children were sent back to their home with quantities of presents,” wrote Mr Portman.

It is likely that, like other isolated tribes and indigenous visited by colonisers, they had succumbed to diseases given to them by their kidnappers.

The experience failed to deter Mr Portman and it got much weirder.

According to an incredibly detailed Twitter thread by an anonymous and widely-followed lawyer, RespectableLaw, which has been shared more than 44,000 times on Twitter, it’s been suggested that Mr Portman became “erotically obsessed with the Andamanese”.

“He indulged his passion for photography by kidnapping members of various tribes and posing them in mock-Greek homoerotic compositions,” RespectableLaw wrote.

“During his 20 years in a sexualised heart of darkness, Portman measured and catalogued every inch of his prisoner’s bodies, with an obsessive focus on genitalia.”

He wrote that Mr Portman returned on a couple occasions, but the Sentinelese hid from him each time, but the story was “certainly passed down among the 100 or so inhabitants of the island”.

Survival International, a human rights organisation that campaigns for the rights of indigenous tribal people, has suggested the impact of Mr Portman’s antics might have driven the Sentinelese tribe’s hostility to outsiders to this day.

“It is not known how many Sentinelese became ill as a result of this ‘science’ but it’s likely that the children would have passed on their diseases and the results would have been devastating,” according to its website.

“It is mere conjecture, but this experience may account for the Sentinelese’s continued hostility and rejection of outsiders?”

Since Mr Portman touched down on the island, brief visits have been paid but the Sentinelese remain untouched by modern civilisation.

Starting in the 1960s, anthropologists succeeded in exchanging gifts and conducting field visits but abandoned their efforts some 25 years ago in the face of renewed hostility.

An Indian Coast Guard helicopter that flew over the island after the 2004 Asian tsunami was attacked with arrows.

The authorities then declared that no further attempts would be made to contact the Sentinelese.

They do make periodic checks, albeit from a safe distance, to ensure the tribe’s wellbeing, following a strict “eyes on, hands off” policy.

Veteran anthropologist T. N. Pandit who visited North Sentinel 50 years ago believes there should be no rush to make contact with the Sentinelese.

“Of the four Andaman tribal communities, we have seen that those in close contact with the outside world have suffered the most. They have declined demographically and culturally,” he told Down To Earth magazine in a recent interview.

The Sentinelese “are a highly vulnerable population and would disappear in an epidemic,” he added.

“The government’s responsibility should be to keep a watch over them in the sense (that) no unauthorised people reach them and exploit them. Otherwise, just leave them alone.”

The nearby Jarawas were the earliest tribe in the Andamans to be contacted by the British. The 2011 census estimated their population to be around 400.

They fiercely resisted contact with outsiders before opening up gradually in the 1970s. Some travel companies were accused of organising “human safari tours” so that tourists could catch a glimpse.

Some say the younger generation has even learnt bits of the Hindi language from frequent interaction with tourists. Some have taken up drinking and smoking.

In 2012, a video of a naked Jarawa woman dancing for tourists set alarm bells ringing and led to tightening of rules and enforcement.

And, in 2016, there were reports of a fair-skinned baby, assumed to have been fathered by an outsider, being killed by Jarawa men according to a custom of the tribe.

NZ Herald

A History of Our Relations With the Andamanese

Maurice Vidal Portman, M.A.I.

Fellow of the University of Calcutta. Officer in charge of the Andamanese.

COMPILED FROM HISTORIES AND TRAVELS, AND FROM THE RECORDS OF THE GOVERNMENT OF INDIA.

Calcutta, 1899

INTRODUCTION

This book has been written at the request of Lieutenant-Colonel R.0. Temple, C.I.E., Chief Commissioner of the Andaman and Nicobar Islands, who, on assuming that office in August 1894, was anxious that the records of the Government relations with the Andamanese, which were perishing, with all that had been written about this interesting race before our occupation of their islands, should be condensed into one work before it was too late.

After giving a description of the Andaman Islands, and of the appearance and customs of the Andamanese, I quote all that has been written about these islands from the earliest times up to the date of our first settlement on them in the last century ; and the present work, if not containing all that is known, at least has, between two covers, a larger number of the earlier records than any other by far, in addition to the assistance afforded me in this direction by Colonel Yule’s article on the Andaman Islands in the ninth edition of the Encyclopedia Britannica, and by Mr. Man’s book, “The Andaman Islanders ”; copies have been made for me of documents in the libraries of the India Office, of the British Museum, and of the Home Department of the Government of India, in Calcutta.

I then include all that can be discovered regarding our occupation of the Andamans from 1789 to 1796, and am indebted to Mr. E.H. Man, C.I.E., for a copy of Lieutenant Colebrooke’e little known paper on the Andamanese, one of the most important extracts in the book; the few notices of the Andamaus which are found between 1796 and 1857 are then given, including the interesting account of the wrecks. Mr. E. H. Man, G.I.E., and Mr. F. E. Tuson, have also assisted me regarding matters which have occurred before I came to Port Blair, and about which the records are either silent, or are altogether missing.

M.V. PORTMAN, Officer in charge of the Andamanese.

PORT BLAIR, ANDAMAN ISLANDS; The 28th April 1896.

CHAPTER 1.

Position and physical geography of the Andaman Islands.

THE Andaman Islands lie in the Bay of Bengal, between the 10th and 14th Parallels of North Latitude, and between the 92nd and 94th Meridians of East Longitude. The Group of Islands is divided into the Great and Little Andaman, the former being subdivided into the North, Middle, and South Andaman, with the outlying Islands of Landfall, Interview, Rutland, and the North and South Sentinel; the Archipelago, and Labyrinth Groups. Including all the small Islets, however, there are 2014 Islands in the Andamans.

The Great Andaman, from Cape Price, the North end of the North Andaman, to the South end of Rutland Island, is 155 miles in length, and nowhere more than 18 miles in breadth. The Little Andaman, 26 miles by 16, lies 31 miles south of Rutland Island, the entire length of the Group being 219 miles.

The Great Andaman Islands are hilly, rising in the North Andaman to 2400 feet, in the Middle Andaman to 1,678 feet, and in the South Andaman to 1,510 feet. Numerous creeks intersect the islands and there are thnee Straits, Bombay, Middle, and McPhersons, which are navigable for vessels of less than twelve feet draught.

Eighteen miles to the westward of the South Andaman is the North Sentinel Island, and 36 miles south of that is the South Sentinel.

About 70 miles to the eastward of the Andaman lie Island of Narcondam, opposite the North Andaman, and Barren Island oppsiite the Middle Andaman. These belong to the Andaman Group.

Geologists are of the opinion that the Andaman are a continuation of the Arracan Yoma range. The older rocks are probably oldest Tertiary or late Cretaceous, though their exact age cannot be told in account of the absence of fossils. These rocks appear again in precisely the same form in the Nias Islands on the west coast of Sumatra.

The Sentinel Islands are also of this formation with super-stratum of coral.

There is a good deal of serpentine rocks in the islands, and jasper, chromite, and copper and iron pyrites are found, also small pockets of coal.

Rink remarks with regard to the newer rocks:

“The extreme uniformity of the strata indicates that these masses were deposited on the bottom of a quiet sea, probably not far from the mouth of a large river. There is not a trace to be found of local causes by which fragments of foreign rocks could have been brought into these deposits. The patches of coal have been derived from driftwood, which was deposited with the clay and sand.”

With regard to certain formations in the sandstone cliffs which may be seen at Port Campbell, on the West coast of the South Andaman, and at Redskin Island in the Labyrinth Group, he states :

“Some spheroidal masses seen sticking out of the cliffs, or regularly arranged in lines, are remarkable. They consist of a much harder substance than the greater part of the sandstone. This imbedded and more solid sandstone is identical in composition with the main mass, differing only by the calcareous cement being present in a larger quantity. This forms in some places round masses four feet in diameter, and because they resist decomposition longer, they protrude in the most varied forms out of the cliffs, and are strewed over the shore indicating the former place of the rock.

“One might, at first sight, suppose that these imbedded masses are, on account of their rounded form, pebbles of a foreign rock, but their composition shows that they have a similar origin with the rest of the sandstone, the only difference being that the calcareous matter, which pervades the whole mass, has been concentrated at certain points. The rounded form, moreover, could not be due to rolling about, for the concentrically laminar structure clearly shows that their exterior form is connected with their internal arrangement.”

Mr. B. D. Oldham states in “ Notes on the Geology of the Andaman Islands”:

“I can only distinguish with certainty two sedimentary formations in the Andaman Islands, which I propose to call the Port Blair, and Archipelago series, respectively.

“The Port Blair series consists principally of firm grey sandstone and inter-bedded slaty shales, not unfrequently containing nests of coaly matter, and, occasionally, beds of conglomerate and pale grey limestone as subsidiary members. The sandstone is the characteristic rock of the series, it is generally, if not always, non-calcareous, and is easily recognised, where exposed between tidemarks, by its peculiar mode of weathering, owing to irregular distribution of the cementing material, bosses of harder stone are left standing up above the general level of the rock, and these bosses are invariably irregularly honey-combed by the solvent action of the sea water.

“In several places I found red and green jaspery beds very similar to what occur in Manipur and Burma, but I was unable to determine whether any of those belonged to an older series or not. In part at least, they seem to belong to the same series as the sandstones and shales, in the midst of which they may be found cropping out, but it is by no means impossible that some of them belong to an older series, for, on the east coast of the South Andaman, close to the boundaries of the serpentine, south of Shoal Bay, I found great banks of conglomernte containing pebbles of similar jaspery rock ; it is of course possible that this conglomerate is newer than the sandstone, but the fact that, though found close to the serpentine it contains no pebbles of that rocks, indicates that it is probably of earlier date than the serpentine intrusions, and consequently probably of the same age as the Port Blair series.

“On Entry Island, and again in a small bay, not marked on the Marine chart, immediately south of Port Meadows, I found beds of volcanic origin. In the middle of the small bay just mentioned, a square rock composed of a breccia of pale green felsite, cemented by a matrix of felsitic ash, stands out of the water, and on Entry Island, among a series of rocks indurated and contorted so as to bafle description, there are some beds full of angular fragments, and apparently of volcanic origin. The age of these it is ditficult to determine; they seem to pass northwards into beds among which jaspery slate and limestone are to be found, and at the northern extremity of the island there is some intrusive serpentine, but at the southern end of the island near the top of the section, if I read it aright, I found in a bed of sandstone an isolated boulder, about a foot long, of a serpentinous rock, evidently derived from the serpentine intrusion. On the whole, it is probable that these are of later date than the Port Blair sandstones.

“The newer series, which I have called the Archipelago series, as the whole of the islands of the Archipelago are formed by it, consists typically of soft limestones formed of coral and shell sand, soft calcareous sandstones and soft white clays. with occasionally a band of conglomerate, the pebbles of which seem originally to have been coral, though no structure is now discernible. These beds seem to cover a large area in the Andamans.”

With regard to the Cinque Islands, the formation of which resembles that of Rutland Island, the South-east coast of the South Andaman, and part of the East coast of the Middle Andaman,he states:

“The Cinque Islands consist principally of intrusive rock of the serpentine series, but there are also some metamorphosed and indurated sedimentary beds; of these, some are siliceous, but for the most part they are calcareous, the most remarkable form being a green chloritic calcite or serpentinous matrix with numerous granules of crystalline calcite scattered through it; the rounded outlines of these granules seem to be due to attrition, and the crystalline structure to subsequent metamorphism. These rocks did not seem to me to belong to the Port Blair, but to the Archipelago series, and at the first blush it would seem as if they had been metamorphosed by the intrusion of the serpentine; fortunately, however, at one or two places, and more specially on the eastern face of the southern island, close to its northern end, there are exposures of a conglomeratic bed, in which the pebbles are of serpentine, and the matrix is fine-grained and very serpentinous. This conglomerate, both from its position and in duration, belongs to the same series as the other sedimentary rocks of the island, and proves that they are of later date than the Serpentine intrusion, and that in all probability their metamorphism is due to the contortion they have locally undergone.

The conglomerate just mentioned is a curious bed, not of the type commonly known as conglomerate, but exhibits that structure, usually considered due to the action of floating ice, which is seen in the boulder bed of the Talchirs, or the Blaini conglomerate of the Himalaya. The matrix is, or rather was, originally, a fine mud or clay, and through it the pebbles are scattered, not touching each other, but each isolated in the matrix.

“As regards the intrusive rocks of the Andamans, I have little to say; they are similar to those of Manipur and Burma, to the north, and of the Nicobars to the south, and, as far as I could judge from the manner of their occurrence, of certainly later date than the Port Blair series, the only section which seems to throw any doubt on this conclusion being the sandstones on Craggy Island. I have followed my predecessors in calling these rocks serpentine, that being the most prominent or remarkable form which they take, but they not unfrequently pass into crystalline diorite or gahbro.

“In tracing the Andaman rocks northwards to Burma, we have little difficulty in identifying the Port Blair series with the Negrais rocks of Theobald. Not only do they resemble each other in the petrographical features and relative proportions of their individual members, but the peculiar mode of weathering, where exposed between tidemarks, which I have remarked in the former, is matched by the sandstones of the Negrais Group, which have been described as usually presenting, when seen on the sea, beach, a ‘honey-combed or cancellated appearance, the result of a peculiar mode of weathering.’ “Unfortunately. the age of the Negrais rocks cannot be determined with accuracy, but they are believed to underlie and be associated with some beds of known immmulitic age, so that we may class the Port Blair rocks as Eocene or slightly older.

“Thus, whatever line we follow, we are brought up to the same conclusion, viz., that the Port Blair series is probably of early Tertiary, or possibly late Cretaceous age. and by tracing them southwards, we find that the rocks of the Archipelago series are probably of Miocene age or even newer.

. . .

CHAPTER II.

The Andamanese

It will be convenient, for the proper appreciation of the accounts of the Andamanese by various travellers which follow, that a brief general description of the people, their mode of life, customs, and superstitions, should be here given.

The Andamanese are divided into twelve Tribes, and these Tribes are grouped into three divisions.

1st. The North Andaman Group of Tribes, comprising: The Chériér Tribe, inhabiting the coast of the northern half of the North Andaman, and the adjacent islands. The Jéru Tribe, inhabiting the interior, and the southern half of the coast of the North Andaman, and the northern extremity of the Middle Andaman.

The Kédé Tribe, inhabiting the northern half of the Middle Andaman, and Interview Island.

The tribes composing this Group use the same bow, the “Chékio,” make comparatively small arrows, have similar ornaments, the same system of tattooing, and their languages are closely allied. They inhabit the country from Landfall Island to a line drawn through the Middle Andaman, from Flat Island on the West coast, to Amit-lzi-Téd on the East coast.

2nd. The South Andaman Group of Tribes, comprising: The Aka-Béa-da Tribe, who inhabit the coast of Rutland Island; the coast, and part of the interior of the South Andaman, south of a line drawn from Port Mount to Port Blair; Termugli and the other islands of the Labyrinth Group; the coast, and most of the interior, of the remaining portion of the South Andaman; Bluff and Spike Islands; and the West coast of the Middle Andaman up to Flat Island.

The Akar-Ba’lé Tribe, who inhabit the Archipelago lslands: The Pliohikwér Tribe, who inhabit all the country between Middle Strait and Homfray Strait, including Colebrooke, Passage, and Strait Islands ; and the Northern bank of Homfray Strait for a short distance inland.

The Aukéu-debi Tribe, who inhabit most of the interior of the Southern half of the Middle Andaman.

The Koi Tribe, who inhabit the coast, and adjacent islands, and part of the interior, of the, Middle Andaman, between Amit-léTéd and Pérléb.

The Tribes composing this Group use the same bow, the “Karama”, make similar large arrows, have the same kind of ornaments, the same system of tattooing, and their languages are closely allied. They inhabit that portion of the. Middle Andaman South of a line drawn from Flat Island on the West coast to Amit-lé-Téd, on the East coast; Bératén Island; most. of the South Andaman; the adjacent Islands to, and including, Rutland Island ; and the Archipelago Islands.

3rd. The Ongé Group of Tribes, comprising: The Ongés, who inhabit the whole of the Little Andaman Island. The people in the interior of Rutlaud Island, The Tribe in the interior of the, South Andaman. The Tribe on the North Sentinel Island.

The Tribes composing this Group have similar ornaments and utensils; use a kind of bow differing entirely from both the “Chékio” and “Karama”; make a different pattern of canoe; do not tattoo themselves; and have allied dialects. Some of these Tribes are also sub-divided into Septs, each Sept having a separate Headman, but all speaking the same language.

The Andamanese are also divided, irrespective of Tribal divisions, into the “A-yaladlo” or “Coast-dwellers,” and the “Erem-téga” or “Jungle-dwellers.”

(These names of course vary in the different languages, but the meaning in all is the same, and the above words of the Aka-Be’a-da language will be used, for convenience sake, when referring to all the tribes.)

Many tribes contain members of both these divisions.

In the South Andaman Group of Tribes, those Aka-Be’a-da living between Port Blair Harbour and Middle Strait, in the interior of the South Andaman, are Erem-téga. The remainder of the Tribe are Ar-yadlo.

All the Akar-Ba’le’ are Ar-yaladlo.

Those Plichikwér living in the interior of the Middle Andaman, North of Homfray Strait, are Erem-téga. The remainder are Ar-yaladlo.

Almost all the Akz‘tu-Juwoi are Erem téga.

All the Kii are Ar-yaladlo.

The Kédé Tribe is composed of both Abym‘oto and Erem-téga, according as they dwell on the coast or inland, the only Eremtéga, however, being the people in the interior of the Northern half of the Middle Andaman.

The Jéru Tribe is composed of both Ar-yaladlo and Erem-téga, but principally of the latter, the only Ar-yauta being those people living in Stewart’s Sound and on the West coast of the Southern part of the North Andaman.

The Chziriér Tribe is composed of Ar-yafoto only.

The Ongés no doubt have similar divisions, but at present we are only acquainted with what We may call the Ar-yaladlo.

The North Sentinel Tribe are Erem‘téga by nature, and Ar-yaladlo by force of circumstances; (indeed, comparing all the Tribes of the Ongé Group with the real Ar-yaladlo of the Great Andaman, this may be said of all of them.)

The Jz‘irawa Tribes on Rutland Island, and in the interior of the South Andaman, are Erem-téga.

The principal differences between Ar-yaladlo and Erem-téga, are the former residing chiefly on the coast, and obtaining their food principally from the see, are more expert at swimming and diving, fish shooting, etc., have a better knowledge of fishe and marine life, and are hardier and braver than the Erem-téga.

These latter are more expert at tracking, or finding their way through the jungle, at pig hunting, etc., have a better knowledge of the Fauna and Flora of the Andamans, but are timid and more cunning.

They are unable to harpoon turtle and dugong, and thus, while the Ar-yaladlo can do all that the Erem-téga can do, though often not so well, in addition to his own peculiar accomplishments, the Eremtéga is ignorant of much which the Ar-yaladlo knows. The two divisions are allowed to inter-marry.

Fights take place between subdivisions of the same Tribe, and between Ar-yaladlo and Erem-téga, who do not mix much.

. . .

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A History of Our Relations With the Andamanese – Maurice Vidal Portman

OFC, Brain Stimulation for Depression – Janice Wood * Direct Electrical Stimulation of Lateral OFC Acutely Improves Mood.

“You could see the improvements in patients’ body language. They smiled, they sat up straighter, they started to speak more quickly and naturally. They said things like ‘Wow, I feel better,’ ‘I feel less anxious,’ ‘I feel calm, cool and collected.”

An important step toward developing a therapy for people with treatment-resistant depression.

Converging lines of evidence from lesion studies, functional neuroimaging, and intracranial physiology point to a role of OFC in emotion processing. Clinically depressed individuals have abnormally high levels of activity in OFC as ascertained by functional neuroimaging, and recovery from depression is associated with decreased OFC activity.

We found that lateral OFC stimulation acutely improved mood in subjects with baseline depression and that these therapeutic effects correlated with modulation of large-scale brain networks implicated in emotion processing.

Our results suggest that lateral OFC stimulation improves mood state at least partly through mechanisms that underlie natural mood variation, and they are consistent with the notion that OFC integrates multiple streams of information relevant to affective cognition.

Unilateral stimulation of lateral OFC consistently produced acute, dose-dependent mood-state improvement across subjects with baseline depression traits.

In a new study, patients with moderate to severe depression reported significant improvements in mood when researchers stimulated the orbitofrontal cortex (OFC).

The orbitofrontal cortex (OFC) is a prefrontal cortex region in the frontal lobes in the brain, which is involved in the cognitive processing of decision-making.

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Researchers at the University of California San Francisco say the study’s findings are “an important step toward developing a therapy for people with treatment-resistant depression, which affects as many as 30 percent of depression patients.”

Using electrical current to directly stimulate affected regions of the brain has proven to be an effective therapy for treating certain forms of epilepsy and Parkinson’s disease, but efforts to develop therapeutic brain stimulation for depression have so far been inconclusive, according to the researchers.

“The OFC has been called one of the least understood regions in the brain, but it is richly connected to various brain structures linked to mood, depression, and decision making, making it very well positioned to coordinate activity between emotion and cognition.”

Two additional observations suggested that OFC stimulation could have therapeutic potential.

First, the researchers found that applying current to the lateral OFC triggered wide-spread patterns of brain activity that resembled what had naturally occurred in volunteers’ brains during positive moods in the days before brain stimulation. Equally promising was the fact that stimulation only improved mood in patients with moderate to severe depression symptoms but had no effect on those with milder symptoms.

“These two observations suggest that stimulation was helping patients with serious depression experience something like a naturally positive mood state, rather than artificially boosting mood in everyone.

This is in line with previous observations that OFC activity is elevated in patients with severe depression and suggests electrical stimulation may affect the brain in a way that removes an impediment to positive mood that occurs in people with depression.”

Psych Central

Direct Electrical Stimulation of Lateral Orbitofrontal Cortex Acutely Improves Mood in Individuals with Symptoms of Depression

Vikram R. Rao, Kristin K. Sellers, Deanna L. Wallace, Maryam M. Shanechi, Heather E. Dawes, Edward F. Chang.

Mood disorders cause significant morbidity and mortality, and existing therapies fail 20%–30% of patients. Deep brain stimulation (DBS) is an emerging treatment for refractory mood disorders, but its success depends critically on target selection. DBS focused on known targets within mood-related frontostriatal and limbic circuits has been variably efficacious.

Here, we examine the effects of stimulation in orbitofrontal cortex (OFC), a key hub for mood-related circuitry that has not been well characterized as a stimulation target. We studied 25 subjects with epilepsy who were implanted with intracranial electrodes for seizure localization. Baseline depression traits ranged from mild to severe. We serially assayed mood state over several days using a validated questionnaire. Continuous electrocorticography enabled investigation of neurophysiological correlates of mood-state changes.

We used implanted electrodes to stimulate OFC and other brain regions while collecting verbal mood reports and questionnaire scores. We found that unilateral stimulation of the lateral OFC produced acute, dose-dependent mood-state improvement in subjects with moderate-to-severe baseline depression. Stimulation suppressed low-frequency power in OFC, mirroring neurophysiological features that were associated with positive mood states during natural mood fluctuation. Stimulation potentiated single-pulse-evoked responses in OFC and modulated activity within distributed structures implicated in mood regulation.

Behavioral responses to stimulation did not include hypomania and indicated an acute restoration to non-depressed mood state.

Together, these findings indicate that lateral OFC stimulation broadly modulates mood-related circuitry to improve mood state in depressed patients, revealing lateral OFC as a promising new target for therapeutic brain stimulation in mood disorders.

Experimental Design and Locations of Stimulated Sites

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Introduction

A modern conception of mood disorders holds that the signs and symptoms of emotional dysregulation are manifestations of abnormal activity within large-scale brain networks. This view, evolved from earlier hypotheses based on chemical imbalances in the brain, has fueled interest in selective neural network modulation with deep brain stimulation (DBS). Although the potential for precise therapeutic intervention with DBS is promising, its efficacy is sensitive to target selection. In treatment-resistant depression (TRD), for example, well-studied targets for DBS include the subgenual cingulate cortex (SCC) and subcortical structures, but the benefits of DBS in these areas are not clearly established.

A major challenge in this regard relates to the fact that clinical manifestations of mood disorders like TRD are heterogeneous and involve dysfunction in cognitive, affective, and reward systems. Therefore, brain regions that represent a functional confluence of these systems are attractive targets for therapeutic brain stimulation.

Residing within prefrontal cortex, the orbitofrontal cortex (OFC) shares reciprocal connections with amygdala, ventral striatum, insula, and cingulate cortex, areas implicated in emotion regulation. As such, OFC is anatomically well positioned to regulate mood. Functionally, OFC serves as a nexus for sensory integration and has myriad roles related to emotional experience, including predicting and evaluating outcomes, representing reward-driven learning and behavior, and mediating subjective hedonic experience.

Converging lines of evidence from lesion studies, functional neuroimaging, and intracranial physiology point to a role of OFC in emotion processing. Clinically depressed individuals have abnormally high levels of activity in OFC as ascertained by functional neuroimaging, and recovery from depression is associated with decreased OFC activity.

Repetitive transcranial magnetic stimulation (rTMS) of OFC was shown to improve mood in a single-subject case study and in a series of patients who otherwise did not respond to rTMS delivered to conventional (non-OFC) targets, but whether intracranial OFC stimulation can reliably alleviate mood symptoms is not known.

Furthermore, OFC is relatively large, and functional distinctions between medial and lateral subregions are known, raising the possibility that subregions of OFC may play distinct roles in mood regulation.

More generally, it remains poorly understood how direct brain stimulation affects local and network-level neural activity to produce complex emotional responses.

We hypothesized that brain networks involved in emotion processing include regions, like OFC, that represent previously unrecognized stimulation targets for alleviation of neuropsychiatric symptoms. To test this hypothesis, we developed a system for studying mood-related neural activity in subjects with epilepsy who were undergoing intracranial electroencephalography (iEEG) for seizure localization. In addition to direct recording of neural activity, iEEG allows delivery of defined electrical stimulation pulses with high spatiotemporal precision and concurrent measurement of behavioral correlates.

Using serial quantitative mood assessments and continuous iEEG recordings, we investigated the acute effects of OFC stimulation on mood state and characterized corresponding changes in neural activity locally and in distributed brain regions. We found that lateral OFC stimulation acutely improved mood in subjects with baseline depression and that these therapeutic effects correlated with modulation of large-scale brain networks implicated in emotion processing.

Our results suggest that lateral OFC stimulation improves mood state at least partly through mechanisms that underlie natural mood variation, and they are consistent with the notion that OFC integrates multiple streams of information relevant to affective cognition.

Discussion

Here, we show that human lateral OFC is a promising target for brain stimulation to alleviate mood symptoms. Unilateral stimulation of lateral OFC consistently produced acute, dose-dependent mood-state improvement across subjects with baseline depression traits. Locally, lateral OFC stimulation increased cortical excitability and suppressed low-frequency power, a feature we found to be negatively correlated with mood state. At the network level, lateral OFC stimulation modulated activity within a network of limbic and paralimbic structures implicated in mood regulation.

Relief of mood symptoms afforded by lateral OFC stimulation may arise from OFC acting as a hub within brain networks that mediate affective cognition.

Previous studies identify OFC as a key node within an emotional salience network activated by anticipation of aversive events. Within this network, OFC is thought to integrate multimodal sensory information and guide emotion-related decisions by evaluating expected outcomes.

Stimulation of other brain regions that encode value information, such as SCC and ventral striatum, has also been found to improve mood, highlighting the relevance of reward circuits to mood state.

Here, using iEEG, we extend previous studies that employed indirect imaging biomarkers, such as glucose metabolism or blood oxygen level, to show that direct OFC stimulation modulates neural activity within a distributed network of brain regions. Our finding that lateral OFC stimulation was more effective than medial OFC stimulation for mood symptom relief advances the idea that these regions have differential contributions to depression, likely due to differences in network connectivity.

We did not observe consistent differences based on laterality of stimulation, but future studies powered to discern such differences may reveal additional layers of specificity.

Although few behavioral variables have been identified to predict which individuals will respond to stimulation of a given target for depression, we found that only patients with significant trait depression experienced mood-state improvement with lateral OFC stimulation. Based on speech-rate analysis, lateral OFC stimulation did not produce supraphysiological mood states, as can be seen with stimulation of other targets, but did specifically elevate speech rate in trait-depressed subjects, resulting in a level similar to that of the non-depressed subjects. Local neurophysiological changes induced by stimulation were opposite of those observed during spontaneous negative mood states. Taken together, these findings suggest that the effect of lateral OFC stimulation is to normalize or suppress pathological activity in circuits that mediate natural mood variation.

Our observations provide potential clues about how lateral OFC stimulation may impact mood. Although functional imaging biomarkers of depression are not firmly established, increased activity in lateral OFC is seen in patients with depression and normalizes with effective antidepressant treatment, and lateral OFC hyperactivity has been proposed as a mood-state marker of depression.

Thus, a speculative possibility is that our stimulation paradigm works by decreasing OFC theta power in a way that may impact baseline hyperactivity. We cannot exclude the possibility that the mechanisms underlying mood improvement with lateral OFC stimulation involve multiple regions and may at least partially overlap with mechanisms responsible for mood improvement with stimulation of SCC. In fact, based on anatomic and functional connectivity between these regions, and the constellation of white matter tracts likely affected by stimulation of these sites, some mechanistic overlap seems probable.

Our results have potential implications for interventional treatments for psychiatric disorders like TRD and anxiety. DBS efficacy for TRD is inconsistent, and a major thrust of the field has been to understand and circumvent inter-subject variability. For example, the heterogeneous responses seen with SCC stimulation may relate to laterality and precise anatomic electrode position. In our study, positive mood responses were induced by unilateral stimulation of the OFC in either hemisphere, and although stimulation of lateral OFC improved mood more than stimulation of medial OFC, we observed mood improvement with stimulation across lateral OFC and did not see evidence of fine subregion specificity. These findings suggest that lateral OFC may be a more forgiving site for therapeutic stimulation than previously reported targets.

Another practical advantage of OFC relative to other targets is that the cortical surface is generally more surgically accessible than deep brain targets and that the ability to forego parenchymal penetration may impart lower risk during electrode implantation. Although seizures are a theoretical risk with any cortical stimulation, this risk is thought to be acceptably low, and we did not observe seizures during OFC stimulation.

Despite the widespread use of DBS in clinical and research applications, the mechanisms by which focal brain stimulation modulates network activity to produce complex behavioral changes remain largely unknown. The effects of stimulation are not limited to the targeted region, and stimulation-induced activity can propagate through anatomical connections to influence distributed networks in the brain. Previous studies have shown that target connectivity may determine likelihood of response to DBS.

Deciphering the precise mechanism of mood improvement with OFC stimulation requires future study, but our observation that stimulation suppresses low-frequency activity broadly across multiple sites suggests a possible local inhibitory effect that reverberates through connected brain regions. Consistent with this, inhibitory transcranial magnetic stimulation of OFC was recently reported to improve mood in one depressed patient. Since the OFC is relatively large and bilateral, it is possible that the mood effects we observed could be improved by more widespread stimulation.

Our study has limitations. The sample size was relatively small, reflecting the rare opportunity to directly and precisely target brain stimulation in human subjects. Although electrode coverage was generally extensive in our subjects, basal ganglia structures known to be important for mood are not typically implanted with electrodes for the purposes of seizure localization. Subjective self-report of mood has intrinsic limitations but remains the best instrument available to measure internal experience.

Our subjects, who had medically refractory epilepsy, may not be representative of all patients with mood disorders. While we cannot rule out the possibility that mood symptoms in our subjects had a seizure-specific etiology, the observed effects of lateral OFC stimulation were robust in a patient group with diverse underlying seizure pathology. To establish generalizability, our findings will need to be replicated in other cohorts.

Finally, it is possible that the acute effects of stimulation we observed may not translate into chronic efficacy for mood disorders in clinical settings. Indeed, rapid mood changes have been previously reported in TRD patients treated with bilateral DBS of SCC and subcortical targets. Whether chronic OFC stimulation can produce durable mood improvement is an important question for future study, ideally under controlled clinical trial conditions with appropriate monitoring of relevant outcomes and adverse events.

The clinical heterogeneity of mood disorders suggests that brain stimulation paradigms may need to be tailored for individual patients. Importantly, this study is one of few to assess the functional consequences of brain stimulation with direct neural recordings. The approach we used for serial quantitative mood state assessment may be useful for sensitively tracking symptoms of mood disorders during clinical interventions, including DBS trials. Our identification of a novel, robust stimulation target and our observation of stimulation-induced changes in endogenous mood-related neural features together set the stage for the next generation of stimulation therapies. OFC theta power may be useful for optimization of stimulation parameters for non-invasive stimulation modalities targeting the OFC in depression, and further characterization of mood biomarkers might enable personalized closed-loop stimulation devices that ameliorate debilitating mood symptoms.

Although the OFC is currently among the least understood brain regions, it may ultimately prove important for the treatment of refractory mood disorders.

Study: Current Biology

University of California, San Francisco (UCSF)

OUR EARLIEST EXPERIENCES SHAPE WHO WE ARE. Babies, Their Wonderful World – Dr Guddi Singh * The Six Faces of Maternal Narcissism – Karyl McBride Ph.D.

Love and attention.

One of the most important things that we know about early brain development is that the first two years of life are crucial.

Our brains are literally built on experience from the moment we are born. Experiences help build strong neural pathways between brain cells and allow brain material to expand.

Strong initial attachment bonds are crucial to making a happy secure adult.

Babies aren’t just eating and sleeping machines. Instead, we know they are like mini computers taking in everything that is going on around them.

In the first few months of life, personality traits start to show like caution, or bravery.

Babies who are not exposed to enough stimulation in their environment do not have the chance to develop the ‘hardware’ they need to be effective adults. Our brains are literally built on experience from the moment we are born. Experiences help build strong neural pathways between brain cells and allow brain material to expand. Stress and neglect can also inhibit brain growth because high levels of the stress hormone cortisone inhibits brain cells, although ironically it may encourage the over development of areas that are involved in the fight or flight response, increasing the likelihood that an individual will be prone to anxiety.

When it comes to smart phones and screens in baby cots, the issue is not so much that technology inhibits brain growth but that it causes a problem when it is a stand-in for parental involvement and love. That’s when we see problems when mobile phones and screens are used as babysitters for long periods while carers divert their attention elsewhere. From observational studies, it seems that it interferes with normal attachment and socialisation as well as inhibiting sleep, and the brain needs sleep for normal growth.

Babies who have siblings may benefit from socialisation and to a baby, nothing is funnier than a sibling. But single children can also be stimulated in a busy, challenging environment where they can still get this type of input including in a nursery environment.

The strongest evidence we have about developmental milestones early in life surround attachment theory. It has been shown time and time again that strong initial attachment bonds are crucial to making a happy secure adult. This is why paediatricians advocate close skin to skin contact in the early days and weeks of life. And we know that babies who are separated from a strong parental figure early on can have all sorts of emotional and social problems later in life.

However, that figure does not have to be the parent but can be someone from an extended family or even the community. It is really helpful to look at different cultures and how they parent their kids, there isn’t a one perfect solution and it can be done in different ways. In the west, there is a fetishisation of biological bonds, but adopted or looked after children can benefit from this strong bond as long as it includes love and attention.

Hippocratic Post

Dr Guddi Singh is a paediatrician based at East London NHS Foundation Trust. She is one of the advisers on the new BBC 2 series, Babies – Their Wonderful World. She is a member of the Royal Society of Medicine’s Paediatrics and Child Health Section Council.

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Also on TPPA = CRISIS

The Six Faces of Maternal Narcissism – Karyl McBride Ph.D.

“We Will Change The World , Starting From The Very Beginning.” Building Babies Brains . Criança Feliz, Brazil’s Audacious Plan To Fight Poverty – Jenny Anderson

Life After Severe Childhood Trauma . I Think I’ll Make It. A True Story Of Lost And Found – Kat Hurley

Chronic Childhood Stress And A Dysfunctional Family – Kylie Matthews * Different Adversities Lead To Similar Health Problems – Donna Jackson Nakazawa

How Our Brains Grow – Ruby Wax

The Deepest Well. Healing The Long Term Effects Of Childhood Adversity – Dr Nadine Burke Harris

Childhood Adversity Can Change Your Brain. How People Recover From Post Childhood Adversity Syndrome – Donna Jackson Nakazawa * Future Directions In Childhood Adversity and Youth Psychopathology – Katie A. McLaughlin

Childhood Disrupted . How Your Biography Becomes Your Biology , And How You Can Heal – Donna Jackson Nakazawa * The Origins Of Addiction . Evidence From The Adverse Childhood Experiences Study – Vincent J. Felitti MD.

Jamal Khashoggi, a picture tells a story at G20.

TIGHTEN BELTS AND SLAM ON THE BRAKES. Fads and fashions in economic policy – Bryan Gould.

Austerity, as a response in 2008, to what threatened to be the worst recession for decades, was the very worst step that could have been taken.

Since the “haves” tend to have louder voices and more influence than the “have nots”, it is often the interests of the former that prevail when economic policy is formulated.

The great economist, John Maynard Keynes, had shown in the Great Depression that the only cure was to spend more, not less, that a depression or recession occurred because there was not enough demand (or, in other words, spending power) and that the proper remedy was to inject more money into an economy that was about to close up shop altogether.

It is only now, after nearly a decade or more of such policies, that a consensus has begun to emerge, supported by agencies like the Word Bank and the IMF, that austerity was a mistake, and had done much unnecessary economic and social damage.

. . . Bryan Gould

Leonardo DaVinci – Walter Isaacson.

“The most relentlessly curious man in history.”

Leonardo had almost no schooling and could barely read Latin or do long division. His genius was of the type we can understand, even take lessons from. It was based on skills we can aspire to improve in ourselves, such as curiosity and intense observation.

His life should remind us of the importance of instilling, both in ourselves and our children, not just received knowledge but a willingness to question it, to be imaginative and, like talented misfits and rebels in any era, to think different.

Had he been a student at the outset of the twenty-first century, he may have been put on a pharmaceutical regimen to alleviate his mood swings and attention-deficit disorder.

I learnt from Leonardo how a desire to marvel about the world that we encounter each day can make each moment of our lives richer. Leonardo knew how to marry observation and imagination, which made him history’s consummate innovator.

Based on thousands of pages from Leonardo’s astonishing notebooks and new discoveries about his life and work, Walter lsaacson weaves a narrative that connects his art to his science. He shows how Leonardo’s genius was based on skills we can improve in ourselves, such as passionate curiosity, careful observation, and an imagination so playful that it fiirted with fantasy.

He produced the two most famous paintings in history, The Last Supper and the Mona Lisa. But in his own mind, he was just as much a man of science and technology. With a passion that sometimes became obsessive, he pursued innovative studies of anatomy, fossils, birds, the heart, fiying machines, botany, geology, and weaponry. His ability to stand at the crossroads of the humanities and the sciences, made iconic by his drawing of Vitruvian Man, made him history’s most creative genius.

His creativity, like that of other great innovators, came from having wide-ranging passions. He peeled flesh off the faces of cadavers, drew the muscles that move the lips, and then painted history’s most memorable smile. He explored the math of optics, showed how light rays strike the cornea, and produced illusions of changing perspectives in The Last Supper.

Isaacson also describes how Leonardo’s lifelong enthusiasm for staging theatrical productions informed his paintings and inventions.

Leonardo’s delight at combining diverse passions remains the ultimate recipe for creativity. So, too, does his ease at being a bit of a misfit: illegitimate, gay, vegetarian, left-handed, easily distracted, and at times heretical. His life should remind us of the importance of instilling, both in ourselves and our children, not just received knowledge but a willingness to question it, to be imaginative and, like talented misfits and rebels in any era, to think different.

INTRODUCTION

I Can Also Paint

Around the time that he reached the unnerving milestone of turning thirty, Leonardo da Vinci wrote a letter to the ruler of Milan listing the reasons he should be given a job. He had been moderately successful as a painter in Florence, but he had trouble finishing his commissions and was searching for new horizons. In the first ten paragraphs, he touted his engineering skills, including his ability to design bridges, waterways, cannons, armored vehicles, and public buildings. Only in the eleventh paragraph, at the end, did he add that he was also an artist. “Likewise in painting, I can do everything possible,” he wrote.

Yes, he could. He would go on to create the two most famous paintings in history, The Last Supper and the Mona Lisa. But in his own mind, he was just as much a man of science and engineering. With a passion that was both playful and obsessive, he pursued innovative studies of anatomy, fossils, birds, the heart, flying machines, optics, botany, geology, water flows, and weaponry. Thus he became the archetype of the Renaissance Man, an inspiration to all who believe that the “infinite works of nature,” as he put it, are woven together in a unity filled with marvelous patterns. His ability to combine art and science, made iconic by his drawing of a perfectly proportioned man spread-eagle inside a circle and square, known as Vitruvian Man, made him history’s most creative genius.

His scientific explorations informed his art. He peeled flesh off the faces of cadavers, delineated the muscles that move the lips, and then painted the world’s most memorable smile. He studied human skulls, made layered drawings of the bones and teeth, and conveyed the skeletal agony of Saint Jerome in the Wilderness. He explored the mathematics of optics, showed how light rays strike the cornea, and produced magical illusions of changing visual perspectives in The Last Supper.

By connecting his studies of light and optics to his art, he mastered the use of shading and perspective to model objects on a two-dimensional surface so they look three-dimensional. This ability to “make a flat surface display a body as if modeled and separated from this plane,” Leonardo said, was “the first intention of the painter.” Largely due to his work, dimensionality became the supreme innovation of Renaissance art.

As he aged, he pursued his scientific inquiries not just to serve his art but out of a joyful instinct to fathom the profound beauties of creation. When he groped for a theory of why the sky appears blue, it was not simply to inform his paintings. His curiosity was pure, personal, and delightfully obsessive.

But even when he was engaged in blue-sky thinking, his science was not a separate endeavor from his art. Together they served his driving passion, which was nothing less than knowing everything there was to know about the world, including how we fit into it. He had a reverence for the wholeness of nature and a feel for the harmony of its patterns, which he saw replicated in phenomena large and small. In his notebooks he would record curls of hair, eddies of water, and whirls of air, along with some stabs at the math that might underlie such spirals. While at Windsor Castle looking at the swirling power of the “Deluge drawings” that he made near the end of his life, I asked the curator, Martin Clayton, whether he thought Leonardo had done them as works of art or of science. Even as I spoke, I realized it was a dumb question. “I do not think that Leonardo would have made that distinction,” he replied.

I embarked on this book because Leonardo da Vinci is the ultimate example of the main theme of my previous biographies: how the ability to make connections across disciplines-arts and sciences, humanities and technology, is a key to innovation, imagination, and genius. Benjamin Franklin, a previous subject of mine, was a Leonardo of his era: with no formal education, he taught himself to become an imaginative polymath who was Enlightenment America’s best scientist, inventor, diplomat, writer, and business strategist. He proved by flying a kite that lightning is electricity, and he invented a rod to tame it. He devised bifocal glasses, enchanting musical instruments, clean-burning stoves, charts of the Gulf Stream, and America’s unique style of homespun humor. Albert Einstein, when he was stymied in his pursuit of his theory of relativity, would pull out his violin and play Mozart, which helped him reconnect with the harmonies of the cosmos. Ada Lovelace, whom I profiled in a book on innovators, combined the poetic sensibility of her father, Lord Byron, with her mother’s love of the beauty of math to envision a general-purpose computer. And Steve Jobs climaxed his product launches with an image of street signs showing the intersection of the liberal arts and technology. Leonardo was his hero. “He saw beauty in both art and engineering,” Jobs said, “and his ability to combine them was what made him a genius.”

Yes, he was a genius: wildly imaginative, passionately curious, and creative across multiple disciplines. But we should be wary of that word. Slapping the “genius” label on Leonardo oddly minimizes him by making it seem as if he were touched by lightning. His early biographer, Giorgio Vasari, a sixteenth-century artist, made this mistake: “Sometimes, in supernatural fashion, a single person is marvelously endowed by heaven with beauty, grace, and talent in such abundance that his every act is divine and everything he does clearly comes from God rather than from human art.” In fact, Leonardo’s genius was a human one, wrought by his own will and ambition. It did not come from being the divine recipient, like Newton or Einstein, of a mind with so much processing power that we mere mortals cannot fathom it. Leonardo had almost no schooling and could barely read Latin or do long division. His genius was of the type we can understand, even take lessons from. It was based on skills we can aspire to improve in ourselves, such as curiosity and intense observation. He had an imagination so excitable that it flirted with the edges of fantasy, which is also something we can try to preserve in ourselves and indulge in our children.

Leonardo’s fantasies pervaded everything he touched: his theatrical productions, plans to divert rivers, designs for ideal cities, schemes for flying machines, and almost every aspect of his art as well as engineering. His letter to the ruler of Milan is an example, since his military engineering skills then existed mainly in his mind. His initial role at the court was not building weapons but conjuring up festivals and pageants. Even at the height of his career, most of his fighting and flying contraptions were more visionary than practical.

At first I thought that his susceptibility to fantasia was a failing, revealing a lack of discipline and diligence that was related to his propensity to abandon artworks and treatises unfinished. To some extent, that is true. Vision without execution is hallucination. But I also came to believe that his ability to blur the line between reality and fantasy, just like his sfumato techniques for blurring the lines of a painting, was a key to his creativity. Skill without imagination is barren. Leonardo knew how to marry observation and imagination, which made him history’s consummate innovator.

My starting point for this book was not Leonardo’s art masterpieces but his notebooks. His mind, I think, is best revealed in the more than 7,200 pages of his notes and scribbles that, miraculously, survive to this day. Paper turns out to be a superb information storage technology, still readable after five hundred years, which our own tweets likely won’t be.

Fortunately, Leonardo could not afford to waste paper, so he crammed every inch of his pages with miscellaneous drawings and looking-glass jottings that seem random but provide intimations of his mental leaps. Scribbled alongside each other, with rhyme if not reason, are math calculations, sketches of his devilish young boyfriend, birds, flying machines, theater props, eddies of water, blood valves, grotesque heads, angels, siphons, plant stems, sawed-apart skulls, tips for painters, notes on the eye and optics, weapons of war, fables, riddles, and studies for paintings. The crossdisciplinary brilliance whirls across every page, providing a delightful display of a mind dancing with nature. His notebooks are the greatest record of curiosity ever created, a wondrous guide to the person whom the eminent art historian Kenneth Clark called “the most relentlessly curious man in history.”

My favorite gems in his notebooks are his to-do lists, which sparkle with his curiosity. One of them, dating from the 1490s in Milan, is that day’s list of things he wants to learn. “The measurement of Milan and its suburbs,” is the first entry. This has a practical purpose, as revealed by an item later in the list: “Draw Milan.” Others show him relentlessly seeking out people whose brains he could pick: “Get the master of arithmetic to show you how to square a triangle. . . . Ask Giannino the Bombardier about how the tower of Ferrara is walled. . . . Ask Benedetto Protinari by what means they walk on ice in Flanders. . . . Get a master of hydraulics to tell you how to repair a lock, canal and mill in the Lombard manner. . . . Get the measurement of the sun promised me by Maestro Giovanni Francese, the Frenchman.” He is insatiable.

Over and over again, year after year, Leonardo lists things he must do and learn. Some involve the type of close observation most of us rarely pause to do. “Observe the goose’s foot: if it were always open or always closed the creature would not be able to make any kind of movement.” Others involve why-is-the-sky-blue questions about phenomena so commonplace that we rarely pause to wonder about them. “Why is the fish in the water swifter than the bird in the air when it ought to be the contrary since the water is heavier and thicker than the air?”

Best of all are the questions that seem completely random. “Describe the tongue of the woodpecker,” he instructs himself. Who on earth would decide one day, for no apparent reason, that he wanted to know what the tongue of a woodpecker looks like? How would you even find out? It’s not information Leonardo needed to paint a picture or even to understand the flight of birds. But there it is, and, as we shall see, there are fascinating things to learn about the tongue of the woodpecker. The reason he wanted to know was because he was Leonardo: curious, passionate, and always filled with wonder.

Oddest of all, there is this entry: “Go every Saturday to the hot bath where you will see naked men.” We can imagine Leonardo wanting to do that, for reasons both anatomical and aesthetic. But did he really need to remind himself to do it? The next item on the list is “Inflate the lungs of a pig and observe whether they increase in width and in length, or only in width.” As the New Yorker art critic Adam Gopnik once wrote, “Leonardo remains weird, matchlessly weird, and nothing to be done about it.”

To wrestle with these issues, I decided to write a book that used these notebooks as its foundation. I started by making pilgrimages to see the originals in Milan, Florence, Paris, Seattle, Madrid, London, and Windsor Castle. That followed Leonardo’s injunction to begin any investigation by going to the source: “He who can go to the fountain does not go to the water-jar.” I also immersed myself in the little-tapped trove of academic articles and doctoral dissertations on Leonardo, each of which represents years of diligent work on very specific topics. In the past few decades, especially since the rediscovery of his Codices Madrid in 1965, there have been great advances in the analysis and interpretation of his writings. Likewise, modern technology has revealed new information about his painting and techniques.

After immersing myself in Leonardo, I did the best I could to be more observant of phenomena that I used to ignore, making a special effort to notice things the way he did. When I saw sunlight hitting drapes, I pushed myself to pause and look at the way the shadows caressed the folds. I tried to see how light that was reflected from one object subtly colored the shadows of another object. I noticed how the glint of a lustrous spot on a shiny surface moved when I tilted my head. When I looked at a distant tree and a near one, I tried to visualize the lines of perspective. When I saw an eddy of water, I compared it to a ringlet of hair. When I couldn’t understand a math concept, I did the best I was able to visualize it. When I saw people at a supper, I studied the relationship of their motions to their emotions. When I saw the hint of a smile come across someone’s lips, I tried to fathom her inner mysteries.

No, I did not come anywhere close to being Leonardo, mastering his insights, or mustering a modicum of his talents. I did not get a millimeter closer to being able to design a glider, invent a new way to draw maps, or paint the Mona Lisa. I had to push myself to be truly curious about the tongue of the woodpecker. But I did learn from Leonardo how a desire to marvel about the world that we encounter each day can make each moment of our lives richer.

There are three major early accounts of Leonardo by writers who were almost contemporaries. The painter Giorgio Vasari, born in 1511 (eight years before Leonardo died), wrote the first real art history book, Lives of the Most Eminent Painters, Sculptors, and Architects, in 1550 and came out with a revised version in 1568 that included corrections based on further interviews with people who knew Leonardo, including his pupil Francesco Melzi. A Florentine chauvinist, Vasari gave Leonardo and especially Michelangelo the most fulsome treatments for creating what he dubbed, for the first time in print, a “renaissance” in art. As Huckleberry Finn said of Mark Twain, there were things that Vasari stretched, but he told the truth, mainly. The remainder is a mix of gossip, embellishments, inventions, and unintentional errors. The problem is knowing which picturesque anecdotes, such as Leonardo’s teacher throwing down his own brush in awe of his pupil, fall into which category.

An anonymous manuscript written in the 1540s, known as the “Anonimo Gaddiano” after the family that once owned it, contains colorful details about Leonardo and other Florentines. Once again, some of the assertions, such as that Leonardo lived and worked with Lorenzo de’ Medici, may be embellished, but it provides colorful details that ring true, such as that Leonardo liked to wear rose-colored tunics that reached only to his knee even though others wore long garments.

A third early source is by Gian Paolo Lomazzo, a painter who became a writer when he went blind. He wrote an unpublished manuscript called Dreams and Arguments in about 1560 and then published a voluminous treatise on art in 1584. He was the student of a painter who had known Leonardo, and he interviewed Leonardo’s pupil Melzi, so he had access to some firsthand stories. Lomazzo is especially revealing about Leonardo’s sexual proclivities. In addition, there are shorter accounts contained in writings by two Leonardo contemporaries, Antonio Billi, a Florentine merchant, and Paolo Giovio, an Italian physician and historian.

Many of these early accounts mention Leonardo’s looks and personality. He is described as a man of eyecatching beauty and grace. He had flowing golden curls, a muscular build, remarkable physical strength, and an elegance of bearing when he was walking through town in his colorful garb or riding on a horse. “Beautiful in person and aspect, Leonardo was well-proportioned and graceful,” according to the Anonimo. In addition, he was a charming conversationalist and a lover of nature, renowned for being sweet and gentle to both people and animals.

There is less agreement about certain specifics. In the course of my research I discovered that many facts about Leonardo’s life, from the site of his birth to the scene at his death, have been the subject of debate, mythology, and mystery. I try to give my best assessment and then describe the controversies and counterarguments in the notes.

I also discovered, at first to my consternation and then to my pleasure, that Leonardo was not always a giant. He made mistakes. He went off on tangents, literally, pursuing math problems that became timesucking diversions. Notoriously, he left many of his paintings unfinished, most notably the Adoration of the Magi, Saint Jerome in the Wilderness, and the Battle of Anghiari. As a result, there exist now at most fifteen paintings fully or mainly attributable to him.

Although generally considered by his contemporaries to be friendly and gentle, Leonardo was at times dark and troubled. His notebooks and drawings are a window into his fevered, imaginative, manic, and sometimes elated mind. Had he been a student at the outset of the twenty-first century, he may have been put on a pharmaceutical regimen to alleviate his mood swings and attention-deficit disorder. One need not subscribe to the artist-as-troubled-genius trope to believe we are fortunate that Leonardo was left to his own devices to slay his demons while conjuring up his dragons.

In one of the quirky riddles in his notebooks is this clue: “Huge figures will appear in human shape, and the nearer you get to them, the more their immense size will diminish.” The answer: “The shadow cast by a man at night with a light.” Although the same may be said of Leonardo, I believe he is, in fact, not diminished by being discovered to be human. Both his shadow and his reality deserve to loom large. His lapses and oddities allow us to relate to him, to feel that we might emulate him, and to appreciate his moments of triumph even more.

The fifteenth century of Leonardo and Columbus and Gutenberg was a time of invention, exploration, and the spread of knowledge by new technologies. In short, it was a time like our own. That is why we have much to learn from Leonardo. His ability to combine art, science, technology, the humanities, and imagination remains an enduring recipe for creativity. So, too, was his ease at being a bit of a misfit: illegitimate, gay, vegetarian, lefthanded, easily distracted, and at times heretical. Florence flourished in the fifteenth century because it was comfortable with such people. Above all, Leonardo’s relentless curiosity and experimentation should remind us of the importance of instilling, in both ourselves and our children, not just received knowledge but a willingness to question it, to be imaginative and, like talented misfits and rebels in any era, to think different.

CHAPTER 1

Childhood: Vinci, 1452-1464

DA VINCI

Leonardo da Vinci had the good luck to be born out of wedlock. Otherwise, he would have been expected to become a notary, like the firstborn legitimate sons in his family stretching back at least five generations.

His family roots can be traced to the early 1300s, when his great-great-great-grandfather, Michele, practiced as a notary in the Tuscan hill town of Vinci, about seventeen miles west of Florence. With the rise of Italy’s mercantile economy, notaries played an important role drawing up commercial contracts, land sales, wills, and other legal documents in Latin, often garnishing them with historical references and literary flourishes.

Because Michele was a notary, he was entitled to the honorific “Ser” and thus became known as Ser Michele da Vinci. His son and grandson were even more successful notaries, the latter becoming a chancellor of Florence. The next in line, Antonio, was an anomaly. He used the honorific Ser and married the daughter of a notary, but he seems to have lacked the da Vinci ambition. He mostly spent his life living off the proceeds from family lands, tilled by sharecroppers, that produced a modest amount of wine, olive oil, and wheat.

Antonio’s son Piero made up for the lassitude by ambitiousiy pursuing success in Pistoia and Pisa, and then by about 1451, when he was twenty-five, establishing himself in Florence. A contract he notarized that year gave his work address as “at the Palazzo del Podesta,” the magistrates’ building (now the Bargello Museum) facing the Palazzo della Signoria, the seat of government. He became a notary for many of the city’s monasteries and religious orders, the town’s Jewish community, and on at least one occasion the Medici family.

On one of his visits back to Vinci, Piero had a relationship with an unmarried local peasant girl, and in the spring of 1452 they had a son. Exercising his littleused notarial handwriting, the boy’s grandfather Antonio recorded the birth on the bottom of the last page of a notebook that had belonged to his own grandfather. “1452: There was born to me a grandson, the son of Ser Piero my son, on the 15th day of April, a Saturday, at the third hour of the night [about 10 p.m.]. He bears the name Leonardo.”

Leonardo’s mother was not considered worth mentioning in Antonio’s birth notation nor in any other birth or baptism record. From a tax document five years later, we learn only her first name, Caterina. Her identity was long a mystery to modern scholars. She was thought to be in her mid-twenties, and some researchers speculated that she was an Arab slave, or perhaps a Chinese slave.

In fact, she was an orphaned and impoverished sixteen-year-old from the Vinci area named Caterina Lippi. Proving that there are still things to be rediscovered about Leonardo, the art historian Martin Kemp of Oxford and the archival researcher Giuseppe Pallanti of Florence produced evidence in 2017 documenting her background. Born in 1436 to a poor farmer, Caterina was orphaned when she was fourteen. She and her infant brother moved in with their grandmother, who died a year later, in 1451. Left to fend for herself and her brother, Caterina had a relationship in July of that year with Piero da Vinci, then twenty-four, who was prominent and prosperous.

There was little likelihood they would marry. Although described by one earlier biographer as “of good blood,” Caterina was of a different social class, and Piero was probably already betrothed to his future wife, an appropriate match: a sixteen-year-old named Albiera who was the daughter of a prominent Florentine shoemaker. He and Albiera were wed within eight months of Leonardo’s birth. The marriage, socially and professionally advantageous to both sides, had likely been arranged, and the dowry contracted, before Leonardo was born.

Keeping things tidy and convenient, shortly after Leonardo was born Piero helped to set up a marriage for Caterina to a local farmer and kiln worker who had ties to the da Vinci family. Named Antonio di Piero del Vacca, he was called Accattabriga, which means “Troublemaker,” though fortunately he does not seem to have been one.

Leonardo’s paternal grandparents and his father had a family house with a small garden right next to the walls of the castle in the heart of the village of Vinci. That is where Leonardo may have been born, though there are reasons to think not. It might not have been convenient or appropriate to have a pregnant and then breast-feeding peasant woman living in the crowded da Vinci family home, especially as Ser Piero was negotiating a dowry from the prominent family whose daughter he was planning to marry.

Instead, according to legend and the local tourist industry, Leonardo’s birthplace may have been a gray stone tenant cottage next to a farmhouse two miles up the road from Vinci in the adjacent hamlet of Anchiano, which is now the site of a small Leonardo museum. Some of this property had been owned since 1412 by the family of Piero di Malvolto, a close friend of the da Vincis. He was the godfather of Piero da Vinci and, in 1452, would be a godfather of Piero’s newborn son, Leonardo, which would have made sense if Leonardo had been born on his property. The families were very close. Leonardo’s grandfather Antonio had served as a witness to a contract involving some parts of Piero di Malvolto’s property. The notes describing the exchange say that Antonio was at a nearby house playing backgammon when he was asked to come over for that task. Piero da Vinci would buy some of the property in the 1480s.

At the time of Leonardo’s birth, Piero di Malvolto’s seventy-year-old widowed mother lived on the property. So here in the hamlet of Anchiano, an easy two-mile walk from the village of Vinci, living alone in a farmhouse that had a run-down cottage next door, was a widow who was a trusted friend to at least two generations of the da Vinci family. Her dilapidated cottage (for tax purposes the family claimed it as uninhabitable) may have been the ideal place to shelter Caterina while she was pregnant, as per local lore.

Leonardo was born on a Saturday, and the following day he was baptized by the local priest at the parish church of Vinci. The baptismal font is still there. Despite the circumstances of his birth, it was a large and public event. There were ten godparents giving witness, including Piero di Malvolto, far more than the average at the church, and the guests included prominent local gentry. A week later, Piero da Vinci left Caterina and their infant son behind and returned to Florence, where that Monday he was in his office notarizing papers for clients.

Leonardo left us no comment on the circumstances of his birth, but there is one tantalizing allusion in his notebooks to the favors that nature bestows upon a love child. “The man who has intercourse aggressively and uneasily will produce children who are irritable and untrustworthy,” he wrote, “but if the intercourse is done with great love and desire on both sides, the child will be of great intellect, witty, lively, and lovable.” One assumes, or at least hopes, that he considered himself in the latter category.

He split his childhood between two homes. Caterina and Accattabriga settled on a small farm on the outskirts of Vinci, and they remained friendly with Piero da Vinci. Twenty years later, Accattabriga was working in a kiln that was rented by Piero, and they served as witnesses for each other on a few contracts and deeds over the years. In the years following Leonardo’s birth, Caterina and Accattabriga had four girls and a boy. Piero and Albiera, however, remained childless. In fact, until Leonardo was twenty-four, his father had no other children. (Piero would make up for it during his third and fourth marriages, having at least eleven children.)

With his father living mainly in Florence and his mother nurturing a growing family of her own, Leonardo by age five was primarily living in the da Vinci family home with his leisure-loving grandfather Antonio and his wife. In the 1457 tax census, Antonio listed the dependents residing with him, including his grandson: “Leonardo, son of the said Ser Piero, non legittimo, born of him and of Caterina, who is now the woman of Achattabriga.”

Also living in the household was Piero’s youngest brother, Francesco, who was only fifteen years older than his nephew Leonardo. Francesco inherited a love of country leisure and was described in a tax document by his own father, in a pot-calling-the-kettle way, as “one who hangs around the villa and does nothing.” He became Leonardo’s beloved uncle and at times surrogate father. In the first edition of his biography, Vasari makes the telling mistake, later corrected, of identifying Piero as Leonardo’s uncle.

“A GOLDEN AGE FOR BASTARDS”

As Leonardo’s well-attended baptism attests, being born out of wedlock was not a cause for public shame. The nineteenth-century cultural historian Jacob Burckhardt went so far as to label Renaissance Italy “a golden age for bastards.” Especially among the ruling and aristocratic classes, being illegitimate was no hindrance. Pius II, who was the pope when Leonardo was born, wrote about visiting Ferrara, where his welcoming party included seven princes from the ruling Este family, among them the reigning duke, all born out of wedlock. “It is an extraordinary thing about that family,” Pius wrote, “that no legitimate heir has ever inherited the principate; the sons of their mistresses have been so much more fortunate than those of their wives.” (Pius himself fathered at least two illegitimate children.) Pope Alexander Vl, also during Leonardo’s lifetime, had multiple mistresses and illegitimate children, one of whom was Cesare Borgia, who became a cardinal, commander of the papal armies, an employer of Leonardo, and the subject of Machiavelli’s The Prince.

For members of the middle classes, however, illegitimacy was not as readily accepted. Protective of their new status, merchants and professionals formed guilds that enforced moral strictures. Although some of the guilds accepted the illegitimate sons of their members, that was not the case with the Arte dei Giuduci e Notai, the venerable (founded in 1197) guild of judges and notaries to which Leonardo’s father belonged. “The notary was a certified witness and scribe,” Thomas Kuehn wrote in Illegitimacy in Renaissance Florence. “His trustworthiness had to be above reproach. He had to be someone fully in the mainstream of society.”

These strictures had an upside. Illegitimacy freed some imaginative and free-spirited young men to be creative at a time when creativity was increasingly rewarded. Among the poets, artists, and artisans born out of wedlock were Petrarch, Boccaccio, Lorenzo Ghiberti, Filippo Lippi, his son Filippino, Leon Battista Alberti, and of course Leonardo.

Being born out of wedlock was more complex than merely being an outsider. It created an ambiguity of status. “The problem with bastards was that they were part of the family, but not totally,” wrote Kuehn. That helped some be, or forced them to be, more adventurous and improvisational. Leonardo was a member of a middle-class family but separate from it. Like so many writers and artists, he grew up feeling a part of the world but also detached. This limbo extended to inheritance: a combination of conflicting laws and contradictory court precedents left it unclear whether a son born out of wedlock could be an heir, as Leonardo was to find out in legal battles with his halfbrothers many years later. “Management of such ambiguities was one of the hallmarks of life in a Renaissance city-state,” explained Kuehn. “It was related to the more celebrated creativity of a city like Florence in the arts and humanism.”

Because Florence’s guild of notaries barred those who were non legittimo, Leonardo was able to benefit from the note-taking instincts that were ingrained in his family heritage while being free to pursue his own creative passions. This was fortunate. He would have made a poor notary: he got bored and distracted too easily, especially when a project became routine rather than creative.

DISCIPLE OF EXPERIENCE

Another upside for Leonardo of being born out of wedlock was that he was not sent to one of the “Latin schools” that taught the classics and humanities to wellgroomed aspiring professionals and merchants of the early Renaissance.” Other than a little training in commercial math at what was known as an “abacus school,” Leonardo was mainly self-taught. He often seemed defensive about being an “unlettered man,” as he dubbed himself with some irony. But he also took pride that his lack of formal schooling led him to be a disciple of experience and experiment. “Leonardo da Vinci, disscepolo della sperientia,” he once signed himself. This freethinking attitude saved him from being an acolyte of traditional thinking. In his notebooks he unleashed a blast at what he called the pompous fools who would disparage him for this:

“I am fully aware that my not being a man of letters may cause certain presumptuous people to think that they may with reason blame me, alleging that I am a man without learning. Foolish folk! . . . They strut about puffed up and pompous, decked out and adorned not with their own labors, but by those of others. . . . They will say that because I have no book learning I cannot properly express what I desire to describe, but they do not know that my subjects require experience rather than the words of others.”

Thus was Leonardo spared from being trained to accept dusty Scholasticism or the medieval dogmas that had accumulated in the centuries since the decline of classical science and original thinking. His lack of reverence for authority and his willingness to challenge received wisdom would lead him to craft an empirical approach for understanding nature that foreshadowed the scientific method developed more than a century later by Bacon and Galileo. His method was rooted in experiment, curiosity, and the ability to marvel at phenomena that the rest of us rarely pause to ponder after we’ve outgrown our wonder years.

To that was added an intense desire and ability to observe the wonders of nature. He pushed himself to perceive shapes and shadows with wondrous precision. He was particularly good at apprehending movement, from the motions of a flapping wing to the emotions flickering across a face. On this foundation he built experiments, some conducted in his mind, others with drawings, and a few with physical objects. “First I shall do some experiments before I proceed further,” he announced, “because my intention is to consult experience first and then with reasoning show why such experience is bound to operate in such a way.”

It was a good time for a child with such ambitions and talents to be born. In 1452 Johannes Gutenberg had just opened his publishing house, and soon others were using his moveable-type press to print books that would empower unschooled but brilliant people like Leonardo. Italy was beginning a rare forty-year period during which it was not wracked by wars among its citystates. Literacy, numeracy, and income were rising dramatically as power shifted from titled landowners to urban merchants and bankers, who benefited from advances in law, accounting, credit, and insurance. The Ottoman Turks were about to capture Constantinople, unleashing on Italy a migration of fleeing scholars with bundles of manuscripts containing the ancient wisdom of Euclid, Ptolemy, Plato, and Aristotle. Born within a year of Leonardo were Christopher Columbus and Amerigo Vespucci, who would lead an era of exploration. And Florence, with its booming merchant class of status-seeking patrons, had become the cradle of Renaissance art and humanism.

CHILDHOOD MEMORIES

The most vivid memory Leonardo had of his infancy was one he recorded fifty years later, when he was studying the flight of birds. He was writing about a hawk-like bird called a kite, which has a forked tail and elegant long wings that allow it to soar and glide. Observing it with his typical acuity, Leonardo perceived precisely how it opened its wings and then spread and lowered its tail when it landed. This aroused a memory from when he was a baby: “Writing about the kite seems to be my destiny since among the first recollections of my infancy, it seemed to me that, as l was in my cradle, a kite came to me and opened my mouth with its tail and struck me several times with its tail inside my lips.” Like much of what came from Leonardo’s mind, there was probably some fantasy and fabulism in the brew. It is hard to imagine a bird actually landing in a cradle and prying open a baby’s mouth with its tail, and Leonardo appears to acknowledge this by using the phrase “it seemed to me,” as if it were perhaps partly a dream.

All of this, a childhood with two mothers, an often absent father, and a dreamlike oral encounter with a flapping tail, would provide great fodder for a Freudian analyst. And it did, from Freud himself. In 1910 Freud used the kite tale as the foundation for a short book, Leonardo da Vinci and a Memory of His Childhood.

Freud got off to a stumbling start by using a poor German translation of Leonardo’s note that mistakenly called the bird a vulture rather than a kite. This sent him into a long tangential explanation about the symbolism of vultures in ancient Egypt and the etymological relationship of the words for vulture and mother, all of which was irrelevant and, Freud later admitted, embarrassing. Leaving aside the bird mix-up, the main thrust of Freud’s analysis was that the word for tail in many languages, including Italian (coda), is slang for “penis” and that Leonardo’s memory was related to his homosexuality. “The situation contained in the fantasy, that a vulture opened the mouth of the child and forcefully belabored it with its tail, corresponds to the idea of fellatio,” Freud wrote. Leonardo’s repressed desires, he speculated, were channeled into his feverish creativity, but he left many works unfinished because he was inhibited.

These interpretations have prompted some devastating critiques, most famously by art historian Meyer Schapiro, and they seem, at least to me, to reveal more about Freud than about Leonardo. Biographers should be cautious about psychoanalyzing someone who lived five centuries earlier. Leonardo’s dreamlike memory may have simply reflected his lifelong interest in the flight of birds, which is how he framed it. And it does not take a Freud to understand that sexual drives can be sublimated into ambition and other passions. Leonardo said so himself. “Intellectual passion drives out sensuality,” he wrote in one of his notebooks.

A better source for insight into Leonardo’s formative character and motivations is another personal memory he recorded, this one about hiking near Florence. The recollection involved chancing upon a dark cave and pondering whether he should enter. “Having wandered some distance among gloomy rocks, I came to the mouth of a great cavern, in front of which I stood some time, astonished,” he recalled. “Bending back and forth, I tried to see whether I could discover anything inside, but the darkness within prevented that. Suddenly there arose in me two contrary emotions, fear and desire, fear of the threatening dark cave, desire to see whether there were any marvelous thing within.”

Desire won. His unstoppable curiosity triumphed, and Leonardo went into the cave. There he discovered, embedded in the wall, a fossil whale. “Oh mighty and once-living instrument of nature,” he wrote, “your vast strength was to no avail.” Some scholars have assumed that he was describing a fantasy hike or riffing on some verses by Seneca. But his notebook page and those surrounding it are filled with descriptions of layers of fossil shells, and many fossilized whale bones have in fact been discovered in Tuscany.

The whale fossil triggered a dark vision of what would be, throughout his life, one of his deepest forebodings, that of an apocalyptic deluge. On the next side of the sheet he described at length the furious power once held by the long-dead whale: “You lashed with swift, branching fins and forked tail, creating in the sea sudden tempests that buffeted and submerged ships.” Then he turned philosophical. “Oh time, swift despoiler of all things, how many kings, how many nations hast thou undone, and how many changes of states and of circumstances have happened since this wondrous fish perished.”

By this point Leonardo’s fears were about a realm far different from whatever dangers might be lurking inside the cave, instead they were driven by an existential dread in the face of the destructive powers of nature. He began scribbling rapidly, using a silverpoint on a redtinted page, describing an apocalypse that begins with water and ends with fire. “The rivers will be deprived of their waters, the earth will no longer put forth her greenery; the fields will no more be decked with waving corn; all the animals, finding no fresh grass for pasture, will die,” he wrote. “In this way the fertile and fruitful earth will be forced to end with the element of fire; and then its surface will be left burnt up to cinder and this will be the end of all earthly nature.”

The dark cave that Leonardo’s curiosity compelled him to enter offered up both scientific discoveries and imaginative fantasies, strands that would be interwoven throughout his life. He would weather storms, literally and psychologically, and he would encounter dark recesses of the earth and soul. But his curiosity about nature would always impel him to explore more. Both his fascinations and his forebodings would be expressed in his art, beginning with his depiction of Saint Jerome agonizing near the mouth of a cave and culminating in his drawings and writings about an apocalyptic deluge.

CHAPTER 2

Apprentice

THE MOVE

Until he was twelve, Leonardo had a life in Vinci that, despite the complexities of being part of an extended family, was quite settled. He lived primarily with his grandparents and his idle uncle Francesco in the family house in the heart of Vinci. His father and stepmother were listed as living there when Leonardo was five, but after that their primary residence was in Florence. Leonardo’s mother and her husband lived with their growing brood of children, along with Accattabriga’s parents and his brother’s family, in a farmhouse an easy walk from town.

But in 1464 this world was disrupted. His stepmother, Albiera, died in childbirth, along with what would have been her first child. Leonardo’s grandfather Antonio, the head of the Vinci household, also had recently died. So just as Leonardo was reaching the age when he needed to prepare for a trade, his father, living alone and probably lonely, brought him to Florence.

Leonardo rarely wrote in his notebooks about his own emotions, so it is hard to know what he felt about the move. But the fables he recorded sometimes give a glimpse of his sentiments. One described the sad odyssey of a stone perched on a hill surrounded by colorful flowers and a grove of trees, in other words, a place like Vinci. Looking at the crowd of stones along the road below, it decided it wanted to join them. “What am I doing here among these plants?” the stone asked. “I want to live in the company of my fellow stones.” So it rolled down to the others. “After a while,” Leonardo recounted, “it found itself in continual distress from the wheels of the carts, the iron hoofs of horses, and the feet of the passers-by. One rolled it over, another trod upon it. Sometimes the stone raised itself up a little as it lay covered with mud or the dung of some animal, but it was in vain that it looked up at the spot whence it had come as a place of solitude and tranquil peace.” Leonardo drew a moral: “This is what happens to those who leave a life of solitary contemplation and choose to come to dwell in cities among people full of infinite evil.”

His notebooks have many other maxims praising the countryside and solitude. “Leave your family and friends and go over the mountains and valleys into the country,” he instructed aspiring painters. “While you are alone you are entirely your own master.” These paeans to country living are romantic and, for those who cherish the image of lonely genius, quite appealing. But they are infused with fantasy. Leonardo would spend almost all of his career in Florence, Milan, and Rome, crowded centers of creativity and commerce, usually surrounded by students, companions, and patrons. He rarely retreated alone to the countryside for an extended period of solitude. Like many artists, he was stimulated by being with people of diverse interests and (willing to contradict himself in his notebooks) declared, “Drawing in company is much better than alone.” The impulses of his grandfather and uncle, who both practiced the quiet country life, were imprinted in Leonardo’s imagination but not practiced in his life.

During his early years in Florence, Leonardo lived with his father, who arranged for him to get a rudimentary education and would soon help him get a good apprenticeship and commissions. But there is one significant thing that Ser Piero did not do, which would have been easy enough for a well-connected notary: go through the legal process of having his son legitimated. This could be accomplished by the father and child appearing before a local official known as a “count palatine,” usually a dignitary who had been granted power to act on such matters, and presenting a petition as the child knelt. Piero’s decision not to do this for Leonardo is particularly surprising, since he then had no other children of his own.

Perhaps one reason that Piero did not legitimate Leonardo was that he hoped to have as his heir a son who would follow family tradition and become a notary, and it was already clear, by the time Leonardo turned twelve, that he was not so inclined. According to Vasari, Piero noticed that his son “never ceased drawing and sculpting, pursuits which suited his fancy more than any other.” In addition, the notary guild had a rule, which may have been difficult to circumvent, that denied membership even to out-of-wedlock sons who had been legitimated. So Piero apparently saw no reason to go through the process. By not legitimating Leonardo, he could hope to have another son who would be his heir as a notary. A year later Piero married the daughter of another prominent Florence notary, but it would only be after his third marriage, in 1475 to a woman six years younger than Leonardo, that he would produce a legitimate heir who indeed became a notary.

FLORENCE

There was no place then, and few places ever, that offered a more stimulating environment for creativity than Florence in the 1400s. Its economy, once dominated by unskilled wool-spinners, had flourished by becoming one that, like our own time, interwove art, technology, and commerce. It featured artisans working with silk makers and merchants to create fabrics that were works of art. In 1472 there were eighty-four woodcarvers, eighty-three silk workers, thirty master painters, and forty-four goldsmiths and jewelry craftsmen working in Florence. It was also a center of banking; the florin, noted for its gold purity, was the dominant standard currency in all of Europe, and the adoption of double-entry bookkeeping that recorded debits and credits permitted commerce to flourish. Its leading thinkers embraced a Renaissance humanism that put its faith in the dignity of the individual and in the aspiration to find happiness on this earth through knowledge. Fully a third of Florence’s population was literate, the highest rate in Europe. By embracing trade, it became a center of finance and a cauldron of ideas.

“Beautiful Florence has all seven of the fundamental things a city requires for perfection,” the essayist Benedetto Dei wrote in 1472, when Leonardo was living there. “First of all, it enjoys complete liberty; second, it has a large, rich, and elegantly dressed population; third, it has a river with clear, pure water, and mills within its walls; fourth, it rules over castles, towns, lands and people; fifth, it has a university, and both Greek and accounting are taught; sixth, it has masters in every art; seventh, it has banks and business agents all over the world.” Each one of those assets was valuable for a city, just as they are today: not only the “liberty” and “pure water,” but also that the population was “elegantly dressed” and that the university was renowned for teaching accounting as well as Greek.

The city’s cathedral was the most beautiful in Italy. In the 1430s it had been crowned with the world’s largest dome, built by the architect Filippo Brunelleschi, which was a triumph of both art and engineering, and linking those two disciplines was a key to Florence’s creativity. Many of the city’s artists were also architects, and its fabric industry had been built by combining technology, design, chemistry, and commerce.

This mixing of ideas from different disciplines became the norm as people of diverse talents intermingled. Silk makers worked with goldbeaters to create enchanted fashions. Architects and artists developed the science of perspective. Wood-carvers worked with architects to adorn the city’s 108 churches. Shops became studios. Merchants became financiers. Artisans became artists.

When Leonardo arrived, Florence’s population was 40,000, which is about what it had been for a century but down from the 100,000 or so who lived there in 1300, before the Black Death and subsequent waves of plague. There were at least a hundred families that could be considered very wealthy, plus some five thousand guild members, shopkeepers, and merchants who were part of a prosperous middle class. Because most of them were new to wealth, they had to establish and assert their status. They did so by commissioning distinctive works of art, buying luxurious clothes of silk and gold, building palatial mansions (thirty went up between 1450 and 1470), and becoming patrons of literature, poetry, and humanist philosophy. Consumption was conspicuous but tasteful. By the time Leonardo arrived, Florence had more wood-carvers than butchers. The city itself had become a work of art. “There is no place more beautiful in all the world,” the poet Ugolino Verino wrote.

Unlike some city-states elsewhere in Italy, Florence was not ruled by hereditary royalty. More than a century before Leonardo arrived, the most prosperous merchants and guild leaders crafted a republic whose elected delegates met at the Palazzo della Signoria, now known as the Palazzo Vecchio. “The people were kept amused every day by shows, festivals, and novelties,” the fifteenth-century Florentine historian Francesco Guicciardini wrote. “They were well fed from the provisions with which the city abounded. Industry of every sort flourished. Talented and able men were maintained, and a welcome and a position secured to all teachers of literature, art, and every liberal pursuit.”

The republic was not, however, democratic or egalitarian. In fact, it was barely a republic. Exercising power from behind its façade was the Medici family, the phenomenally wealthy bankers who dominated Florentine politics and culture during the fifteenth century without holding office or hereditary title. (In the following century they became hereditary dukes, and lesser family members became popes.)

After Cosimo de’ Medici took over the family bank in the 1430s, it became the largest in Europe. By managing the fortunes of the continent’s wealthy families, the Medici made themselves the wealthiest of them all. They were innovators in bookkeeping, including the use of debit-and-credit accounting that became one of the great spurs to progress during the Renaissance. By means of payoffs and plotting, Cosimo became the de facto ruler of Florence, and his patronage made it the cradle of Renaissance art and humanism.

A collector of ancient manuscripts who had been schooled in Greek and Roman literature, Cosimo supported the rebirth of interest in antiquity that was at the core of Renaissance humanism. He founded and funded Florence’s first public library and the influential but informal Platonic Academy, where scholars and public intellectuals discussed the classics. In art, he was a patron of Fra Angelico, Filippo Lippi, and Donatello. Cosimo died in 1464, just as Leonardo arrived in Florence from Vinci. He was succeeded by his son and then, five years later, his famous grandson, Lorenzo de’ Medici, aptly dubbed Lorenzo the Magnificent.

Lorenzo had been tutored in humanist literature and philosophy under the watchful eye of his mother, an accomplished poet, and he patronized the Platonic Academy, launched by his grandfather. He was also an accomplished sportsman, distinguishing himself in jousting, hunting, falconry, and breeding horses. All of this made him a better poet and patron than he was a banker; he took more delight in using wealth than in making it. During his twenty-three-year reign, he would sponsor innovative artists, including Botticelli and Michelangelo, as well as patronize the workshops of Andrea del Verrocchio, Domenico Ghirlandaio, and Antonio del Pollaiuolo, which were producing paintings and sculptures to adorn the booming city.

Lorenzo de’ Medici’s patronage of the arts, autocratic rule, and ability to maintain a peaceful balance of power with rival city-states helped to make Florence a cradle of art and commerce during Leonardo’s early career there. He also kept his citizenry amused with dazzling public spectacles and grandly produced entertainments, ranging from Passion Plays to pre-Lenten carnivals. The work done for these pageants was ephemeral, but it was lucrative and stimulated the creative imagination of many of the artists involved, most notably young Leonardo.

Florence’s festive culture was spiced by the ability to inspire those with creative minds to combine ideas from disparate disciplines. In narrow streets, cloth dyers worked next to goldbeaters next to lens crafters, and during their breaks they went to the piazza to engage in animated discussions. At the Pollaiuolo workshop, anatomy was being studied so that the young sculptors and painters could better understand the human form. Artists learned the science of perspective and how angles of light produce shadows and the perception of depth. The culture rewarded, above all, those who mastered and mixed different disciplines.

BRUNELLESCHI AND ALBERTI

The legacy of two such polymaths had a formative influence on Leonardo. The first was Filippo Brunelleschi (1377-1446), the designer of the cathedral dome. Like Leonardo, he was the son of a notary. Desiring a more creative life, he trained to become a goldsmith. Fortunately for his wide-ranging interests, goldsmiths were lumped together with other artisans as members of the guild of silk weavers and merchants, which also included sculptors. Brunelleschi’s interests soon embraced architecture as well, and he traveled to Rome to study classical ruins with his friend Donatello, another young Florentine goldsmith, who later achieved fame as a sculptor. They measured the Pantheon dome, studied other great buildings, and read the works of ancient Romans, most notably Vitruvius’s paean to classical proportions, De Architectura. Thus they became embodiments of the multidisciplinary interests and rebirth of classical knowledge that shaped the early Renaissance.

To build his cathedral dome, a self-supporting structure of close to four million bricks that is still the largest masonry dome in the world, Brunelleschi had to develop sophisticated mathematical modeling techniques and invent an array of hoists and other engineering tools. In an example of the diverse forces that were animating creativity in Florence, some of these hoists were then used to stage Lorenzo de’ Medici’s magnificent theatrics involving flying characters and moving scenery.

Brunelleschi also rediscovered and greatly advanced the classical concepts of visual perspective, which had been missing in the art of the Middle Ages. In an experiment that foreshadowed the work of Leonardo, he painted a panel that depicted the view of the Florence Baptistery across the plaza from the cathedral. After drilling a small hole in the panel, he put the back of it up to his eye while he faced the Baptistery. Then he took a mirror and held it at arm’s length, reflecting back on the painting. As he moved the mirror in and out of his line of sight, he would compare the reflection of his painting to the real Baptistery. The essence of realistic painting, he thought, was to render a three-dimensional view onto a two-dimensional surface. After accomplishing this trick on a painted panel, Brunelleschi showed how parallel lines seemed to converge in the distance toward a vanishing point. His formulation of linear perspective transformed art and also influenced the science of optics, the craft of architecture, and the uses of Euclidean geometry.

Brunelleschi’s successor as a theorist of linear perspective was another of the towering Renaissance polymaths, Leon Battista Alberti (1404 -1472), who refined many of Brunelleschi’s experiments and extended his discoveries about perspective. An artist, architect, engineer, and writer, Alberti was like Leonardo in many ways: both were illegitimate sons of prosperous fathers, athletic and good-looking, never-married, and fascinated by everything from math to art. One difference is that Alberti’s illegitimacy did not prevent him from being given a classical education. His father helped him get a dispensation from the Church laws barring illegitimate children from taking holy orders or holding ecclesiastical offices, and he studied law at Bologna, was ordained as a priest, and became a writer for the pope. During his early thirties, Alberti wrote his masterpiece analyzing painting and perspective, On Painting, the Italian edition of which was dedicated to Brunelleschi.

Alberti had an engineer’s instinct for collaboration and, like Leonardo, was “a lover of friendship” and “open-hearted,” according to the scholar Anthony Grafton. He also honed the skills of courtiership. Interested in every art and technology, he would grill people from all walks of life, from cobblers to university scholars, to learn their secrets. In other words, he was much like Leonardo, except in one respect: Leonardo was not strongly motivated by the goal of furthering human knowledge by openly disseminating and publishing his findings; Alberti, on the other hand, was dedicated to sharing his work, gathering a community of intellectual colleagues who could build on each other’s discoveries, and promoting open discussion and publication as a way to advance the accumulation of learning. A maestro of collaborative practices, he believed, according to Grafton, in “discourse in the public sphere.”

When Leonardo was a teenager in Florence, Alberti was in his sixties and spending much of his time in Rome, so it is unlikely they spent time together. Alberti was a major influence nonetheless. Leonardo studied his treatises and consciously tried to emulate both his writing and his demeanor. Alberti had established himself as “an avatar of grace in every word or movement,” a style that very much appealed to Leonardo. “One must apply the greatest artistry in three things,” Alberti wrote, “walking in the city, riding a horse, and speaking, for in each of these one must try to please everyone.” Leonardo mastered all three.

Alberti’s On Painting expanded on Brunelleschi’s analysis of perspective by using geometry to calculate how perspective lines from distant objects should be captured on a two-dimensional pane. He also suggested that painters hang a veil made of thin thread between themselves and the objects they are painting, then record where each element falls on the veil. His new methods improved not only painting but endeavors ranging from mapmaking to stage designs. By applying mathematics to art, Alberti elevated the painter’s status and advanced the argument that the visual arts deserve a standing equal to that of other humanist fields, a cause that Leonardo would later champion.

EDUCATION

Leonardo’s only formal learning was at an abacus school, an elementary academy that emphasized the math skills useful in commerce. It did not teach how to formulate abstract theories; the focus was on practical cases. One skill that was emphasized was how to draw analogies between cases, a method that Leonardo would use repeatedly in his later science. Analogies and spotting patterns became for him a rudimentary method of theorizing.

His enthusiastic early biographer Vasari wrote, with what seems to be typical exaggeration, “In arithmetic, during the few months that he studied it, he made so much progress, that, by continually suggesting doubts and difficulties to the master who was teaching him, he would very often bewilder him.” Vasari also noted that Leonardo was interested in so many things that he got easily distracted. He turned out to be good in geometry, but he never mastered the use of equations or the rudimentary algebra that existed at the time. Nor did he learn Latin. In his thirties he would still be trying to remedy this deficiency by drawing up lists of Latin words, painstakingly writing out awkward translations, and wrestling with grammar rules.

A left-hander, Leonardo wrote from right to left on a page, the opposite direction of the words on this and other normal pages, and drew each letter facing backward. “They are not to be read save with a mirror,” as Vasari described these pages. Some have speculated that he adopted this script as a code to keep his writings secret, but that is not true; it can be read, with or without a mirror. He wrote that way because when using his left hand he could glide leftward across the page without smudging the ink. The practice was not completely uncommon. When his friend the mathematician Luca Pacioli described Leonardo’s mirror writing, he made the point that some other lefthanders wrote likewise. A popular fifteenth-century calligraphy book even shows left-handed readers the best way to do lettera mancina, or mirror script.

Being left-handed also affected Leonardo’s method of drawing. As with his writing, he drew from right to left so as not to smudge the lines with his hand. Most artists draw hatching strokes that slope upward to the right, like this: ////. But Leonardo’s hatching was distinctive because his lines started on the lower right and moved upward to the left, like this: \\. Today this style has an added advantage: the left-handed hatching in a drawing is evidence that it was made by Leonardo.

When viewed in a mirror, Leonardo’s writing is somewhat similar to that of his father, indicating that Piero probably helped Leonardo learn to write. However, many of his numerical calculations are written in conventional fashion, showing that the abacus school probably did not indulge his use of mirror script for math. Being left-handed was not a major handicap, but it was considered a bit of an oddity, a trait that conjured up words like sinister and gauche rather than dexterous and admit, and it was one more way in which Leonardo was regarded, and regarded himself, as distinctive.

VERROCCHIO

Around the time Leonardo was fourteen, his father was able to secure for him an apprenticeship with one of his clients, Andrea del Verrocchio, a versatile artist and engineer who ran one of the best workshops in Florence. Vasari wrote, “Piero took some of his drawings and carried them to Andrea del Verrocchio, who was his good friend, and asked if he thought it would be profitable for the boy to study drawing.” Piero knew Verrocchio well, and he notarized at least four legal settlements and rental documents for him around this time. But Verrocchio probably gave the boy an apprenticeship on merit, not just as a favor to his father. He was, Vasari reported, “astonished” at the boy’s talent.

Verrocchio’s workshop, which was nestled in a street near Piero’s notarial office, was the perfect place for Leonardo. Verrocchio conducted a rigorous teaching program that involved studying surface anatomy, mechanics, drawing techniques, and the effects of light and shade on material such as draperies.

When Leonardo arrived, Verrocchio’s workshop was creating an ornate tomb for the Medici, sculpting a bronze statue of Christ and Saint Thomas, designing banners of white taffeta gilded with flowers of silver and gold for a pageant, curating the Medici’s antiques, and generating Madonna paintings for merchants who wanted to display both their wealth and their piety. An inventory of his shop showed that it had a dining table, beds, a globe, and a variety of books in Italian, including translated classical poetry by Petrarch and Ovid as well as humorous short stories by the fourteenth-century popular Florentine writer Franco Sacchetti. The topics of discussion in his shop included math, anatomy, dissection, antiquities, music, and philosophy. “He applied himself to the sciences, and particularly geometry,” according to Vasari.

Verrocchio’s bottega, like those of his five or six main competitors in Florence, was more like a commercial shop, similar to the shops of the cobblers and jewelers along the street, than a refined art studio. On the ground floor was a store and workroom, open to the street, where the artisans and apprentices mass-produced products from their easels, workbenches, kilns, pottery wheels, and metal grinders. Many of the workers lived and ate together in the quarters upstairs. The paintings and objects were not signed; they were not intended to be works of individual expression. Most were collaborative efforts, including many of the paintings commonly attributed to Verrocchio himself. The goal was to produce a constant flow of marketable art and artifacts rather than nurture creative geniuses yearning to find outlets for their originality.

With their lack of Latin schooling, the artisans in such shops were not considered to be part of the cultural elite. But the status of artists was beginning to change. The rebirth of interest in the ancient Roman classics had revived the writings of Pliny the Elder, who extolled classical artists for representing nature so accurately that their grapes could fool birds. With the help of the writings of Aiberti and the development of mathematical perspective, the social and intellectual standing of painters was rising, and a few were becoming sought after names.

Trained as a goldsmith, Verrocchio left much of the brushwork of painting to others, most notably a crop of young artists that included Lorenzo di Credi. Verrocchio was a kind master; students such as Leonardo often continued to live with and work for him after their apprenticeships were completed, and other young painters, including Sandro Botticelli, became part of his circle.

Verrocchio’s collegial nature did have one downside: he was not a tough taskmaster and his workshop was not renowned for delivering commissions on time. Vasari noted that Verrocchio once made preparatory drawings for a battle scene of nude figures and other narrative works of art, “but for some reason, whatever it may have been, they remained unfinished.” Verrocchio held on to some paintings for years before completing them. Leonardo would far exceed his master in all things, including in his propensity to get distracted, walk away from projects, and linger over paintings for years.

One of Verrocchio’s most captivating sculptures was a four-foot bronze of the young warrior David standing in triumph over the head of Goliath. His smile is tantalizing and a bit mysterious, what exactly is he thinking?, like the ones Leonardo would later paint. It quavers between expressing a childlike glory and a dawning realization of future leadership; a cocky smile is caught in the moment of being transformed into resolution. Unlike Michelangelo’s iconic marble statue of a muscular David as a man, Verrocchio’s David seems to be a slightly effeminate and strikingly pretty boy of about fourteen.

. . .

from

Leonardo DaVinci

by Walter Isaacson

get it at Amazon.com

The Buddhist Schools: Theravada and Mahayana * Mahayana Buddhism – Gaurav Manandhar * Facts and Details.

The different forms of Buddhism can be understood by becoming familiar with the two major schools that arose out of the Buddha’s basic teachings:

BuddhaNet

The two major schools of Buddhism, Theravada and the Mahayana, are to be understood as different expressions of the same teaching of the historical Buddha. Because, in fact, they agree upon and practice the core teachings of the Buddha’s Dharma. And while there was a schism after the first council on the death of the Buddha, it was largely over the monastic rules and academic points such as whether an enlightened person could lapse or not.

. . .

Mahayana Buddhism
by Gaurav Manandhar

TPPA = CRISIS

The Truth About Killer Robots: the year’s most terrifying documentary – Zach Vasquez.

“A robot may not injure a human being or, through inaction, allow a being to come to harm.” Isaac Asimov’s First Law of Robotics.

Have we already crossed the point of no return? Is the current political climate throughout the west the result of this degradation of empathy, stemming perhaps from the way we communicate with each other online, where we can automate personal exchanges via a retweet, like, or eye-roll emoji – to say nothing of the way we spread vitriol?

Ultimately, it’s just one of the ways in which the takeover of machines is well under way. Even as we continue to reel from the pace at which it is happening, those in charge of, or with access to, the technology – the corporate owners, the military, the police – will not hesitate to use it. Nor will they concern themselves with “the philosophical consequences and complications of breaking Asimov’s Law”.

. . . The Guardian

IT IS FINE!?, ‘I don’t believe it’, EARTH DEMANDS YOU ACT! NOW! STOP THIS LUNATIC.

Donald Trump has told reporters he doesn’t believe his own government’s climate change findings that the US economy will suffer substantially with continued warming from greenhouse gas pollution.

“I’ve seen it, I’ve read some of it, and it’s fine,” he said outside the White House on Monday. “I don’t believe it.”

The Guardian

THE “GREAT REPLACEMENT”. 60% of Britons believe in conspiracy theories – Esther Addley * Critical Thinking Skills. Why more highly educated people are less into conspiracy theories – Christian Jarrett.

Leavers are more likely to doubt immigration figures and think there is a plot to make Muslims the majority in UK.

Sixty per cent of British people believe at least one conspiracy theory about how the country is run or the veracity of information they have been given, a major new study has found, part of a pattern of deep distrust of authority that has become widespread across Europe and the US.

In the UK, people who supported Brexit were considerably more likely to give credence to conspiracy theories than those who opposed it, with 71% of leave voters believing at least one theory compared with 49% of remain voters.

Almost half (47%) of leave voters believed the government had deliberately concealed the truth about how many immigrants live in the UK, versus 14% of remain voters. A striking 31% of leave voters believed that Muslim immigration was part of a wider plot to make Muslims the majority in Britain, a conspiracy theory that originated in French far-right circles that was known as the “great replacement”. The comparable figure for remain voters was 6%.

The disparities between those who voted for Donald Trump and Hillary Clinton in the US was even more stark, where 47% of Trump voters believed that man-made global warming was a hoax, compared with 2.3% of Clinton voters.

The figures were the result of a large-scale international project conducted over six years and in nine countries by researchers at the University of Cambridge and YouGov, funded by the Leverhulme Trust. The study was the most comprehensive examination of conspiracy theories ever conducted, and marks the first time academics have explored questions of conspiracy beliefs, social trust and news consumption habits across different countries.

. . . The Guardian

Conspiracy and Democracy: History, Political Theory and Internet Research

The Leverhulme-funded project based at Cambridge University at CRASSH

Directors: Professor Sir Richard J Evans (History), Professor John Naughton (CRASSH), Professor David Runciman (Politics and International Studies)

Theories and beliefs about conspiracies are an enduring feature of modern societies. This is partly a reflection of the fact that real conspiracies do exist, and have existed in the past. But the pervasiveness of conspiracy theories in the twenty-first century suggests that many other factors are also at work, And studying them provides opportunities for understanding how people make sense of the world and how societies function. What does the prevalence of conspiracy theories tell us about trust in democratic societies, and about the differences between cultures and societies? How have conspiracies and conspiracy theorising changed over the centuries and what, if any, is the relationship between them? Have conspiracy theories appeared at particular moments in history, and why?

This ambitious, five-year, interdisciplinary research project aims to explore these and related questions. It sets out not to debunk particular theories but to provide a “natural history” of conspiracy theorising. To do that, the project combines the perspectives, investigative methods and insights of historians, political theorists, network engineers and other disciplines to produce what we hope will be a deeper and richer understanding of a fascinating and puzzling phenomenon.

Conspiracy and Democracy Study

Also on TPPA = CRISIS

Critical Thinking Skills. Why more highly educated people are less into conspiracy theories – Christian Jarrett

Debunking the Conspiratists. The Federal Reserve System, Illuminati and The New World Order. Real Facts.

World Happiness Report 2018 – John F. Helliwell, Richard Layard and Jeffrey D. Sachs.

The most striking finding is that a ranking of countries according to the happiness of their immigrant populations is almost exactly the same as for the rest of the population.

Happiness can change, and does change, according to the quality of the society in which people live.

The countries with the happiest immigrants are not the richest countries, but instead the countries with a more balanced set of social and institutional supports for better lives.

A higher value for migrant acceptance is linked to greater happiness for both immigrants and the native-born, by almost equal amounts.

Human psychology is complicated, and behavioural economics has now documented hundreds of ways in which people mispredict the impact of decisions upon their happiness. It does not follow that we should over-regulate their lives, which would also cause unhappiness. It does follow that we should protect people after they make their decisions, by ensuring that they can make positive social connections in their new communities (hence avoiding or reducing discrimination), and that they are helped to fulfill the dreams that led them to move in the first place.

The World Happiness Report is a landmark survey of the state of global happiness. The World Happiness Report 2018, ranks 156 countries by their happiness levels, and 117 countries by the happiness of their immigrants.

The main focus of this year’s report, in addition to its usual ranking of the levels and changes in happiness around the world, is on migration within and between countries.

The overall rankings of country happiness are based on the pooled results from Gallup World Poll surveys from 2015-2017, and show both change and stability. There is a new top ranking country, Finland, but the top ten positions are held by the same countries as in the last two years, although with some swapping of places. Four different countries have held top spot in the four most recent reports, Denmark, Switzerland, Norway and now Finland.

All the top countries tend to have high values for all six of the key variables that have been found to support well-being: income, healthy life expectancy, social support, freedom, trust and generosity. Among the top countries, differences are small enough that year-to-year changes in the rankings are to be expected.

The analysis of happiness changes from 2008-2010 to 2015-2015 shows Togo as the biggest gainer, moving up 17 places in the overall rankings from the last place position it held as recently as in the 2015 rankings. The biggest loser is Venezuela, down 2.2 points on the 0 to 10 scale.

Five of the report’s seven chapters deal primarily with migration, as summarized in Chapter 1. For both domestic and international migrants, the report studies not just the happiness of the migrants and their host communities, but also of those left behind, whether in the countryside or in the source country. The results are generally positive.

Perhaps the most striking finding of the whole report is that a ranking of countries according to the happiness of their immigrant populations is almost exactly the same as for the rest of the population. The immigrant happiness rankings are based on the full span of Gallup data from 2005 to 2017, sufficient to have 117 countries with more than 100 immigrant respondents.

The ten happiest countries in the overall rankings also are ten of the top eleven spots in the ranking of immigrant happiness. Finland is at the top of both rankings in this report, with the happiest immigrants, and the happiest population in general.

The closeness of the two rankings shows that the happiness of immigrants depends predominantly on the quality of life where they now live, illustrating a general pattern of convergence. Happiness can change, and does change, according to the quality of the society in which people live. Immigrant happiness, like that of the locally born, depends on a range of features of the social fabric, extending far beyond the higher incomes traditionally thought to inspire and reward migration.

The countries with the happiest immigrants are not the richest countries, but instead the countries with a more balanced set of social and institutional supports for better lives.

While convergence to local happiness levels is quite rapid, it is not complete, as there is a ‘footprint’ effect based on the happiness in each source country. This effect ranges from 10% to 25%. This footprint effect, explains why immigrant happiness is less than that of the locals in the happiest countries, while being greater in the least happy countries.

A very high proportion of the international differences in immigrant happiness (as shown in Chapter 2), and of the happiness gains for individual migrants (as studied in Chapters 3 and 5) are thus explained by local happiness and source country happiness.

The explanation becomes even more complete when account is taken of international differences in a new Gallup index of migrant acceptance, based on local attitudes towards immigrants, as detailed in an Annex to the Report.

A higher value for migrant acceptance is linked to greater happiness for both immigrants and the native-born, by almost equal amounts.

The report studies rural-urban migration as well, principally through the recent Chinese experience, which has been called the greatest mass migration in history. That migration shows some of the same convergence characteristics of the international experience, with the happiness of city-bound migrants moving towards, but still falling below urban averages.

The importance of social factors in the happiness of all populations, whether migrant or not, is emphasized in Chapter 6, where the happiness bulge in Latin America is found to depend on the greater warmth of family and other social relationships there, and to the greater importance that people there attach to these relationships.

The Report ends on a different tack, with a focus on three emerging health problems that threaten happiness: obesity, the opioid crisis, and depression. Although set in a global context, most of the evidence and discussion are focused on the United States, where the prevalence of all three problems has been growing faster and further than in most other countries.

Edited by John F. Helliwell, Richard Layard and Jeffrey D. Sachs This publication may be reproduced using the following reference: Helliwell, J., Layard, R., & Sachs, J. (2018). World Happiness Report 2018, New York: Sustainable Development Solutions Network.

Chapter 1

Happiness and Migration: An Overview

Increasingly, with globalisation, the people of the world are on the move; and most of these migrants are seeking a happier life. But do they achieve it? That is the central issue considered in this 2018 World Happiness Report. But what if they do? The migrants are not the only people affected by their decision to move. Two other major groups of people are affected by migration: • those left behind in the area of origin, and • those already living in the area of destination.

This chapter assesses the happiness consequences of migration for all three groups. We shall do this separately, first for rural-urban migration within countries, and then for international migration.

Rural-Urban Migration

Rural-urban migration within countries has been far larger than international migration, and remains so, especially in the developing world. There has been, since the Neolithic agricultural revolution, a net movement of people from the countryside to the towns. In bad times this trend gets partially reversed. But in modern times it has hugely accelerated.

The timing has differed in the various parts of the world, with the biggest movements linked to boosts in agricultural productivity combined with opportunities for employment elsewhere, most frequently in an urban setting. It has been a major engine of economic growth, transferring people from lower productivity agriculture to higher productivity activities in towns.

In some industrial countries this process has gone on for two hundred years, and in recent times rural-urban migration within countries has been slowing down. But elsewhere, in poorer countries like China, the recent transformation from rural to urban living has been dramatic enough to be called “the greatest mass migration in human history”. Over the years 1990-2015 the Chinese urban population has grown by 463 million, of whom roughly half are migrants from villages to towns and cities. By contrast, over the same period the increase in the number of international migrants in the entire world has been 90 million, less than half as many as rural to urban migrants in China alone.

Thus internal migration is an order of magnitude larger than international migration. But it has received less attention from students of wellbeing, even though both types of migration raise similar issues for the migrants, for those left behind, and for the populations receiving the migrants.

The shift to the towns is most easily seen by looking at the growth of urban population in developing countries (see Table 1.1). Between 1990 and 2015 the fraction of people in these countries who live in towns rose from 30% to nearly 50%, and the numbers living in towns increased by over 1,500 million people. A part of this came from natural population growth within towns or from villages becoming towns. But at least half of it came from net migration into the towns. In the more developed parts of the world there was also some rural-urban migration, but most of that had already happened before 1990.

International Migration

If rural-urban migration within countries is an age-old phenomenon, large-scale international migration has increased greatly in recent years due to globalisation (see Table 1.2). In 1990 there were in the world 153 million people living outside the country where they were born. By 2015 this number had risen to 244 million, of whom about 10% were refugees. So over the last quarter century international migrants increased by 90 million.

This is a large number, even if dwarfed by the scale of rural-urban migration. In addition, on one estimate there are another 700 million people who would like to move between countries but haven’t yet done so.

Of the increased number of recent migrants over a half comes from migration between continents (see Table 1.3). There were big migrations into North America and Europe, fuelled by emigration from South/Central America, Asia and Africa.

There were also important flows of international migrants within continents (see Table 1.4). In Asia for example there were big flows from the Indian sub-continent to the Gulf States; and in Europe there was the strong westward flow that has followed the end of Communism.

From the point of view of the existing residents an important issue is how many immigrants there are, as a share of the total population. This requires us to look at immigrants as a fraction of the total population. At the world level this has risen by a half in recent years (see Table 1.2).

But in most of the poorer and highly populous countries of the world the proportion of migrants remains quite low. It is in some richer countries that the proportion of immigrants is very high. In Western Europe, most countries have immigrants at between 10 and 15 per cent of the population. The same is true of the USA; while Canada, Australia and New Zealand have between 20 and 30%. The most extreme cases are the UAE and Kuwait, both over 70%.

Figure 1.1 shows the situation worldwide.

The Happiness of International Migrants

As already noted, migration within and between countries has in general shifted people from less to more productive work, and from lower to higher incomes. In many cases the differences have been quite extreme. International migration has also saved many people from extremes of oppression and physical danger, some 10% of all international migrants are refugees, or 25 million people in total.

But what can be said about the happiness of international migrants after they have reached their destination?

Chapter 2 of this report begins with its usual ranking and analysis of the levels and changes in the happiness of all residents, whether locally born or immigrants, based on samples of 1,000 per year, averaged for 2015-2017, for 156 countries surveyed by the Gallup World Poll. The focus is then switched to international migration, separating out immigrants to permit ranking of the average life evaluations of immigrants for the 117 countries having more than 100 foreign-born respondents between 2005 and 2017. (These foreign-born residents may include short-term guest workers, longer term immigrants, and serial migrants who shift their residency more often, at different stages of their upbringing, careers, and later lives).

So what determines the happiness of immigrants living in different countries and coming from different, other countries? Three striking facts emerge:

1. In the typical country, immigrants are about as happy as people born locally. (The difference is under 0.1 point out of 10). This is shown in Figure 1.2. However the figure also shows that in the happiest countries immigrants are significantly less happy than locals, while the reverse is true in the least happy countries. This is because of the second finding.

2. The happiness of each migrant depends not only on the happiness of locals (with a weight of roughly 0.75) but also on the level of happiness in the migrant’s country of origin (with a weight of roughly 0.25). Thus if a migrant goes (like many migrants) from a less happy to a more happy country, the migrant ends up somewhat less happy than the locals. But the reverse is true if a migrant goes from a more to a less happy country.

This explains the pattern shown in Figure 1.2, and is a general (approximate) truth about all bilateral flows. Another way of describing this result is to say that on average a migrant gains in happiness about three-quarters of the difference in average happiness between the country of origin and the destination country.

3. The happiness of immigrants also depends, importantly, on how accepting the locals are towards immigrants. (To measure acceptance local residents were asked whether the following were “good things” or “bad things”: having immigrants in the country, having an immigrant as a neighbour, and having an immigrant marry your close relative).

In a country that was more accepting (by one standard deviation) immigrants were happier by 0.1 points (on a 0 to 10 scale). Thus the analysis in Chapter 2 argues that
migrants gain on average if they move from a less happy to a more happy country (which is the main direction of migration). But that argument was based on a simple comparison of the happiness of migrants with people in the countries they have left.

What if the migrants were different types of people from those left behind? Does this change the conclusion? As Chapter 3 shows, the answer is, No.

In Chapter 3 the happiness of migrants is compared with individuals in their country of origin who are as closely matched to the migrants as possible and are thinking of moving. This again uses the data from the Gallup World Poll. The results from comparing the migrants with their look-a-likes who stayed at home suggests that the average international migrant gained 0.47 points (out of 10) in happiness by migration (as measured by the Cantril ladder). This is a substantial gain. But there is an important caveat: the majority gain, but many lose. For example, in the only controlled experiment that we know of, Tongans applying to migrate to New Zealand were selected on randomised basis. After moving, those who had been selected to move were on average less happy than those who (forcibly) stayed behind.

Migration clearly has its risks. These. include separation from loved ones,. discrimination in the new location, and a feeling of relative deprivation, because you now compare yourselfwith others who are richer than your previous reference group back home.

One obvious question is: Do migrants become happier or less happy the longer they have been in a country? The answer is on average, neither, their happiness remains flat. And in some countries (where this has been studied) there is evidence that second-generation migrants are no happier than their immigrant parents.

One way of explaining these findings (which is developed further in Chapter 4) is in terms of reference groups: When people first move to a happier country their reference group is still largely their country of origin. They experience an immediate gain in happiness. As time passes their objective situation improves (which makes them still happier) but their reference group becomes increasingly the destination country (which makes them less happy). These two effects roughly offset each other. This process continues in the second generation.

The Gallup World Poll excludes many current refugees, since refugee camps are not surveyed. Only in Germany is there sufficient evidence on refugees, and in Germany refugees are 0.4 points less happy than other migrants. But before they moved the refugees were also much less happy than the other migrants were before they moved.

So refugees too are likely to have benefitted from migration. Thus average international migration benefits the majority of migrants, but not all. Does the same finding hold for the vast of the army of people who have moved from the country to the towns within less developed countries?

The Happiness of Rural-Urban Migrants

The fullest evidence on this comes from China and is presented in Chapter 4. That chapter compares the happiness of three groups of people:

• rural dwellers, who remain in the country,

• rural-urban migrants, now living in towns, and

• urban dwellers, who always lived in towns.

Migrants have roughly doubled their work income by moving from the countryside, but they are less happy than the people still living in rural areas. Chapter 4 therefore goes on to consider possible reasons for this.

Could it be that many of the migrants suffer because of the remittances they send home? The evidence says No. Could it be that the people who migrate were intrinsically less happy? The evidence says No. Could it be that urban life is more insecure than life in the countryside, and involves fewer friends and more discrimination? Perhaps.

The biggest factor affecting the happiness of migrants is a change of reference group: the happiness equation for migrants is similar to that of urban dwellers, and different from that of rural dwellers. This could explain why migrants say they are happier as a result of moving, they would no longer appreciate the simple pleasures of rural life.

Human psychology is complicated, and behavioural economics has now documented hundreds of ways in which people mispredict the impact of decisions upon their happiness. It does not follow that we should over-regulate their lives, which would also cause unhappiness. It does follow that we should protect people after they make their decisions, by ensuring that they can make positive social connections in their new communities (hence avoiding or reducing discrimination), and that they are helped to fulfil the dreams that led them to move in the first place.

It is unfortunate that there are not more studies of rural-urban migration in other countries. In Thailand one study finds an increase in happiness among migrants, while in South Africa one study finds a decrease?

The Happiness of Families Left Behind

In any case the migrants are not the only people who matter. What about the happiness of the families left behind? They frequently receive remittances (altogether some $500 billion in 2015), but they lose the company and direct support of the migrant. For international migrants we are able to examine this question In Chapter 3.

This is done by studying people in the country of origin and examining the effect of having a relative who is living abroad. On average this experience increases both life-satisfactlon and positive affect. But there is also a rise in negative affect (sadness, worry, anger), especially if the migrant is abroad on temporary work. Unfortunately there is no comparable analysis of families left behind by rural-urban migrants who move to towns and cities in the same country.

The Happiness of the Original Residents in the Host Country

The final issue is how the arrival of migrants affects the existing residents in the host country or city. This is one of the most difficult issues in all social science.

One approach is simply to explain happiness in different countries by a whole host of variables including the ratio of immigrants to the locally born population (the “immigrant share”). This is done in Chapter 2 and shows no effect of the immigrant share on the average happiness of the locally born. It does however show that the locally born population (like immigrants) are happier, other things equal, if the country is more accepting of immigrants.

Nevertheless, we know that immigration can create tensions, as shown by its high political salience in many immigrant-receiving countries, especially those on migration trails from unhappy source countries to hoped-for havens in the north.

Several factors contribute to explaining whether migration is welcomed by the local populations.

First, scale is important. Moderate levels of immigration cause fewer problems than rapid surges,

Second, the impact of unskilled immigration falls mainly on unskilled people in the host country, though the impact on public services is often exaggerated and the positive contribution of immigrants is often underestimated.

Third, the degree of social distress caused to the existing residents depends importantly on their own frame of mind, a more open-minded attitude is better both for immigrants and for the original residents.

Fourth, the attitude of immigrants is also important if they are to find and accept opportunities to connect with the local populations, this is better for everyone. Even if such integration may initially seem difficult, in the long run it has better results, familiarity eventually breeds acceptance, and inter-marriage more than anything blurs the differences.

The importance of attitudes is documented in the Gallup Annex on migrant acceptance, and in Chapter 2, where the migrant acceptance index is shown to increase the happiness of both sectors of the population, immigrants and the locally born.

Chapter 5 completes the set of migration chapters. It seeks to explain why so many people emigrate from Latin American countries, and also to assess the happiness consequences for those who do migrate. In Latin America, as elsewhere, those who plan to emigrate are on average less happy than others. Similar to themselves in income, gender and age. They are also on average wealthier, in other words they are “frustrated achievers”.

But those who do emigrate from Latin American countries also gain less in happiness than emigrants from some other continents. This is because, as shown in chapters 2 and 6, they come from pretty happy countries. Their choice of destination countries is also a less happy mix. This combination lessens their average gains, because of the convergence of immigrant happiness to the general happiness levels in the countries to which they move, as documented in Chapter 2. If immigrants from Latin America are compared to other migrants to the same countries, they do very well in relation both to other immigrants and to the local population. This is shown in Chapter 2 for immigration to Canada and the United Kingdom, countries with large enough happiness surveys to permit comparison of the happiness levels of immigrants from up to 100 different source countries.

Chapter 6 completes the Latin American special package by seeking to explain the happiness bulge in Latin America. Life satisfaction in Latin America is substantially higher than would be predicted based on income, corruption, and other standard variables, includIng having someone to count on. Even more remarkable are the levels of positive affect, with eight of the world‘s top ten countries being found in Latin America.

To explaIn these differences, Chapter 6 convincingly demonstrates the strength of family relationships in Latin America. In a nutshell, the source of the extra Latin American happiness lies in the remarkable warmth and strength of family bonds, coupled with the greater importance that Latin Americans attach to social life in general, and especially to the family. They are more satisfied with their family life and, more than elsewhere, say that one of their main goals is making their parents proud.

Conclusion

In conclusion, there are large gaps in happiness between countries, and these will continue to create major pressures to migrate. Some of those who migrate between countries will benefit and others will lose. In general, those who move to happier countrIes than their own will gain in happiness, while those who move to unhappier countries will tend to lose. Those left behind will not on average lose, although once again there will be gainers and losers. Immigration will continue to pose both opportunities and costs for those who move, for those who remain behind, and for natives of the immigrant-receiving countries.

Where immigrants are welcome and where they integrate well, immigration works best. A more tolerant attitude in the host country will prove best for migrants and for the original residents. But there are clearly limits to the annual flows which can be accommodated without damage to the social fabric that provides the very basis of the country’s attraction to immigrants.

One obvious solution, which has no upper limit, is to raise the happiness of people in the sending countries, perhaps by the traditional means of foreign aid, and better access to rich-country markets, but more importantly by helping them to grow their own levels of trust, and institutions of the sort that make possible better lives in the happier countries.

Download the full report, Pdf

World Happiness Report

RICH ENOUGH? A laid-back guide for every kiwi – Mary Holm * THE HAPPINESS EQUATION. The Surprising Economics of Our Most Valuable Asset – Nick Powdthavee.

One recent study suggests that beyond a certain point, people with more money are less happy.

What really matters is how you save.

You don’t have to earn a lot to become wealthy. I’ll show you how to get much more mileage out of what money you have.

WHY DO YOU WANT TO BE RICHER?

Books about money and investing are full of info on how to boost your wealth. But I’ve never seen one that also asks ‘why?’.

At first that might seem a silly question. More money buys us more things and more experiences, and that adds up to more happiness, right?

Not necessarily. Lots of research shows that once we have a certain amount of money enough to easily cover the basics and have some fun, having more doesn’t necessarily make us happier. In fact, one recent study suggests that beyond a certain point, people with more money are less happy. More on this later in the book.

For five years I taught a course on financial literacy to non-Business School students at the University of Auckland. Worried that students might think my main message was ‘the more money, the better’, I asked every student to attend a discussion group where we looked into what made people happy, and the role of wealth in that.

Before coming to the class, the students were asked to do the following (which I dreamt up one day on a long drive). You might want to try it.

1. Write a list of eight individuals or couples you know well.

2. Give each one a score of 1 to 5 for wealth, with at least one getting a 1 and one getting a 5.

3. Give each one a score of 1 to 5 for happiness again with at least one 1 and one 5.

4. See if the high scorers for wealth are also the high scorers for happiness.

Some students found the two were correlated that wealthier people tended to be more content. But many saw no clear correlation, and every now and then someone saw the opposite their poorer friends and relations tended to have a better time.

On balance, though, the students did tend to know more happy rich people than happy poor people. So is the research wrong?

Nick Powdthavee, a UK professor of behavioural science who looked at a great deal of research for his book The Happiness Equation, raises an intriguing question: Does wealth make us happier, or do happy people get wealthier?

He found that happy people:

– tend to be more creative and productive

– have better health which tends to lead to more wealth

– are more likely to be financially successful

It seems that happiness is more likely to lead to wealth than the other way around.

As Nobel Peace Prize winner Albert Schweitzer put it: ‘Success is not the key to happiness. Happiness is the key to success. If you love what you are doing, you will be successful.’

If you start out with a happy disposition, there’s a good chance you’ll end up well off. If you start out grumpy, you’re less likely to do well financially. Of course, you might get lucky with money, but it’s unlikely to change your outlook on life.

So where does this leave you, as you’re starting to read a book about investing? Why try to get richer if it probably won’t make you happier?

Check back to what I said above. While wealth and happiness don’t seem to be highly correlated after you’ve got the basics well covered, many of you will feel you haven’t covered all the basics yet.

Nobody would argue that if you’re struggling to cut credit card debt, or to get together a deposit for a modest first home, or to save up enough to do some fun things in retirement, having a few more bucks wouldn’t be welcome.

Even if you’re financially comfortable, more money gives you more choices. These might include supporting others, from family members to charities.

So, while it may not make sense to put lots of time, effort and worry into absolutely maximising your wealth, it does make sense to take a few straightforward steps to make your money work better for you.

Read this book, take the steps that apply to you, and you’ll have the money stuff sorted. You can then spend less time working and more time getting on with things that will really improve your wellbeing.

What might that be? At the end of the book, we’ll look a little further into some of the fascinating research about what makes people happy. But for now, let’s get on with making you financially strong enough to make the most of your life.

Step 1

START NOW, IT’S EASY

In which we . ..

– Observe that laid-back investing is good

– Compare savvy Sally and slow Suzy

– Also compare the apprentice and the graduate

– See that you’ll have a lot more than twice as much if you save for 40 years instead of 20

– Learn that compounding is a friend for savers, a foe for those in debt

– Discard those ‘You need a million dollars’ messages

People often ask me if I’ve read the latest book about the share market or investing. ‘No’, I reply. ‘There are too many good novels to read. Besides, a lot of what’s written about investing isn’t much and sometimes it’s actually a big worry. It can persuade readers to take steps that will do them more harm than good. When it comes to investing, laziness is good.

That might sound crazy. In pretty much everything else we do, from running marathons to getting promoted fast at work to mastering the piano to creating a magical garden, the more work we put into it the better we’ll do.

But investing is different.

We all know people who put hours into their investments. They read the financial pages, and listen to the economists who tell them, more like guess actually, what’s likely to happen in the next year. Then they read about which investments have done well lately. On the strength of that they choose which shares or bonds to buy or sell, and when to buy or sell them.

And guess what? Most of them end up with less than you will after you’ve read this book, set up your investments and got on with other things. It’s sometimes called ‘Set and forget’.

Let’s not be misleading here. I’m not saying you should never do anything after the initial set-up. Every few years it’s a good idea to do a quick review of your investments. But the changes you might make are easy half-hour sort of stuff. There’ll be more about this in Step 6: ‘Stay cool’, but for now, let’s look at the basics.

Three ways to get more savings

It’s quite simple, really. The three ways to get more savings are:

1. Earn more.

2. Save more.

3. Be smarter with what you do with your savings.

Of course, it’s also great to get a pay rise either in your current job or by starting a new job.

During my extended OE in the United States, I still recall the excitement of moving from a smalltown Michigan newspaper, the wonderfully named Jackson Citizen Patriot, to the Chicago Daily News. The pay rise meant less than the thrill of knowing I would work with some great journalists. But still, my pay went from something like $US14,000 to $US21,000 a year, not to be sneezed at back then when a dollar was worth a dollar.

Chances are you will get at least one huge pay jump in your life. Fantastic! But that’s not what this book is about. It’s not what you earn, but how much you save that matters. And, perhaps more importantly, what really matters is how you save.

Key message: You don’t have to earn a lot to become wealthy. I’ll show you how to get much more mileage out of what money you have.

Get going

I know the feeling. Practical friends tell me I should get the runners on the sliding door to my deck fixed. I don’t understand much about things like that, and I don’t know who to ask, and it all gets too hard and doesn’t happen.

Maybe you feel that way about your finances. The ‘Don’t Know and Don’t Know Who to Trust’ syndrome finds us doing nothing, week after week, year after year. With my house, it might matter if it all starts falling apart. With your money, there are no ‘ifs’. It will matter. Muck around for a year or two and you can end up retiring with much, much less.

But don’t panic! This book will teach you how to invest your money. It’s not hard I promise. . .

RICH ENOUGH? A laid-back guide for every kiwi – Mary Holm

THE HAPPINESS EQUATION. The Surprising Economics of Our Most Valuable Asset – Nick Powdthavee.

Modern Monetary Theory. Japan still to slip into the sea under its central bank debt burden – Bill Mitchell.

The Bank of Japan continues to demonstrate the categorical failure of mainstream macroeconomics and, conversely, ratify the core principles of Modern Monetary Theory (MMT).

President Trump banned a CNN reporter only to find his position overturned by the judicial system. Well CNN is guilty of at least one thing, publishing misleading and alarmist economic reports about Japan. In a CNN Business article last week (November 13, 2018), Japan’s economy has a $5 trillion problem, readers were told that the Bank of Japan has no “dwindling options to juice growth if a new crisis hits” because “it’s now sitting on assets worth more than the country’s entire economy”.

The real story should have been that the Bank of Japan continues to demonstrate the categorical failure of mainstream macroeconomics and, conversely, ratify the core principles of Modern Monetary Theory (MMT).

That is what the Japanese experience since the early 1990s tells us. And all the stories about special cases; cultural peculiarities, closed markets, etc that the mainstream economists wheel out when another one of their predictions about how Japan is about to sink into the sea as a result of its public debt levels, or that interest rates are about to go through the roof because of the on-going and substantial fiscal deficits; or that inflation is about to accelerate because of the massive monetary injections; and more, are just smokescreens to divert our attention from the poverty of their analytical framework.

The Japanese 10-year bond trade is called the ‘widow maker’ because hedge funds who try to short it lose big. The Japanese monetary system is my real-time, non-linear economic laboratory which allows all the key macroeconomic propositions to play out live. And MMT is never very far off the mark. Try juxtaposing New Keynesian theory against Japan, total dissonance.

The same old

At some regular interval, which I guess I could work out if I cared, the media runs a story that goes like this.

First, there is a sensational headline, which usually has some massive monetary figure listed that is so large that it befuddles the reckoning of ordinary citizens (even me) who are used to dealing in 10s not trillions.

Of course, that is the intent. Evoke fear and alarm rather than understanding.

Then the story tells us that the Bank of Japan’s balance sheet has expanded by some massive amount. Okay.

Why is that a problem?

Well hints are provided about the dangers of ‘printing money’ (none ever substantiated), it is all nod-nod, wink-wink sort of stuff.

Then the reader is usually told that the central bank risks insolvency if the bonds go south.

The disconnect in the claims is never made obvious, if the central bank is out there ‘printing’ all this money how can it go broke.

The twain is never met here!

Perhaps the journalist or Op-Ed writer hasn’t twigged to this internal inconsistency.

After all, they are just pushing through an 800-1000 word template and all the usual points have to be made. Forget logic and consistency.

Then the reader is told that the strategy hasn’t worked anyway, inflation remains low and despite low interest rates, economic activity is hardly booming, yet the disconnect between that observation and some of the more salacious claims about hyperinflation etc is also never really made.

The observation that despite considerable efforts by the Bank of Japan to kickstart its inflation rate little progress has been made tells us that monetary policy is a relatively ineffective macroeconomic tool.

Which is counter what the mainstream New Keynesian consensus tells us.

That is the real story here that escapes the journalists and commentators.

Finally, the stories usually touch on the assertion that with so much bond buying and such an enlarged balance sheet, the Bank of Japan is not capable of defending the economy from the next crisis.

And the scaremongering is complete.

The reader isn’t allowed to think that maybe fiscal policy is the main game anyway and its capacity is not impeded by past deficits or enhanced by past surpluses.

In other words, the Japanese government has all the ‘fire power’ it ever needs to respond to a non-government sector spending collapse whether it come from domestic demand or via the export markets.

It can also respond to any natural or unnatural disaster.

And so the reader turns the pages and forgets about all this until some time later when the story is recycled by some other bored journalist who has nothing better to do on that particular day.

That was what was dished up in CNN Business’s latest offering cited in the Introduction.

We read gems like:

1. “An epic bond-buying spree by Japan’s central bank means it’s now sitting on assets worth more than the country’s entire economy.”

2. “following years of money printing aimed at jump starting the country’s stagnant economy”.

3. “The years of heavy stimulus have warped parts of Japan’s financial markets and left the central bank with dwindling options to juice growth if a new crisis hits. But the splurge is unlikely to end anytime soon.”

Note the language, “warped”, “juice”, “splurge”, all loaded to make out something is wrong.

4. “Kuroda has said the bank won’t consider ending the protracted stimulus effort until that goal is reached. Risky strategy. But that may be an impossible task, and continuing the stimulus program indefinitely carries significant risks.”

Which risks?

Come in spinner! Just in time. These type of articles all have to quote some doom merchant from the private sector.

So we get a quote from a person with a Masters degree who has been an accountant and worked for Credit Suisse:

“There are limits to how many assets the Bank of Japan can buy.”

Yes, the bank can only buy what is for sale.

And as long as the Japanese Finance Ministry keeps running fiscal deficits and does not change the unnecessary institutional arrangement of matching those deficits with bond issuance then there will be bonds to buy.

The actual concern here from the commentator is revealed next, the fact the central bank is keeping interest rates low is “making it too hard for commercial banks to make profits.”

So:

Negative interest rates have squeezed their margins, and the huge asset purchases have effectively killed regular trading in the once lucrative bond market.

Ah. The corporate welfare argument. They want public debt because it gives them a risk-free asset to make money from.

And, by way of finale, the restatement of the doom:

The Bank of Japan’s ultra-loose monetary policy also leaves it with little in the way of fire power to help prop up the economy in the event of another big crisis.”

So, Japan slips into the sea … eventually. Sorry Jimi.

Data update – Japan goes on in its merry way.

Defying mainstream macroeconomic predictions, that is …

. . . Bill Mitchell

Education Impossible, Poverty and Inequality, New Zealand’s Neoliberal Legacy – Principal of one of NZ’s most challenging schools.

‘I shut my door and burst into tears’.

I’ve travelled the world. I have seen hard and I have done rough. But this was something else. It was not how a school should function.

Very few of our kids were actually functioning as they should. It broke my heart every single day.

Our teachers are doctors, psychologists, counsellors, behavioural therapists, and, for a small part of their day, educators.

These are beautiful kids, they can be anything they want to be, they just need to know we believe in them.

At 9am on my first day as principal of a small primary school, I shut my office door and burst into tears. After just 30 minutes on the job, I’d been sworn at by a child, abused by a parent, and a teacher had threatened to walk out. It only got worse. I had kids breaking windows. There were four or five fist fights a day. The police were on call.

I’ve travelled the world. I have seen hard and I have done rough. But this was something else. It was not how a school should function.

The behaviour issues meant there was no such thing as learning. For six weeks, I went home crying every night and said ‘I’m not going back.’ But I did. Because nothing has ever beaten me, and I was furious that this was happening to our children.
I wrote a list of every child in our school. We identified all of their needs. Seventy five per cent of our kids had high-level health, wellbeing, behaviour or academic issues. Very few of our kids were actually functioning as they should. It broke my heart every single day.

So our staff meetings weren’t about appraisals or the curriculum, they were about survival. How do we get to day two? How do we get to day three? We had to go back to basics before we could even start teaching.
I began to understand what was going on in the community. In one family, the kids’ clothes were dirty because they had no power. In another, the fridge didn’t work, there were rats in the walls, and the ceiling leaked. Their kids were constantly sick. It was clear the landlord didn’t care: I suspected in his eyes they weren’t “good enough” people to have the house repaired.

Some kids weren’t at school because their parents had no money for petrol. The stress was immense, and there were a lot of mental health issues. Tough, then, to bring your child up with a lust for life.

When I realised that this was bigger than me, I reached out to everyone who could help. The kids lacked resilience. If someone said “boo” to them in the playground there was a fight, or someone was crying. So we ran programmes about friendship and anger management. The kids have learnt to brainstorm, and problem solve, and communicate. Now we don’t have fights. It meant that in term two, we could start teaching the curriculum.

We realised the other big issue was hunger. When you get to the bottom of why a kid is acting up, it’s often because they haven’t eaten anything that day. Now, with KidsCan’s help, I watch 15 to 20 kids sitting around the school’s breakfast table every morning, chatting over a hot meal of baked beans. It’s a really positive start to the day. They know there’s no shame in needing food, if anyone is hungry they can go into the kitchen and help themselves to snacks too.

The change is huge. They have energy. In term one we struggled hugely with exercise. Everyone would opt out. Now, every morning we pump the sound system and everyone walks or runs laps of the field to ready us for learning. They go for it! We don’t have a single kid that opts out of exercise now, because they’ve got food in their bellies, and that makes them feel happier and more secure.

The day we handed out KidsCan’s jackets and shoes was incredible, the kids couldn’t believe that someone would give them something. I’ve never seen them that excited. They said, “oh Miss, this is the coolest thing I own.” They literally walked higher and taller and prouder. The parents were gobsmacked; many said they just couldn’t have afforded them. And because they have that extra money, it seems the families’ out-of-school lives are better too.

In term one we were too terrified to take the kids out of school. But in term three I took them out to the zoo. We all wore our jackets and I said to them, “we’re a team, we’re a unit”. I could not have been more proud. It was an amazing day with not a single behaviour issue. I hardly see students in my office in trouble anymore. I see them for stickers, and pencils for good writing, and for a hug if they need it.

But caring for these kids does take its toll. Our teachers are doctors, psychologists, counsellors, behavioural therapists, and, for a small part of their day, educators. My biggest fear for our kids is that their needs are far greater than the Government recognises. They don’t understand what’s really happening in our schools. They’ve just been setting standards for kids, and comparing them as if they all arrive at school on an equal footing. They don’t.

These are beautiful kids. They just need to know we believe in them. Sometimes I’ll purposefully leave my class and put a child in charge. Once, one boy said “Miss, he’s the worst person to put in charge!”
I said, “No he’s not, I’ve picked him, and he’s going to do it, just you watch.” I came back in and everything was perfect.
We built that child up. He sat there with a full tummy, feeling warm, with us supporting him, all those things together create success. Many of the kids recognise they don’t have as much money as others, so they think they’re not as good as them. I want them to throw all that away and know they can be anything they want to be.

Stuff.co.nz

To sponsor a Kiwi kid in need for $20 a month, visit KidsCan

THE HAPPINESS EQUATION. The Surprising Economics of Our Most Valuable Asset – Nick Powdthavee.

What do we do, then? What do we do when our lives are a series of trade-offs between different combinations of ‘what ifs”? What do we do when there is an endless horizon of time and resource constraints constantly telling us that whatever we do, we can’t possibly have it all?

“Happiness is not having what you want, but wanting what you have.” Rabbi Hyman Schachtel.

Why is marriage worth £200,000 a year? Why will having children make you unhappy?

Why does happiness from winning the lottery take two years to arrive?

Why does time heal the pain of divorce or the death of a loved one but not unemployment?

Everybody wants to be happy. But how much happiness precisely will each life choice bring? Should I get married? Am I really going to feel happy about the career that I picked? How can we decide not only which choice is better for us, but how much it’s better for us?

The result of new, unique research, The Happiness Equation brings to a general readership for the first time the new science of happiness economics.

It describes how we can measure emotional reactions to different life experiences and present them in ways we can relate to. How, for instance, monetary values can be put on things that can’t be bought or sold in the market such as marriage, friendship, even death so that we can objectively rank them in order of preference. It also explains why some things matter more to our happiness than others (like why seeing friends is worth more than a Ferrari) while others are worth almost nothing (like sunny weather).

Nick Powdthavee whose work on happiness has been discussed on both the Undercover Economist and Freakanomics blogs brings cutting-edge research on how we value our happiness to a general audience with a style that wears its learning lightly and is a joy to read.

Dr Nattavudh (Nick) Powdthavee is a behavioural economist at the University of York (shortly to move to the Department of Economics, Nanyang Technological University, Singapore). Discussions of his work on the economics of happiness have appeared in over 50 major international newspapers in the past five years, including the New York Times and the Guardian, as well as on TV, including Channel 5 News and The Wright Stuff. He is originally from Thailand.

CHAPTER 1

THE PURSUIT

Most of us go through life believing we know exactly what we need to make us happy. For the most part, we believe that all we ever need is to have someone we love loving us back. Or it’s a combination of more money, a good job, a stable marriage and perfect health. Sometimes it’s the little things in life, like a day off work; a clear blue sky on an autumn afternoon; a nice cup of cool mochaccino on a hot day; an hour-long foot rub; a day spent laughing with friends and family; 45 minutes of uninterrupted sex with our partner, and the energy to last for the best part of it.

But unfortunately in the words of Mick Jagger and Keith Richards we can’t always get what we want. At least, we can’t always get what we want all the time. A day off work every so often sounds like a good idea until, of course, we realise that we will become a little poorer because of it. And that’s no good because, according to the abstract idea we have in our heads of what makes a good life, money matters a lot. Okay then, in that case, we’ll put in more hours at work. But wait. That will also mean less time to be spent with friends and family, and that doesn’t seem so good either.

So what do we do, then? What do we do when our lives are a series of trade-offs between different combinations of ‘what ifs”? What do we do when there is an endless horizon of time and resource constraints constantly telling us that whatever we do, we can’t possibly have it all? Well, according to economists, who are supposedly experts on decision-making, what usually happens is that we try to do the best we can with our choices. We gather all necessary information about our options. We engage in rationalisation and mental calculations. We quietly argue and debate within ourselves over the potential impacts of each individual decision on our happiness. We cross-refer them to the rule-book of ‘All the things that make me happy’, put each possibility into an order of preference, and then, subject to both time and resource constraints, choose the best combination of bundles that we know would optimise our wellbeing. Easy.

Bounded rationality

But of course, if that were true if we always chose the best possible combination of options according to stable preference functions and the constraints facing them then the way we led our lives would literally be disappointment-free. Whatever decisions we made, we would know exactly well in advance what we were getting ourselves into. After all, our rationality would have already done the homework for us: we would be getting the greatest reward at the lowest cost.

How could we possibly not be happy with that?

The reality, however, is that our lives are too often filled with disappointing and regrettable decisions, whether big or small. The holiday we went on last summer; that antique car we bought; or even the job or college degrees we picked. The following anecdotal evidence from a chance meeting between two economists and a dentist makes it all too clear.

Two economics professors and friends, John Bennett and Chuck Blackorby, were attending an economics conference. On the first evening, they met a dentist at the hotel bar who was at an annual conference for dentists just next door to them. After a brief introduction and a couple of drinks, Chuck, who was known for his sometimes brash and direct manner, decided to ask the dentist, by then a little tipsy, a somewhat personal question.

‘So, tell me, are you very happy being a dentist?’

‘Happy? I’m miserable as a dentist’, replied the man.

Chuck smiled to himself. ‘What? If you’re so unhappy, why on earth did you choose to become a dentist in the first place?’

‘I didn’t choose to become a dentist.’ The man took another swig of his drink before delivering the final hammer blow. ‘It’s that stupid kid eighteen years ago that chose to become a dentist. Not me.’

And even when we’re not too disappointed; when we actually think we’re fairly satisfied with the choices we made, sometimes there’s just no way for us to know for certain whether or not we would have been happier if we’d gone with the alternatives. Take having children, for example. For most parents, a natural and genuine response to the question, ‘Would you be happier without children?’ would be a screaming ‘No!’ However, there’s no real way of knowing precisely what life would have been like if these parents had decided not to have their little David or Sarah simply because the childless alternative didn’t take place for them. The same argument holds true for partners who choose not to become parents.

One of the main reasons why we aren’t always able to choose the best options for ourselves is that our rationality is often bounded by the amount of information it possesses, the cognitive limitations of our brains, and the finite amount of time we have to make a decision. According to the so-called ‘bounded rationality’ concept, we human beings are only partly rational and downright irrational in the remaining part of our actions. While economists believe that all human beings are approximately Homo economicus (economic man), rational and broadly self-interested by nature, the reality is that we are just as likely, if not more likely, to let emotions overrule rationality and completely dictate the way we behave.

That we are not wholly rational is shown by studies that have identified two distinct sides to our brains: one that is rational controlled, slow, deliberative and deductive; and one that is emotional automatic, rapid, associative and affective. The mesh between the two is extremely complex, and one does not always dominate the other. And while economic theories of decision making have tended to emphasise the operation of the rational side of our brain in guiding choice behaviour, it’s often the case that, when making decisions under pressure or under conditions where information is incomplete or overly complex, we tend to rely on simplifying heuristics or ‘gut feelings’ rather than extensive algorithmic processing. These ‘rules of thumb’ are far from perfect, and it’s precisely why we sometimes spend too much money on food when we go grocery shopping with an empty stomach, or find it increasingly difficult to walk away from a bus stop the longer we have been waiting for a bus to come even if it would have been a lot quicker to walk than to wait for that damn bus to arrive.

The adaptive unconscious and past experiences

But maybe it’s not always such a bad thing to trust our emotions. Research carried out by psychology professor Timothy Wilson suggests that, in situations where we have had a lot of experience, decisions made without thinking (those made on impulses and gut feelings) can often lead to better and happier outcomes than if they had been made under a strict rule of optimisation, simply because this is when the emotional part of our brain works best at detecting that something is out of the ordinary even if we may not know ourselves what that something is at the time and alerts us in the form of emotional alarm bells such as sweaty palms and butterflies in our stomach. And it’s in these scenarios that practice really makes perfect. It’s also where thinking too much about our past experiences can actually hurt rather than help us.

The question is: Why?

One reason. According to psychologist and Nobel laureate Daniel Kahneman, the cognitive part of our brain tends to suffer from what he called the ‘peak-end’ effect, which is the tendency to judge past experiences both pleasant and unpleasant almost entirely on how they were at their peak and how they ended.

Kahneman and his colleagues illustrated the core concept of the peak-end theory in a series of experiments, most notably that involving hospital patients and the very painful colonoscopy procedure. While undergoing a colonoscopy, the patients reported their level of discomfort every 60 seconds throughout the procedure. Afterwards, the patients were asked to remember how unpleasant the procedure was, using several different scales including a ten-point scale, and also about the relative unpleasantness of the colonoscopy compared to other unpleasant experiences such as stubbing a toe, or an average visit to the dentist.

What Kahneman and his colleagues found was astonishing. While there was almost zero correlation between the duration of the colonoscopies that different patients experienced and the global rating of the procedure, the relationship between the peak-end average (the average of the peaks and how the patients felt at the end of the procedure) and the global rating of the procedure was simply undeniable. In other words, we are more likely to remember our experience of a colonoscopy as being awful if the peaks of unpleasantness were very high or if it ended awfully for us, than if the entire procedure itself took a long time to finish. What matters is not the duration of an experience; we hardly ever think about it when we try to recall and judge how happy or unhappy we were in the past. It’s how we were feeling at the peaks and at the end of our experience that count the most.

What about frequency? Surely having experienced something often can teach us to repeat only the things that we remember with pleasure and fondness, and avoid those that we remember with embarrassment and regret? The trouble is, according to Harvard psychologist Daniel Gilbert, we are just not very good at remembering them correctly. He illustrates his point by prompting the readers of his book Stumbling on Happiness to think about where they were, whom they were with, and what they were doing when they first heard the news about the 9/11 attacks in 2001.

Okay, that sounds easy enough. Closing my eyes, I can still remember that I was standing at one of the check-in counters at London Heathrow airport, trying to get on the evening flight to Bangkok. Sitting behind the Finnair counter was a man in his late 50s who, as I recall, spoke with a very thick Glaswegian accent.

‘So you’re off to Thailand then, eh? Ah, what a beautiful country! Lovely food, gorgeous beaches, very pretty women!’ His eyes twinkled as he said this.

I smiled politely, acknowledging his appreciation of my country of birth. I knew he was just trying to be friendly in what seemed to be a surprisingly empty airport on a Tuesday afternoon.

‘Okay, sir. Here’s your boarding pass. Have a nice flight. Oh, and have you heard? Two planes hit the World Trade Center not half an hour ago. Probably a terrorist attack. But since you’re flying to Finland first, I’m sure you’ll be just fine.’ He ended with a beam while I stood there, rigid as a board.

Like me, most people will be able to remember in fine detail what they were doing when they first heard the news. But, Gilbert added, would the same people also remember precisely where they were, whom they were with, and what they were doing on the morning of 10 September 2001, one day before the attacks?

I personally couldn’t, of course. And I’m confident enough to bet that not many people could either, a fact that is also true for most Americans.

The main reason why it’s relatively easier for us to recall the exact details of 11 September 2001, but nearly impossible to remember what happened a day earlier, is because momentous events like the 9/11 attacks do not happen frequently in our lifetime. While 11 September 2001 defied our every sense of normality, 10 September, by contrast, was like almost any other day. And unless we religiously keep a diary of everything that ever happened in our lives, any other day is nothing more than a blob in our memory bank.

Daniel Gilbert’s message is clear: it is the infrequent and unusual experiences that are most memorable. These are the ones that stick like glue to the clipboard of our memory cortex. Not the other way round.

Conventional wisdom and imagination

There are two lessons we can draw at this stage. The first is that, in situations where we have had a lot of experience, it’s perhaps better to trust our instincts when it comes to making a decision. And the second lesson, related to the first, is that it seems important not to rely completely on emotions in situations where we have had little or no prior experience. The explanation is simple: in these circumstances, the emotional part of our brain will not have had enough chances to adapt and learn from our past experiences, which will inevitably make it impossible for it to distinguish which decision is better for us.

That sounds perfectly reasonable. All we need to do now is follow any great professional’s advice and just practise, practise, practise. Then afterwards, we can sit back in situations where we have had a lot of these experiences and just make snap decisions without having to think too much about the best outcomes.

Two problems, though. First, how do we know when we have had enough practice doing something? How do we know when we can let the rational brain take a back seat and the emotional brain do all the work? Will 10,000 hours of doing something repetitively be enough? Or will it take a lifetime of experience? Second, what about other, more novel situations? How do we know that we will be happier being married than staying single? How do we know whether we will be happier in a job that pays less but is nevertheless much closer to home? How can we be sure that rationality will not fail us when we have to face dilemmas that we have never faced before?

So now we’ve come full circle: economists’ description of how the world works though somewhat incomplete actually turns out to be useful advice on what we should do in situations where we have had little or no prior experience. According to theories on rational choice, there are perhaps two essential ingredients to successful decision-making when a degree of rationality is involved. The first is time. Unlike the emotional part of our brain where all decision-making is done instantaneously, the rational part of our brain needs time to think things over, to mull over the information. The second ingredient is getting the right information. It’s important that we have perfect awareness of all relevant information regarding the outcome of our choice before making a decision, especially one that could change our lives.

Since we can often find time to think things over before coming up with a solution for many of our life problems, could it just be the case that we don’t always have the right information about the choices we plan to make? Going back to the unhappy dentist, could it be possible that he decided to obtain a degree in dentistry on a whim or, worse, on a dare? Maybe. Nevertheless, considering the potentially life-changing impact of choosing the right career, it’s perhaps more likely that he did try to seek all the available information about how happy a career in dentistry would make him in eighteen years’ time. How could he then have been so wrong?

There are usually two ways of getting the information we need about the potential impacts of a novel experience. First, we can do some research about the experience. So in the case of the unhappy dentist, his decision to study dentistry could have been influenced by what he was expecting to get objectively from becoming a dentist, such as financial return, or by other people’s accounts of their subjective experiences as dentists, or even by conventional wisdom passed down from generation to generation.

Second, if all else fails, we can still use our imagination to conjure up the information we need to undertake a decision. We can try, for example, to picture ourselves in the future: what life would be like being married, or having kids, or having so much money we don’t know what to do with it.

. . .

from

THE HAPPINESS EQUATION. The Surprising Economics of Our Most Valuable Asset

by Nick Powdthavee

get it at Amazon.com

MIND IN THE MIRROR * Neuroplasticity in a Nutshell * Mindsight, Change Your Brain and Your Life – Daniel J. Siegel MD.

We come to know our own minds through our interactions with others.

As we welcome the neural reality of our interconnected lives, we can gain new clarity about who we are, what shapes us, and how we in turn can shape our lives.

Riding the Resonance Circuits

It’s folk wisdom that couples in long and happy relationships look more and more alike as the years go by. Peer closely at those old photographs, and you’ll see that the couples haven’t actually grown similar noses or chins. Instead, they have reflected each other’s expressions so frequently and so accurately that the hundreds of tiny muscle attachments to their skin have reshaped their faces to mirror their union. How this happens gives us a window on one of the most fascinating recent discoveries about the brain, and about how we come to “feel felt” by one another.

Some of what I’ll describe here is still speculative, but it can shed light on the most intimate ways we experience mindsight in our daily lives.

Neurons That Mirror Our Minds

In the mid-1990s, a group of Italian neuroscientists were studying the premotor area of a monkey’s cortex. They were using implanted electrodes to monitor individual neurons, and when the monkey ate a peanut, a certain electrode fired. No surprise there, that’s what they expected. But what happened next has changed the course of our insight into the mind. When the monkey simply watched one of the researchers eat a peanut, that same motor neuron fired. Even more startling: The researchers discovered that this happened only when the motion being observed was goal-directed. Somehow, the circuits they had discovered were activated only by an intentional act.

This mirror neuron system has since been identified in human beings and is now considered the root of empathy. Beginning from the perception of a basic behavioral intention, our more elaborated human prefrontal cortex enables us to map out the minds of others. Our brains use sensory information to create representations of others’ minds, just as they use sensory input to create images of the physical world. The key is that mirror neurons respond only to an act with intention, with a predictable sequence or sense of purpose. If I simply lift up my hand and wave it randomly, your mirror neurons will not respond. But if I carry out any act you can predict from experience, your mirror neurons will “figure out” what I intend to do before I do it. So when I lift up my hand with a cup in it, you can predict at a synaptic level that I intend to drink from the cup. Not only that, the mirror neurons in the premotor area of your frontal cortex will get you ready to drink as well.

We see an act and we ready ourselves to imitate it. At the simplest level, that’s why we get thirsty when others drink, and why we yawn when others yawn. At the most complex level, mirror neurons help us understand the nature of culture and how our shared behaviors bind us together, mind to mind. The internal maps created by mirror neurons are automatic, they do not require consciousness or effort. We are hardwired from birth to detect sequences and make maps in our brains of the internal state, the intentional stance, of other people. And this mirroring is “cross-modal”, it operates in all sensory channels, not just vision, so that a sound, a touch, a smell, can cue us to the internal state and intentions of another.

By embedding the mind of another into our own firing patterns, our mirror neurons may provide the foundation for our mindsight maps.

Now let’s take another step. Based on these sensory inputs, we can mirror not only the behavioral intentions of others, but also their emotional states. In other words, this is the way we not only imitate others’ behaviors but actually come to resonate with their feelings, the internal mental flow of their minds. We sense not only what action is coming next, but also the emotional energy that underlies the behavior. In developmental terms, if the behavioral patterns we see in our caregivers are straightforward, we can then map sequences with security, knowing what might happen next, embedding intentions of kindness and care, and so create in ourselves a mindsight lens that is focused and clear. If, on the other hand, we’ve had parents who are confusing and hard to “read,” our own sequencing circuits may create distorted maps.

So from our earliest days, the basic circuitry of mindsight can be laid down with a solid foundation, or created on shaky ground.

Knowing Me, Knowing You

I once organized an interdisciplinary think tank of researchers to explore how the mind might use the brain to perceive itself. One idea we discussed is that we make maps of intention using our cortically based mirror neurons and then transfer this information downward to our subcortical regions. A neural circuit called the insula seems to be the information superhighway between the mirror neurons and the limbic areas, which in turn send messages to the brainstem and the body proper. This is how we can come to resonate physiologically with others, how even our respiration, blood pressure, and heart rate can rise and fall in sync with another’s internal state.

These signals from our body, brainstem, and limbic areas then travel back up the insula to the middle prefrontal areas. I’ve come to call this set of circuits, from mirror neurons to subcortical regions, back up to the middle prefrontal areas, the “resonance circuits.” This is the pathway that connects us to one another. Notice what happens when you’re at a party with friends. If you approach a group that is laughing, you’ll probably find yourself smiling or chuckling even before you’ve heard the joke. Or perhaps you’ve gone to dinner with people who’ve suffered a recent loss. Without their saying anything, you may begin to sense a feeling of heaviness in your chest, a welling up in your throat, tears in your eyes. Scientists call this emotional contagion. The internal states of others, from joy and play to sadness and fear, directly affect our own state of mind. This contagion can even make us interpret unrelated events with a particular bias, so that, for example, after we’ve been around someone who is depressed we interpret someone else’s seriousness as sadness.

For therapists, it’s crucial to keep this bias in mind. Otherwise a prior session may shape our internal state so much that we aren’t open and receptive to the new person with whom we need to be resonating.

Our awareness of another person’s state of mind depends on how well we know our own. The insula brings the resonating state within us upward into the middle prefrontal cortex, where we make a map of our internal world. So we feel others’ feelings by actually feeling our own, we notice the belly fill with laughter at the party or with sadness at the funeral home. All of our subcortical data, our heart rate, breathing, and muscle tension, our limbic coloring of emotion, travels up the insula to inform the cortex of our state of mind. This is the main reason that people who are more aware of their bodies have been found to be more empathic.

The insula is the key: When we can sense our own internal state, the fundamental pathway for resonating with others is open as well.

The mind we first see in our development is the internal state of our caregiver. We coo and she smiles, we laugh and his face lights up. So we first know ourselves as reflected in the other. One of the most interesting ideas we discussed in our study group is that our resonance with others may actually precede our awareness of ourselves. Developmentally and evolutionarily, our modern self-awareness circuitry may be built upon the more ancient resonance circuits that root us in our social world.

How, then, do we discern who is “me” and who is “you”? The scientists in our group suggested that we may adjust the location and firing pattern of the prefrontal images to perceive our own mind. Increases in the registration of our own bodily sensations combined with a decrease in our mirror neuron response may help us know that these tears are mine, not yours, or that this anger is indeed from me, not from you. This may seem like a purely philosophical and theoretical question until you are in the midst of a marital conflict and find yourself arguing about who is the angry one, you or your spouse. And certainly, as a therapist, if I do not track the distinction between me and other, I can become flooded with my patients’ feelings, lose my ability to help, and also burn out quickly.

When resonance literally becomes mirroring, when we confuse me with you, then objectivity is lost. Resonance requires that we remain differentiated, that we know who we are, while also becoming linked. We let our own internal states be influenced by, but not become identical with, those of the other person.

It will take much more research to elucidate the exact way our mindsight maps make this distinction, but the basic issues are clear. The energy and information flow that we sense both in ourselves and in others rides the resonance circuits to enable mindsight.

As I consider the resonance circuits, two mind lessons stand out for me. One is that becoming open to our body’s states, the feelings in our heart, the sensations in our belly, the rhythm of our breathing, is a powerful source of knowledge. The insula flow that brings up this information and energy colors our cortical awareness, shaping how we reason and make decisions. We cannot successfully ignore or suppress these subcortical springs. Becoming open to them is a gateway to clear mindsight.

The second lesson is that relationships are woven into the fabric of our interior world. We come to know our own minds through our interactions with others. Our mirror neuron perceptions, and the resonance they create, act quickly and often outside of awareness. Mindsight permits us to invite these fast and automatic sources of our mental life into the theater of consciousness. As we welcome the neural reality of our interconnected lives, we can gain new clarity about who we are, what shapes us, and how we in turn can shape our lives.

Neuroplasticity in a Nutshell – Daniel J. Siegel MD

Change Your Brain and Your life – Daniel J. Siegel MD

from

Mindsight, change your brain and your life

by Daniel J. Siegel MD

get it at Amazon.com

Inequality and Revolution – Bryan Bruce * An Analysis of ‘The New Zealand Way’ – Georg Menz.

Today inequality is an all too familiar word in our country and the coalition’s handing of the economy isn’t fixing it.

Why? Because it’s the same neoliberal approach the last National government took and the Clarke government before it .. going all the way back to David Lange and Roger Douglas who introduced this economic virus in 1984.

So how and when will things change?

Bryan Bruce . . . The Daily Blog

The New Zealand Way

Georg Menz

How did a country known for its progressive policies, its welfare state and its anti nuclear and environmental policies so quickly and emphatically embrace the tenets of Neoliberalism and the New Right?

New Zealand, in the 1980s, went from being one of the most regulated countries in the OECD to being one of the most deregulated.

. . . An Analysis of ‘The New Zealand Way’ – Georg Menz

WE MUST ACT NOW! If We’d Been Lucky – Chris Trotter * IPCC Special Report 2018. Global Warming of 1.5°C, The Impact.

The Big IFs: We are so unlucky that it has come to this. Especially when, had things worked out just a little differently we might have had a chance. If Florida’s voters had swung decisively behind Al Gore in the 2000 US Presidential Election. If the Baby Boom Generation hadn’t abandoned their idealism for cycling holidays in France and a renovated kitchen. If the Millennials possessed an attention span just a little bit longer than a goldfish’s. If the Internet hadn’t allowed us all to become so stupid.

NOBODY WANTS TO KNOW. That 150 academics have put their name to a letter urging the government to do something – anything – about climate change: nobody wants to know. The letter itself is a response to the latest report from the Intergovernmental Panel on Climate Change (IPCC). That report gives the world just 12 years to fundamentally refashion industrial civilisation or face runaway global warming. But, nobody wants to know.

Al Gore would almost certainly have got Bin Laden before he got America. (The Democrats recognised Osama as a threat, the Republicans were more focussed on Iraq and Iran.) So, no 9/11. No War on Terror. No invasions of Afghanistan and Iraq. A less crazed world. A real chance that the big global players: the USA, the UK, the EU, China, Japan and the Russian Federation might have trusted each other enough to come together around the science and take climate change seriously.

What would that have looked like?

. . . Bowalley Road

WE MUST ACT NOW! IPCC Special Report 2018. Global Warming of 1.5°C, The Impact.

THE HOME OF EMPATHY. The Mirror Neuron System – V. Rajmohan and E. Mohandas.

The Mirror Neuron System (MNS) discovery is considered to be the most important landmark in neuroscience research during the last decade.

The Mirror neuron system is a group of specialized neurons that “mirrors” the actions and behaviour of others.

Theory of mind (ToM) or mentalisation is the ability to recognize that someone else has a mind different from one’s own.

The Mirror neuron system is a group of specialized neurons that “mirrors” the actions and behaviour of others. The involvement of mirror neuron system (MNS) is implicated in neurocognitive functions (social cognition, language, empathy, theory of mind) and neuropsychiatric disorders. MNS discovery is considered to be the most important landmark in neuroscience research during the last decade.

MIRROR NEURON SYSTEM DISCOVERY

The mirror neurons were discovered serendipitously by Giacomo Rizzolatti and colleagues while working on the grasp response of macaques. They observed that a group of neurons in the area F5 of the premotor cortex that fires when a macaque performs an action; also discharges when it observes the same action being performed by another animal. Subsequent research has elucidated the diverse regions involved in the MNS of monkeys. Recently different cortical structures have been described as part of the MNS in humans.

MNS in monkeys

The area F5 of the premotor cortex (premotor area located in the posterior bank of the inferior arcuate sulcus and the cortical convexity immediately caudal to it) in monkeys has two sets of visuomotor neurons namely the ‘canonical’ and the ‘mirror neurons’. The ‘canonical neurons’ (in F5 bank region) respond to presentation of an object while mirror neurons (in F5 convexity) respond to performance of an action and observation of an object directed action. The mirror neurons are triggered by any action that involves the interaction between a biological effector (mouth, hand etc.) and an object. They are stimulated by the observation of the exact same action involving the effector and object (‘strictly congruent’ neurons) and also by actions that are similar but not having exact effect or object interaction (‘broadly congruent’ neurons).

Other areas that form part of the MNS are the superior temporal sulcus (STS) and the area 7b (PF of Von Economo) in the inferior parietal lobule (IPL). The STS codes for a larger number of movements than the F5 neurons but lacks motor properties (i.e., does not discharge while performing the movement). The area 7b neurons in IPL are heterogeneous and have a role in coding sensory stimuli and respond to somatosensory, visual or bimodal stimuli. In addition to this, they also have motor properties and discharge on action observation and performance. The IPL receives inputs from the STS and sends an important output to the ventral premotor cortex including area F5.

Figure 1. Basic mirror neuron circuitry in monkey. F1: Primary motor cortex, F5: Premotor cortex, IPL: inferior parietal lobule, STS: superior temporal sulcus.

MNS in humans

Brain imaging studies reveal that action observation in humans activates the inferior frontal gyrus (IFG), lower part of the precentral gyrus, the rostral part of the IPL and also the temporal, occipital and parietal visual areas. The frontal and the parietal mirror neuron regions are somatotopically organized. The activation of pars opercularis of the IFG reflects the observation of distal hand and mouth actions, whereas the activation of the premotor cortex reflects proximal arm and neck movements [Figure 2]. The mirror neurons in humans, unlike those in monkeys fire even while observing meaningless (intransitive) movements. The observation of transitive actions causes the firing of the frontal and the temporal nodes of the MNS while that of intransitive actions result in the firing of the frontal node only.

Figure 2. Mirror neuron regions in humans

FUNCTIONS OF MNS

Action understanding

Action understanding is the fundamental function of the MNS. Each time the animal observes a certain action being performed by another animal, the mirror neurons representing the performance of that action are activated. The mirror neurons transform visual observation into knowledge. Studies on humans during action observation have shown activation of the IFG, the IPL and a region within the STS. The precentral motor cortex though not activated by action observation is involved indirectly in action understanding as they have a role in motor imagery.

The main hypotheses to explain the phenomenon of action understanding are the visual hypothesis, direct-match hypothesis and the ‘generate and test’ model. Visual hypothesis is based on the visual analysis of the effector, the object and on the context in which the action is going on to draw conclusions as to the meaning of the action. The neural substrates are visual extrastriate areas, inferotemporal lobe and STS region. The direct match hypothesis is based on the mapping of observed action on his/her own motor representation of the observed action. Therefore it involves a process of observation induced motor representation, followed by matching of this to the motor representation generated during active outcome directed action performed by the individual (simulation). If both these motor representations correspond, it leads to action understanding.

A more complex hypothesis suggested for action understanding is the ‘generate and test’ model. According to this model, action understanding involves finding a ‘pretend’ goal that would generate an action plan in the observer’s own motor planning system. This is then matched with the observed action. It is presumed that when the simulated motor action does not match the observed one, a new hypothesis is generated and tested for congruence with the observed action. So actions are understood not just in terms of their outcomes, but also in terms of the mental states and especially the goals, that have generated them.

Imitation

Basic circuit underlying imitation coincides with that which is active during action observation. Imitation requires a perfect matching of the performed action onto the observed one. Mirror neurons are able to recognize the actions of others and the intention associated with them. So they can code for likely future actions of others, thereby observers are able to anticipate the actions of others.

Human imitation involves flow of information through the STS, IPL and the IFG. STS provides higher order visual processing of observed action while the fronto-parietal MNS codes for the goal of the action and the motor plan on how to achieve it. The fronto-parietal system then sends copies of this motor plan to the STS, which matches the predicted sensory consequence of the planned motor action with the visual description of the observed action. The efferent copies to the STS originate from the ventral sector of the pars opercularis of the IFG, the activity of which is specific to imitation.

There is a difference during imitative learning of tasks between novel tasks and the tasks that are part of the observer’s motor repertoire. The frontal and parietal areas are activated during observation of a task that is part of one’s repertoire. The imitation of novel action in addition to the above regions involves the dorsolateral prefrontal cortex (DLPFC) and the cortical areas relevant to motor preparation namely: dorsal premotor cortex (PMd), mesial prefrontal cortex and the superior parietal lobule. So the basic imitation learning circuit consists of IFG, IPL, STS, motor preparation areas and DLPFC.

Figure 3. Mirror neuron structures in imitation

Speech and language

The presence of mirror neurons in Broca’s area of humans suggests that human language may have evolved from a gesture performance/understanding system. The tasks like spontaneous speech and reading activate the hand motor area and the IFG, on the left side. So language mirror neurons seem to be lateralized to the left side involving the dominant hand motor cortex and the higher levels of language network.

Theory of mind

Theory of mind (ToM) or mentalisation is the ability to recognize that someone else has a mind different from one’s own. It involves the ability to infer someone else’s mind by facial expression, tone of voice and non-verbal communication. It involves the area concerned with action imitation, face imitation and intention understanding. The neural structures involved in ToM include IFG, right STS, right IPL, medial prefrontal cortex including the anterior cingulate cortex (ACC) orbitofrontal cortex (OFC), precuneus, somatosensory cortex, amygdala and the occipital cortex. Therefore the MNS is considered integral to the theory of mind.

Social communication and empathy

Social communication and identification involve imitation. The more people tend to imitate each other, the more they are able to develop an empathic relationship. Social mirroring involves the interaction of the core mirror neuron system with the limbic system. Imaging studies have shown that observation and imitation of facial emotional expression involve the fronto-parietal mirror neuron system, STS, insula and the limbic system [Figure 3].

Empathy is a process which involves the affective sharing between self and others, adopting the perspective of others and the ability for self agency and self regulation. The neural correlates empathy include IFG, right STS, right IPL, ACC, ventromedial prefrontal cortex (VMPFC), somatosensory cortex, amygdala, precuneus, insula and the posterior cingulate. Thus empathy involves a significant interaction of the core MNS and its limbic extension.

Table 1. Neural correlates of mirror neuron system, theory of mind and empathy

Social cognition

Social cognition refers to thought processes involved in understanding and dealing with others. It involves regions that mediate face perception, emotional processing, theory of mind, empathy (especially self reference) and working memory. The MNS involvement in mediating empathy and ToM reflects its significant role in social cognition.

Mirror neurons and neuropsychiatric disorders

Autism and autism spectrum disorders (ASD) are characterized by social impairment, the lack of ToM and demonstrable defects in imitation skills. This implies dysfunctional MNS in ASD. Neuroimaging studies have demonstrated lesser activation of Broadman’s area (BA) 44/45, the superior temporal gyrus (BA 22), the right insula and the left amygdala. A recent study also demonstrated the lack of MNS activity during observation and emotional expression in children with ASD.

The mirror neurons may also be involved in the development of disorders with hypersociality like William’s syndrome and Turner’s syndrome. The relevance of mirror neurons in social cognition may account for dysfunctional MNS in social phobia and asociality observed in schizophrenia.

The MNS also plays an important role in bonding and attachment. Dysfunctional MNS may play a role in antisocial and borderline personality disorder. The patients with borderline personality disorder lack the ability to discern the mental states of self and others. They have fractured early attachments leading to a deficiency in learning of the concepts like secure attachment and the capacity to mentalise. Psychotherapeutic processes involve the MNS accounting for empathy and ToM.

CONCLUSION

The fascinating discovery of MNS has generated tremendous enthusiasm among researchers in cognitive neuroscience. The involvement of MNS in social cognition, empathy and ToM has fuelled interest in explaining its role in ASD, schizophrenia, personality disorders and psychotherapeutic processes. The future research may unravel mysteries surrounding MNS.

Indian Journal of Psychiatry

SOUL DAMAGE. The Precious Resources of Our Time and Attention – Linda and Charlie Bloom.

How do we nurture our soul?

Soul-damage occurs when we deny ourselves the kinds of enriching experiences that we need to have in order to thrive, rather than simply survive, experiences that make our heart sing, that infuse our lives with a sense of passion and vitality.

Most of us know that there are certain kinds of experiences that nurture our souls and others that don’t. We also know that “experiences” are not “things,” and that although things, like money, homes, and motor vehicles do matter in our lives, they do not nourish our hearts and spirits. There’s nothing wrong with something that enhances only the material as long as we don’t expect more from it than that. For most of us, separating unrealistic expectations from real ones is not easy.

If we spent even 10% as much of our time and energy on matters of the heart as we do on matters that relate to the fulfillment of our ego’s desires, our quality of life would transform.

For most of us, even 10% would represent a several-fold increase of our time. Many of us give more time and concern towards the maintenance of our cars than to our deeper needs. We may insist that what we most value is love, inner peace, family, or ‘truth”, yet our lives may not reflect this priority.

It has been said that you can know a person by the way in which they spend their time, not by their words. What we truly love is what we give our energies to, and this may not be what we say matters most to us.

It is the first and most critical step in the process of bringing integrity into our lives. Until we have done so, self-deception and rationalization will permeate our daily existence.

Psychology Today