A Mother’s Reckoning. Living in the aftermath of the Columbine tragedy – Sue Klebold.

To all who feel alone, hopeless, and desperate, even in the arms of those who love them.

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On April 20, 1999, Eric Harris and Dylan Klebold walked into Columbine High School in Littleton, Colorado. Over the course of minutes, they would kill twelve students and a teacher and wound twenty-four others before taking their own lives.

Since then, Sue Klebold, Dylan’s mother, has lived with the indescribable grief and shame of that day. How could her child, the promising young man she had loved and raised, be responsible for such horror? And how, as his mother, had she not known something was wrong? Were there subtle signs she had missed? What, if anything, could she have done differently?

These are questions that Klebold has grappled with every day since the Columbine tragedy. In A Mother’s Reckoning, she chronicles with unflinching honesty her journey as a mother trying to come to terms with the incomprehensible. In the hope that the insights and understanding she has gained may help other families recognize when a child is in distress, she tells her story in full, drawing upon her personal journals, the videos and writings that Dylan left behind, and on countless interviews with mental health experts.

Filled with hard-won wisdom and compassion, A Mother’s Reckoning is a powerful and haunting book that sheds light on one of the most pressing issues of our time. And with fresh wounds from the recent Newtown and Charleston shootings, never has the need for understanding been more urgent.

All author profits from the book will be donated to research and to charitable organizations focusing on mental health issues.

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About the author

Sue Klebold is the mother of Dylan Klebold, one of the two shooters at Columbine High School in 1999 who killed 13 people before ending their own lives, a tragedy that saddened and galvanized the nation. She has spent the last 15 years excavating every detail of her family life, and trying to understand the crucial intersection between mental health problems and violence. Instead of becoming paralyzed by her grief and remorse, she has become a passionate and effective agent working tirelessly to advance mental health awareness and intervention.

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Klebold family photo, Christmas 1991. From I to r: me, Byron, Dylan, and Tom.

Introduction

And must I, indeed, Pain, live with you
All through my life? – sharing my fire, my bed,
Sharing-oh, worst of all things! – the same head?
And, when I feed myself, feeding you, too?
Edna St. Vincent Millay

We have consistently blamed parents for the apparent defects of their children. The eighteenth-century theory of imaginationism held that children had deformities because of their mothers’ unexpressed lascivious longings. In the twentieth century, homosexuality was said to be caused by overbearing mothers and passive fathers; schizophrenia reflected the parents’ unconscious wish that their child did not exist; and autism was the result of “refrigerator mothers,” whose coldness doomed their children to a fortress of silence.

We’ve now realized that such complex and overdetermined conditions are not the result of parental attitude or behavior. We nonetheless continue to assume that if you could only get inside the households in which killers were raised, you’d see the parents’ errors writ large.

The perception of children as tractable has been a hallmark of social justice; it has led us to seek rehabilitation for juveniles rather than simply punishment. According to this logic, a bad adult may be irrecoverably bad, but a bad kid is only a reflection of negative influences, the product of pliable nurture rather than immutable nature. There can be truth in that pleasant optimism, but to go from there to presuming parental culpability is a gross injustice.

We cling to the notion that crime is the parents’ fault for two primary reasons. First, it is clear that severe abuse and neglect can trigger aberrant behavior in vulnerable people. Poor parenting can push such children toward substance abuse, gang membership, domestic violence, and thievery. Attachment disorders are frequent in victims of childhood cruelty; so is a repetition compulsion that drives them to recapitulate the aggression they have known. Some parents damage their children, but that does not mean that all troubled children have incompetent parents. In particular, extreme, irrational crimes are not usually triggered by anything the parents have done; they come out of an illogic too profound to be instigated by trauma.

Second, and far more powerfully, we want to believe that parents create criminals because in supposing that, we reassure ourselves that in our own house, where we are not doing such wrong things, we do not risk this calamity. I am aware of this delusion because it was mine.

When I met Tom and Sue Klebold for the first time on February 19, 2005, I imagined that I would soon identify their flaws. I was working on a book, Far from the Tree, about parents and their challenging offspring, and I thought these parents would be emblematic of erroneous parenting. l never imagined they had egged their child on to heinous acts, but I did think that their story would illuminate innumerable, clear mistakes. I didn’t want to like the Klebolds, because the cost of liking them would be an acknowledgment that what happened wasn’t their fault, and if it wasn’t their fault, none of us is safe. Alas, I liked them very much indeed. So I came away thinking that the psychopathy behind the Columbine massacre could emerge in anyone’s household. It would be impossible to predict or recognize; like a tsunami, it would make a mockery of all our preparations.

In Sue Klebold’s telling, she was an ordinary suburban mother before Columbine. I didn’t know her then, but in the wake of that tragedy, she found the strength to extract wisdom from her devastation. To sustain your love in these circumstances is an act of courage. Her generosity in friendship, her lively gift for affection, and her capacity for attention, all of which I’ve been privileged to know, render the tragedy more bewildering.

I started off thinking that the Klebolds should have disavowed their child, but I ended up understanding that it took far more steel to deplore what he had done yet be unflagging in their love. Sue’s passion for her son is evident in every one of these griefstricken pages, and her book is a testament to complexity.

She argues that good people do bad things, that all of us are morally confused, and that doing something terrible does not erase other acts and motives.

The ultimate message of this book is terrifying: you may not know your own children, and, worse yet, your children may be unknowable to you. The stranger you fear may be your own son or daughter.

“We read our children fairy tales and teach them that there are good guys and bad guys,” Sue said to me when l was writing Far from the Tree. “I would never do that now. I would say that every one of us has the capacity to be good and the capacity to make poor choices. If you love someone, you have to love both the good and the bad in them.”

At the time of Columbine, Sue worked in the same building as a parole office and had felt alienated and frightened getting on the elevator with ex-convicts. After the tragedy, she saw them differently. “I felt that they were just like my son. That they were just people who, for some reason, had made an awful choice and were thrown into a terrible, despairing situation. When I hear about terrorists in the news, I think, ‘That’s somebody’s kid.’ Columbine made me feel more connected to mankind than anything else possibly could have.” Bereavement can give its dupes great compassion.

Two kinds of crime upset us more than any others: crimes in which children are the victims, and crimes in which children are the perpetrators. In the first case, we mourn the innocent; in the second, our misapprehension that children are innocent. School shootings are the most appalling crimes of all, because they involve both problems, and among school shootings Columbine remains something of a gold standard, the ultimate exemplar to which all others are indebted.

The extreme selfimportance tinged with sadism, the randomness of the attack, and the scale of the advance planning have made Eric Harris and Dylan Klebold heroes to a large community of causeless young rebels, while they are hailed by most people as psychologically damaged and by some religious communities as icons of Satanism. The boys’ motives and purposes have been analyzed time and again by people who want to protect their children from such assaults. The most dauntless parents also wonder how to be certain that their children are incapable of committing such crimes. Better the enemy you know than the enemy you don’t know, says the adage, and Columbine was above all an ambush of unknowability, of horror hidden in plain sight.

It has been impossible to see the killers clearly. We live in a society of blame, and some of the victims’ families were relentless in their demand for impossible “answers” that were being kept “hidden.” The best evidence that the parents didn’t know is the surety that if they had, they’d have done something.

Jefferson County magistrate John DeVita said of the two boys, “What’s mind-boggling is the amount of deception. The ease of their deception. The coolness of their deception.”

Most parents think they know their children better than they do; children who don’t want to be known can keep their inner lives very private. The victims’ families’ lawsuits were predicated on the dubious principles that human nature is knowable, that interior logic can be monitored, and that tragedies follow predictable patterns. They have sought some missing information that would change what happened. Jean-Paul Sartre once wrote, “Evil is not an appearance,” adding that “knowing its causes does not dispel it.” Sartre seems not to have been read very much in the Denver suburbs.

Eric Harris appears to have been a homicidal psychopath, and Dylan Klebold, a suicidal depressive, and their disparate madnesses were each other’s necessary condition. Dylan’s depressiveness would not have turned into murderousness without Harris’s leadership, but something in Eric might have lost motivation without the thrill of dragging Dylan down with him. Eric’s malice is shocking, Dylan’s acquiescence, equally so.

Dylan wrote, “Thinking of suicide gives me hope that i’ll be in my place wherever I go after this life, that I’ll finally not be at war with myself, the world, the universe, my mind, body, everywhere, everything is at PEACE, me, my soul (existence).” He described his own, “eternal suffering in infinite directions through infinite realities.” The most common word in his journals is love.

Eric wrote, “how dare you think that l and you are part of the same species when we are sooooooooo different. you aren’t human, you are a robot and if you pissed me off in the past, you will die if I see you.” His journal describes how in some imagined collegiate future he would have tricked girls to come to his room and raped them. Then, “I want to tear a throat out with my own teeth like a pop can. I want to grab some weak little freshman and just tear them apart like a fucking wolf, strangle them, squish their head, rip off their jaw, break their arms in half, show them who is god.” Eric was a failed Hitler; Dylan was a failed Holden Caulfield.

Sue Klebold emphasizes the suicidal element in her son’s death. Karl Menninger, who has written extensively on suicide, said that it requires the coincidence of “the wish to kill, the wish to be killed, and the wish to die.” The wish to kill is not always directed outward, but it is an essential piece of the puzzle. Eric Harris wanted to kill and Dylan Klebold wanted to die, and both thought their experience contained seeds of the divine; both wrote of how the massacre would make them into gods. Their combination of grandiosity and ineptitude contains echoes of ordinary adolescence.

In the commons at Columbine High School, toward the end of the spree, a witness hiding in the cafeteria heard one of the killers say, “Today the world’s going to come to an end. Today’s the day we die.” This is an infantile conflation of the self with the other.

G. K. Chesterton wrote, “The man who kills a man kills a man. The man who kills himself kills all men. As far as he is concerned, he wipes out the world.”

Advocates for the mentally ill point out that most crime is not committed by people with mental illnesses, and that most people with mental illnesses do not commit crimes. What does it mean to consider Columbine as the product of minds that were not mentally ill? There are many crimes that people resist either because they know they’d get in trouble or because they have learned moral standards. Most people have seen things they’d like to steal. Most people have felt an occasional flash of murderous rage toward someone with whom they are intimate. But the reasons for not killing kids you barely know at school and holding the place hostage is not that you fear punishment or grapple with received morality; it’s that the whole idea never crosses healthy minds.

Though he was depressed, Dylan did not have schizophrenia, PTSD, bipolar illness, or any other condition that fits the neat parameters of psychiatric diagnosis.

The existence of disordered thinking does not mitigate the malevolence of Dylan’s acts. Part of the nobility of this book is that it doesn’t try to render what he did into sense. Sue Klebold’s refusal to blame the bullies, the school, or her son’s biochemistry reflects her ultimate determination that one must simply accept what can never be explained away. She does not try to elucidate the permanently confused borderline between evil and disease.

Immediately after the massacre, a carpenter from Chicago came to Littleton and erected fifteen crosses-one for each victim, including Dylan and Eric. Many people piled flowers at Eric’s and Dylan’s crosses just as they did at the others. Brian Rohrbough, father of one of the victims, removed Harris’s and Klebold’s markers.

“You don’t cheapen what Christ did for us by honoring murderers with crosses,” he said. “There’s nowhere in the Bible that says to forgive an unrepentant murderer. You don’t repent, you don’t forgive them that’s what the Bible says.”

There is obviously scope for revising this interpretation of Christian doctrine, but Rohrbough’s assertion hinges on the mistaken notion that mourning the deaths of the killers is tantamount to forgiveness, and that forgiveness conceals the horror of what was done. Sue Klebold does not seek or even imagine forgiveness for her son. She explains that she didn’t know what was happening, but she doesn’t exonerate herself; she presents her not knowing as a betrayal of her son and the world. The death of someone who has committed a great crime may be for the best, but any dead child is some parent’s vanquished hope. This mournful book is Sue’s act of vicarious repentance. Hatred does not obliterate love. Indeed, the two are in constant fellowship.

Sue told me at our first meeting about the moment on April 20, 1999, when she learned what was happening at Columbine High School. “While every other mother in Littleton was praying that her child was safe, I had to pray that mine would die before he hurt anyone else,” she said. “I thought if this was really happening and he survived, he would go into the criminal justice system and be executed, and I couldn’t bear to lose him twice. I gave the hardest prayer I ever made, that he would kill himself, because then at least I would know that he wanted to die, and I wouldn’t be left with all the questions I’d have if he got caught by a police bullet. Maybe I was right, but I’ve spent so many hours regretting that prayer: I wished for my son to kill himself, and he did.”

At the end of that weekend, I asked Tom and Sue what they would want to ask Dylan if he were in the room with us, Tom said, “I’d ask him what the hell he was thinking and what the hell he thought he was doing!” Sue looked down at the floor for a minute before saying quietly, “I would ask him to forgive me, for being his mother and never knowing what was going on inside his head, for not being able to help him, for not being the person that he could confide in.”

When I reminded her of this conversation five years later, she said, “When it first happened, I used to wish that I had never had children, that I had never married. lf Tom and I hadn’t crossed paths at Ohio State, Dylan wouldn’t have existed and this terrible thing wouldn’t have happened. But over time, I’ve come to feel that, for myself, I am glad I had kids and glad I had the kids I did, because the love for them, even at the price of this pain, has been the single greatest joy of my life. When I say that, I am speaking of my own pain, and not of the pain of other people. But I accept my own pain; life is full of suffering, and this is mine. I know it would have been better for the world if Dylan had never been born. But I believe it would not have been better for me.”

We tend to lose someone all at once, but Sue’s loss came in repeated waves: the loss of the boy himself; the loss of her image of him; the loss of her defenses against recognizing his darkest self; the loss of her identity as something other than the mother of a killer; and the loss of the fundamental belief that life is subject to logic, that if you do things right you can forestall certain grim outcomes. Comparative grief is not a fruitful measurement, and it would be wrong to say that Sue Klebold’s was the most shattering of all the losses in Littleton. But she is stuck with the impossibility of disentangling the pain of finding she had never known her son from the pain of knowing what devastation he caused others. She fights the sadness of a dead child, the sadness of the other dead children, and the sadness of having failed to bring up a happy child who makes the world better.

It’s a heady experience to have young children and be able to fix the little problems they bring to you; it’s a terrible loss when they start to have problems beyond your ability to resolve. That universal disappointment is presented here on a vastly inflated scale. Sue Klebold describes her natural impulse to please people, and makes it clear that writing has required a disavowal of that predilection. Her book is a tribute to Dylan without being an excuse, and a moving call to action for mental health advocacy and research. Moral, determined, and dignified, Sue Klebold has arrived at an impenetrable aloneness. No one else has had this experience. To some degree, it has made Sue unknowable, just as Dylan was. In writing of her experience, she has chosen a kind of public unknowability.

Ovid delivered a famous injunction to “welcome this pain, for you will learn from it.” But there is little choice about such pain; you do not have the option of not welcoming it. You can express displeasure at its arrival, but you cannot ask it to leave the house. Sue Klebold has never complained of being a victim, but her narrative echoes that of Job, who says, “Shall we receive good from God and shall we not receive evil?” And then, “For the thing which I greatly feared is come upon me, and that which I was afraid of is come unto me. I was not in safety, neither had I rest, neither was i quiet; yet trouble came.” And finally, “Though I speak, my grief is not assuaged.”

Sue Klebold’s book narrates her Job-like descent into an incomprehensible hell, her divorce from safety. Perhaps most impressively, her book acknowledges that speech cannot assuage such grief. She doesn’t even try. This book is not a cathartic document intended to make her feel better. It is only a narrative of acceptance and of fight, of harnessing her torment in hopes of sparing others pain like hers, like her son’s, and like his victims’.

Andrew Solomon

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Preface

ON APRIL 20, 1999, Eric Harris and Dylan Klebold armed themselves with guns and explosives and walked into Columbine High School. They killed twelve students and a teacher, and wounded twenty-four others, before taking their own lives. It was the worst school shooting in history.

Dylan Klebold was my son.

I would give my life to reverse what happened that day. In fact, I would gladly give my own in exchange for just one of the lives that was lost. Yet I know that such a trade is impossible. Nothing I will ever be able to do or say can possibly atone for the massacre.

Sixteen years have passed since that terrible day, and l have dedicated them to understanding what is still incomprehensible to me, how a promising boy’s life could have escalated into such a disaster, and on my watch. I have interrogated experts as well as our family, Dylan’s friends, and, most of all, myself. What did I miss, and how could I have missed it? I have scoured my daily journals. l have analyzed our family life with the ferocity of a forensic scientist, turning over mundane events and exchanges in search of the clues I missed.

What should I have seen? What could I have done differently?

My quest for answers began as a purely personal mission, a primal need to know as strong as the shame and horror and grief that overwhelmed me. But I have come to see that the fragments I hold offer clues to a puzzle many are desperate to solve. The hope that what I have learned may help has led me to the difficult but necessary step of going public with my story.

There is a world between where I stand now and the view I had before Columbine, when our family life looked like that of a typical suburban American family. In more than a decade of searching through the wreckage, my eyes have opened, not only to those things once hidden to me about Dylan and the events leading up to that day, but also to the realization that these insights have implications that extend far beyond Columbine.

I’ll never know whether I could have prevented my son’s terrible role in the carnage that unfolded that day, but I have come to see things I wish I had done differently. These are small things, threads in the larger tapestry of a normal family’s life. Because if anyone had peeked inside our lives before Columbine, I believe that what they would have seen, even with the tightest zoom lens, was thoroughly ordinary, no different from the lives unfolding in countless homes across the country.

Tom and I were loving, attentive, and engaged parents, and Dylan was an enthusiastic, affectionate child. This wasn’t a kid we worried and prayed over, hoping he would eventually find his way and lead a productive life. We called him “The Sunshine Boy”, not just because of his halo of blond hair, but because everything seemed to come easily to him. I was grateful to be Dylan’s mother, and loved him with my whole heart and soul.

The ordinariness of our lives before Columbine will perhaps be the hardest thing for people to understand about my story. For me, it is also the most important. Our home life was not difficult or fraught. Our youngest child was not a handful, let alone someone we (or others who knew him) would have imagined to be a risk to himself or to anyone else. I wish many things had been different, but, most of all, I wish I had known it was possible for everything to seem fine with my son when it was not.

When it comes to brain health issues, many of our children are as vulnerable today as children a hundred years ago were to infectious diseases. Far too often, as in our case, their susceptibility goes undetected. Whether a child flames out in a horrifying scenario, or whether their potential for happiness and productivity merely fizzles, this situation can be as confounding as it is heartbreaking. If we do not wake up to these vulnerabilities, the terrible toll will continue to rise. And that toll will be counted not just in tragedies such as Columbine or Virginia Tech or Newtown or Charleston, but in countless quieter, slow-burning tragedies playing out every day in the family lives of our coworkers, friends, and loved ones.

There is perhaps no harder truth for a parent to bear, but it is one that no parent on earth knows better than I do, and it is this: love is not enough.

My love for Dylan, though infinite, did not keep Dylan safe, nor did it save the thirteen people killed at Columbine High School, or the many others injured and traumatized. I missed subtle signs of psychological deterioration that, had I noticed, might have made a difference for Dylan and his victims, all the difference in the world.

By telling my story as faithfully as possible, even when it is unflattering to me, I hope to shine a light that will help other parents see past the faces their children present, so that they can get them help if it is needed.

Many of my own friends and colleagues have changed their parenting styles as a result of knowing our story. In some instances, their interventions have had dramatic results, as when a former colleague noticed that her thirteen-year-old daughter seemed slightly withdrawn. With Dylan in mind, she pressed (and pressed, and pressed). Eventually, her daughter broke down and confessed that a stranger had raped her while she was sneaking out to see a friend. The girl was deeply depressed and ashamed and afraid, and she was seriously considering taking her own life.

My colleague was able to help her child because she noticed subtle changes, and kept asking. I take heart in knowing that my colleague effected a happier ending for her daughter’s story because she knew ours, and I believe only good can come from widening the circle of people who know it.

It is not easy for me to come forward, but if the understanding and insights l have gained in the terrible crucible of Columbine can help, then I have a moral imperative to share them. Speaking out is frightening, but it is also the right thing to do. The list of things I would have done differently if I had known more is long. Those are my failures. But what I have learned implies the need for a broader call to action, a comprehensive overview of what should be in place to stop not only tragedies like the one committed by my son but the hidden suffering of any child.

I began writing about the experience of Columbine almost from the moment it happened, because writing about my son’s cruel behavior and his suicide was one of the ways I coped with the tragedy. I never made a conscious decision to write. I kept writing just as I kept breathing.

Deciding what to do with the words I had put down on paper came much later. Initially, I didn’t think I had the inner strength to publish my thoughts about Dylan and our family. I was terrified that sharing my personal account would cause members of the community as well as my own loved ones to relive the shattering experience of the Columbine shootings. I didn’t want the hate mail and the media circus to begin all over again, because I didn’t think that any of us could withstand it a second time.

It wasn’t until years after the incident that I secured a publisher, and the manuscript was completed. As I inched toward the inevitable day when A Mother’s Reckoning would be released to the public and I would have to make media appearances to support the book, I felt like a rabbit ready to bolt across an open field.

In the end, I was able to take that step because the messages I hoped to convey were a matter of life and death. I felt a responsibility to educate parents and families about what happened, and why. I believed that hearing what Dylan had gone through might be beneficial to others, especially those who are struggling with lethal thoughts, or who find themselves or their loved ones trapped in a cycle of hopelessness.

If anyone close to Dylan had been able to grasp that he was experiencing a health crisis that impaired his judgement, compelled him to fixate on violence, misled him to dehumanize others, and enabled him to kill his schoolmates and a teacher before killing himself, we could have intervened, and gotten him the help he needed to move beyond the period of crisis.

In the years since the Columbine tragedy, the world has changed and people are more willing to consider that behavioral health is part of health. Since the tragedy l have witnessed significant changes in mental health care, school policy, active shooter responses, and suicide prevention. More and more people recognize that we don’t lose our bearings because we’re bad people. Persistent thoughts of death and suicide are symptoms of pathology, not of flawed character.

When A Mother’s Reckoning came out, l was surprised and grateful for the heartfelt, positive response from readers and from the media. My deepest fear that the book would regenerate a firestorm of anger and pain and reopen the wounds of April 1999 did not materialize. The message I most often hear from readers is, “Thank you for sharing your story.” A number of parents have told me that they see their own children in a new light, and are listening to them more carefully. Some have gone on to say they think every parent should read the book. Others shared with me their own struggles with suicidal thinking. The book, they said, made them see for the first time how devastating their deaths would be to those who loved them. The voices I hear are part of the growing demand for improved care and treatment for those who experience disordered thinking, addictions, behavioral disabilities, and other brain health concerns.

And there was another, unexpected blessing from the book’s publication: it led several more survivors of the Columbine tragedy to contact me. I feel privileged to have had a chance to meet them, and humbled by their grace and generosity. In the immediate wake of Columbine, I could only dream that one day it would be possible for me to encounter one of Dylan’s victims or one of their family members and exchange a heartfelt hug. This has finally come to pass and I am overcome with gratitude.

Since the book’s release, I have cut back on most of my local volunteer commitments and focused more on participation at the national level. I have spoken at events designed to educate school personnel, medical practitioners, and journalists. One thing that surprised me about the book’s release was the interest in it shown by readers all over the world. At the time of publication, I had no idea that the difficult subject matter would be of interest outside the United States. But to date, the book has been translated into almost a dozen languages, including Hungarian, Italian, Dutch, German, French, Korean, Chinese, Portuguese, and Russian. The global level of interest is a testament to the pervasive concerns people are having about mental wellness.

Another privilege for which I am grateful is the opportunity to donate my share of book profits to organizations dedicated to suicide prevention, evidence-based programs, and brain health research. I never would have been able to make these gifts to deserving organizations had I not published the book.

One thing that has not changed during years of continual soul-searching about Columbine is the way I feel about Dylan. My abiding love for him was the force that kept me writing and alive. It is what keeps me focused on the causes that I support. I carry him in my heart every waking moment and in dreams when I sleep. I like to imagine that he has walked with me through the long, heart-rending process of telling our story together. I will never stop wishing that I knew then what I know now, so I would have been better equipped to help him when he needed me. So many would have been spared if I had.

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CHAPTER 1

“There’s Been a Shooting at Columbine High School”

APRIL 20, 1999, 12:05 P.M.

I was in my office in downtown Denver, getting ready to leave for a meeting about college scholarships for students with disabilities, when I noticed the red message light on my desk phone flashing.

I checked, on the off chance my meeting had been canceled, but the message was from my husband, Tom, his voice tight, ragged, urgent.

“Susan-this is an emergency! Call me back immediately!”

He didn’t say anything more. He didn’t have to: I knew just from the sound of his voice that something had happened to one of our boys.

It felt as if it took hours for my shaking fingers to dial our home phone number. Panic crashed over me like a wave; my heart pounded in my ears. Our youngest son, Dylan, was at school; his older brother, Byron, was at work. Had there been an accident?

Tom picked up and immediately yelled: “Listen to the television!” But I couldn’t make out any distinct words. It terrified me that whatever had happened was big enough to be on TV. My fear, seconds earlier, of a car wreck suddenly seemed tame. Were we at war? Was the country under attack?

“What’s happening?” I screamed into the receiver. There was only static and indecipherable television noise on the other end. Tom came back on the line, finally, but my ordinarily steadfast husband sounded like a madman. The scrambled words pouring out of him in staccato bursts made no sense: “gunman shooter school.”

I struggled to understand what Tom was telling me: Nate, Dylan’s best friend, had called Tom’s home office minutes before to ask, “Is Dylan home?” A call like that in the middle of the school day would have been alarming enough, but the reason for Nate’s call was every parent’s worst nightmare come to life: gunmen were shooting at people at Columbine High School, where Dylan was a senior.

There was more: Nate had said the shooters had been wearing black trench coats, like the one we’d bought for Dylan.

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from

A Mother’s Reckoning. Living in the aftermath of the Columbine tragedy

by Sue Klebold

get it at Amazon.com

Marx’s analysis of the laws of capital and the share market crisis – Nick Beams.

Down through the years one of the most persistent attacks on Karl Marx by the high priests of bourgeois economics, the ideological guardians of the profit system, has been his contention that, in the final analysis, capitalism depends on the impoverishment of the working class. History, they maintain, has proven otherwise and refuted Marx. While there have been periods of crisis, and rapid and even prolonged falls in the living standards of the masses, in the long run the profit system has served to uplift them and will continue to do so into the indefinite future, whatever fluctuations it may undergo.

Moreover, there is no possible alternative because the market system is not a historically developed mode of production, which came into being at one point and is therefore destined to pass away like earlier modes of production before it, slavery and feudalism. Rather, it is rooted in the laws of nature itself and is necessary and therefore eternal. In other words, despite some imperfections, which may give rise to problems at certain points, all is really for the best in the best of all possible worlds.

In feudal times, the high priests of the Church, who played the key role in sustaining and sanctifying the ruling classes of their day, maintained that when crises arose this was not a product of the social system but an “act of God,” a punishment for the sins of man deriving from his fall.

While there have been enormous advances in social and political thought since then—a product of the Enlightenment and the vast advances in the scientific understanding—the modus operandi of the present day “high priests” of capitalist economy, the bourgeois economists and pundits, is not altogether different from their predecessors.

When confronted with economic crises and their persistence, they maintain that these are not a product of the inexorable workings of the capitalist system itself, but arise from “market imperfections” or some external, unforeseen or accidental event. That is, they proceed, as Marx put it, on the basis that so long as capitalism acts according to the textbooks—the modern day scriptures used to justify the present socio-economic order—crises are not endemic to the system.

The events of the past two weeks, with the largest fall in markets since the crisis of 2008, raising the spectre of an even bigger disaster than that of a decade ago, have provided a damning exposure of this entire ideological framework.

Before going into a deeper analysis of the underlying driving forces and the inherent and irresolvable contradictions of which these events are an expression, let us begin with one undeniable economic fact.

In the decade since the eruption of the global financial crisis of 2008, none of the underlying contradictions that exploded to the surface has been resolved. At the same time, the immediate and ongoing consequences of the breakdown have been the reduction of the living standards of billions of people, while creating unprecedented wealth for a capitalist oligarchy occupying the heights of society. Or as Marx put it, the accumulation of wealth at one pole, amid poverty, misery and degradation at the other.

Whatever the immediate outcome, the financial turmoil of the past days has established, as an undeniable reality, the continuing threat of a meltdown of the capitalist economy. It hangs like a sword of Damocles over the working masses of the world, destined to fall, if not in this crisis, then in others to come.

Moreover, one of the most striking features of the latest crisis, is that it was not sparked by the immediate threat of recession but by news that economic growth was enjoying an uptick—the best period of synchronised global growth since 2009, according to the International Monetary Fund. Most significantly, it was triggered by data showing that wages in the US experienced their largest annual rise since 2009.

Most of what passed for analysis in the bourgeois media did little better than the tweet forthcoming from the very limited intelligence of US President Donald Trump. He noted: “In the ‘old days,’ when good news was reported the Stock Market would go up. Today, when good news is reported, the Stock Market goes down. Big mistake and we have so much good (great) news about the economy!”

Trump’s “analysis” omitted a central feature of the market rise over the past nine years. It has not taken place on the basis of “good news” but in a period of the lowest growth in any “recovery” in the post-World War II period. It has been sustained only by the continued inflow of ultra-cheap money from the US Federal Reserve and other major central banks.

Lawrence Summers, former treasury secretary in the Clinton administration and now Harvard professor of economics, was slightly more insightful. “This is not yet a major earthquake,” he wrote. “Whether it’s an early tremor or a random fluctuation remains to be seen. I’m nervous and will stay nervous. [It is] far from clear that good growth and stable finance are compatible.”

Summers is at least vaguely aware that in the present situation there is something deeply troubling for the capitalist class for which he speaks. The very measures undertaken in response to the last crisis, supposedly aimed at restoring economic health and growth, may in fact have created the conditions for another financial disaster as growth begins to rise.

The tendency of the rate of profit to fall

To analyse the present situation, it is necessary to leave the sphere of bourgeois economics—based on the premise that there are no inherent and objective contradictions in the profit system—and probe its historical development on the basis of the laws of motion of the capitalist economy uncovered by Marx.

The ongoing turmoil in financial markets, beginning with the Wall Street crash of October 1987, must be analysed on the basis of one of the most important contradictions of the capitalist economy explained by Marx. That is the long-term tendency of the rate of profit to fall.

This tendency was noted by the foremost representatives of English classical political economy—Adam Smith and David Ricardo—who preceded Marx in the period when the bourgeoisie was a rising and progressive class.

While Smith and Ricardo found the tendency of the rate of profit to fall deeply disturbing, especially the latter because of its implications for the long-term future of the capitalist economy, they were unable to give any scientific explanation for it. That was provided by Marx, beginning with his uncovering of the secret of surplus value.

While Smith and Ricardo had the notion that the origin of surplus value was the labour of the developing working class, its actual source always remained a mystery to Marx’s predecessors. How was it possible, they cudgelled their brains, on the basis of the laws of commodity exchange in the market, where equivalents exchange for equivalents, for a surplus to arise and for this surplus to be appropriated by capital?

Marx’s solution consisted in his probing of the most important commodity exchange in capitalist economy, that between capital and labour. He showed that the commodity which the worker sold to the capitalist was not, as had been previously maintained, his or her labour, but labour power, the capacity to work.

Like every other commodity in the market, labour power’s value was determined by the value of the commodities needed to reproduce it—in this case, the value of the commodities needed to sustain the individual worker and his or her family to ensure the continued supply of wage workers.

Surplus value arose from the difference between the value created by the worker in the course of the working day through the production process, and the value of the commodity, labour power, that the worker sold to capital through the wage contract.

The raw materials and machinery used up in the production process did not add new value, but passed on to the final product the value they already embodied.

Yet the analysis was not yet complete. The rate of profit had to be explained. This rate was not determined at the level of the individual capitalist firm, but at the level of the capitalist economy as a whole. It was given by the ratio of the total surplus value extracted from the working class to the total capital outlaid—the expenditure on labour power plus the expenditure on the means of production, raw materials and machinery.

The tendency of the rate of profit to fall arose not from some external factor, Marx showed, but from a contradiction at the very heart of this process.

The development of capitalist production led to the expansion of the productive forces and the use of ever-larger amounts of raw materials and machinery in the production process. As a result, expenditure on materials and machinery tended to comprise an increasing proportion of the total capital laid out. But this increased expenditure on what Marx called constant capital, as opposed to the expenditure on labour power, or variable capital, did not give rise to additional or surplus value.

Because the rate of profit was determined by the ratio of total surplus value to the total mass of capital—constant and variable—employed, there was an inherent tendency for it to decline.

Now, as Marx clearly identified, there were countervailing factors. These included: the increased exploitation of the working class in order to widen the difference between the value of labour power and the value created by the worker in the course of the working day; the lowering of wages to below the value of labour power, enforced through the creation of unemployment and a surplus working population; the cheapening of the costs of raw materials and machinery, so reducing the total value of capital on which the rate of profit was calculated; and the expansion of foreign trade.

But while these countervailing factors lessened the tendency of the rate of profit to fall, and at times could operate very powerfully—even lifting the profit rate—the basic tendency continually reasserted itself.

Marx characterised the law of the tendency of the rate of profit to fall as the most important law of political economy, above all from an historical point of view. This was because, on the one hand, it drove capital to develop the productive forces in an attempt to overcome its effects, while, on the other, it was the source of the continually recurring crises that beset the capitalist mode of production.

Marx’s critics and the end of the post-war boom

With the development of the post-war capitalist boom, extending from the late 1940s to the early 1970s, Marx’s law, it was claimed, had been refuted by historical events. As had been seen in the case of the German revisionist Eduard Bernstein at the end of the 19th century, the attack on Marx’s analysis came from those who claimed to be his followers, but insisted it needed to be revised and updated.

The assault on Marx’s law of the tendency of the rate of profit to fall was at the centre of one of the most influential books of the late 1960s, Monopoly Capital, written by the “independent” Marxist economist Paul Sweezy in co-authorship with Paul Baran in the midst of the post-war boom.

Sweezy, the founder of the journal Monthly Review, had already cast considerable doubt on the validity of Marx’s law in his first book, The Theory of Capitalist Development, published in 1941. He now maintained that Marx had developed the law under conditions of competition in the 19th century and that in 20th century monopoly capitalism it no longer applied, if it ever had.

Sweezy maintained that the key question confronting capital was not the insufficient extraction of surplus value relative to the ever-growing mass of capital—the issue to which Marx’s law had pointed—but the reverse. Monopoly capital created an increased mass of surplus value that had to be continually “absorbed.”

A key aspect of Sweezy’s theory, flowing directly from his economic analysis, was that in the advanced capitalist countries, dominated by monopolies, the working class was no longer a revolutionary force. The vehicle for socialist revolution, he claimed, was now the masses in the so-called Third World countries, striving for national liberation.

Monopoly Capital is no longer widely read but it continues to exert an influence. David Harvey, for example, adheres to much of Sweezy’s economic analysis, as well as his insistence on the non-revolutionary role of the working class.

However, as so often happens, Sweezy’s “refutation” of Marx came right at the point when developments in the capitalist economy were confirming Marx’s scientific insights. Earlier, Bernstein had maintained that the Marxist analysis of the inevitable breakdown of capitalism was rendered a fiction by the boom beginning in the late 1890s. The collapse of Bernstein’s prognosis came just 14 years after its elaboration, with the outbreak of World War I in 1914.

In Sweezy’s case, his refutation was almost instantaneous. The publication of Monopoly Capital in 1966 came at a point when profit rates in the advanced capitalist economies were starting to turn down. This led to mounting economic problems and the rise of class tensions that were soon to produce potentially revolutionary struggles by the working class from 1968 to 1975.

Starting with the May–June 1968 general strike in France, the largest and most extended in history, and including the 1969 hot autumn in Italy, the 1974 miners’ strike that brought down the Tory government in Britain, the revolutionary situation in Chile (1970–73) and the upheavals in the US, to name just some of the events, world capitalism was shaken to its foundations.

With the direct collaboration of the Stalinist, social democratic and trade union apparatuses, which betrayed these struggles, the capitalist classes were able to bring the situation under control and maintain their rule.

However, the underlying economic problems of the US and other major capitalist economies, rooted in declining profit rates, remained. Having kept themselves in the saddle, the ruling classes undertook a massive offensive against the working class, coupled with a restructuring the world economy.

The global counter-offensive was initiated in the US under Federal Reserve chairman Paul Volcker, who put in place a high-interest rate regime. Its purpose was two-fold: to wipe out unprofitable sections of industry and force a major industrial restructure, and eliminate the large industrial complexes that were the centres of militant working class struggles in an earlier period. The Volcker purge had vast global ramifications, leading in 1982–83 to the most serious global recession since the Great Depression.

The decade of the 1980s was characterised by major class battles, of which the mass sacking of US air traffic controllers in 1981 by Reagan and the state violence unleashed by the Thatcher Tory government against the British miners’ strike in 1984–85 were two of the most prominent. The decade also saw a fundamental transformation in the role of the trade unions. From organisations that had fought for limited gains by the working class, they betrayed all of its struggles as they became the chief enforcers of the program of pro-market, capitalist restructuring.

The attack on the social position of the working class—aimed at increasing the extraction of surplus value to counter the fall in the rate of profit—was accompanied by a reorganisation of production, through downsizing and globalisation to take advantage of cheaper sources of labour.

The growth of financial speculation

Crucial to this restructuring was the freeing of financial capital from the restrictions and regulations that were set in place following the disastrous experiences of the 1930s. The growing operations of finance, through the issuing of so-called junk bonds and other measures, were central to hostile takeovers, downsizing and mergers and acquisitions that transformed the organisation of capitalist production.

At the same time, the pressure on profit rates, as Marx predicted, resulted in a turn by capital to operations in the financial markets and speculative ventures as a means of profit accumulation.

This process led to financial storms by the end of the 1980s, with the eruption of the savings and loans debacle and the October 1987 share market crash, in which the Dow plunged by more than 22 percent in a single day.

The response of the incoming Federal Reserve chairman, Alan Greenspan, represented a major turning point. He committed the central bank to the provision of liquidity to the financial markets in what became known as the “Greenspan put.” In effect, the Fed became the guarantor to the financial markets, reversing previous policy.

While the October 1987 crash was the most severe one-day fall in history—a position it retains to this day—it did not lead to a broader crisis in the economy as a whole.

This was because the onslaught against the working class in the US and the first wave of globalisation, marked by the transfer of large areas of industrial production to the cheaper-labour countries of East Asia, the “Asian Tigers,” was beginning to lift the rate of profit.

This was reinforced after 1991 with the liquidation of the Soviet Union and the consequent abandonment by countries such as India of their nationally-regulated development programs and the increasing turn to the free market.

Most significant was the restoration of capitalism in China and its opening up to global corporations. China, which became a source of cheap labour production in the 1980s through the establishment of special economic zones, opened up still further. The Tiananmen Square massacre of June 1989 was the signal by the Chinese Communist Party regime that it stood ready, by whatever means necessary, to ensure the exploitation of the Chinese working class by global capital.

In the first period of the Clinton presidency, beginning in 1993, the US economy enjoyed rising profit rates as a result of the boost provided by the exploitation of cheaper labour, paid as little as one thirtieth of US wages.

However, the basic tendency identified by Marx began to reassert itself from around 1997, when the average US profit rate began to turn down. As a result, the accumulation of profits by financial means, which had grown by leaps and bounds in the 1990s, became increasingly vulnerable.

By 1996, Greenspan pointed to what he called “irrational exuberance,” expressed in the tendency of stock prices to become ever-more divorced from the real economy. This warning, however, came to nothing. Greenspan, responding to the dictates and demands of finance capital, turned more openly to the provision of cheap money for speculation.

The Asian financial crisis of 1997–98 was a significant turning point. It produced a depression in South-East Asia equivalent in scope to that of the 1930s in the advanced capitalist countries, but Clinton dismissed it as a mere “glitch” on the road to globalisation.

That was followed by the 1998 collapse of the US investment fund Long Term Capital Management, which had to be wound up in an operation conducted by the New York Federal Reserve, lest its demise brought down the whole financial system.

The dot.com bubble was then getting under way as the Fed provided ever-cheaper money. And at the behest of the financial markets, the last remnants of the regulatory mechanisms controlling their predatory operations, put in place as a result of the 1930s depression, were scrapped with the Clinton administration’s 1999 repeal of the Glass-Steagall Act.

The 2001 collapse of Enron revealed the dubious practices and outright criminality that increasingly marked the speculative financial bubble. Enron had pioneered new accounting practices in which profit was decided in advance to meet market expectations and then the accounts were manipulated to show the desired result.

Following the collapse of the tech and dot.com bubble, finance capital turned to the development of new methods for speculative profit accumulation, again facilitated with cheap money from the Fed. It developed highly complex and arcane financial derivatives, centred on the sub-prime mortgage market, but extending well beyond it. Goldman Sachs, among others, was a key player. It issued new products that it knew would eventually fail, but made money in the meantime by financing both sides of the deals.

The 2008 global financial crisis

In April 2007, the then chairman of the Fed, Ben Bernanke, dismissed the possibility that the growing signs of problems with sub-prime mortgages could impact the broader market because these products only amounted to a $50 billion operation.

However, when the crisis erupted, it engulfed the entire financial system, threatening to bring down the insurance giant AIG following the collapse of Lehman Brothers. This was because the methods employed in the sub-prime market were not “rogue” activities but typical of the financial markets as a whole.

The response of the Fed and other central banks to the 2008 crisis marked another decisive turning point. No longer was it a question of stepping in to rescue a failed individual firm. Massive intervention was required to prop up the US and global financial system as a whole.

The lowering of interest rates to historic lows—in some cases to negative levels—and the injection of trillions of dollars into the financial system did not overcome the contradictions manifested in speculation—the expression of the laws of the capitalist mode of production laid bare by Marx—but exacerbated them.

The rise and rise of financial wealth accumulation in the decade following the 2008 crisis is not the outcome of growth in the real economy. In fact, the “recovery” since 2009 has been the weakest in the post-war period, and marked by the fall of investment in the real economy to historic lows and a decline in productivity.

After the Lehman crisis, finance capital responded to the blowing up of its previous mechanisms for profit accumulation via speculation by creating new ones. One of these, exchange traded notes based on “shorting” the volatility index, or Vix—that is, betting on continued market calm, has now resulted in the most significant turbulence since the 2008 crash.

However, these new forms of speculation are only a trigger. The broader significance of the recent volatility and whatever else eventuates—no one is sure that the storm has passed—is that it was provoked by the prospect of faster growth and a push by the working class for higher wages following decades of the suppression of the class struggle.

Economic events have once again confirmed the essential conclusion of Marx’s analysis of the laws of motion of the capitalist economy. Whatever its ups and downs and even periods of long upturn, the accumulation of profit—the essential driving force of capitalism—is, in the final analysis, based on the ongoing suppression of the working class and its impoverishment.

The lie, which forms the basis of all bourgeois economics, that somehow the growth of capitalist economy can, at least in the long run, provide the road to advancement for the mass of humanity, the working class, the producers of all wealth, has been exposed. It has been laid bare by the fact that signs of economic growth and a growing movement of workers against the decline in living standards have raised the prospect of a new financial disaster, even more serious than that of a decade ago.

Marx’s analysis of the laws of motion of capital—laws which express themselves, as he put it, in the same way that the law of gravity asserts itself when a house collapses around our ears—far from being refuted or rendered outdated, have been confirmed by living events.

This analysis, and Marx’s central conclusion that the working class has to take conscious control of the very wealth it has produced, must become its guiding perspective in the struggles now unfolding.

This historic task does not arise out of an abstract theoretical construct. In opposition to all the nostrums of bourgeois economy, which are self-serving justifications of the capitalist system, Marx’s analysis is a scientific elaboration of the objective tendencies and inherent logic of capitalist development.

This logic, which assumes ever-more explosive forms, now poses directly before the international working class the necessity, if humanity is to avert a catastrophe and advance, to fight in every struggle for a perspective based on the overthrow of the reactionary and historically-outmoded profit system. That is the essential meaning of the latest round of turmoil on the financial markets.

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The progressive case for replacing the welfare state with Basic Income – Scott Santens.

It appears some establishment voices have picked up on a way of opposing the idea of the monthly citizen dividend of about $1,000 per month, known as universal basic income (UBI), in a way that successfully leaves some progressively minded people afraid.

The fear inspired is that those with the greatest need may be left worse off with UBI compared to the existing status quo of more than 100 government programs that currently comprise the U.S. safety net that UBI has the potential to entirely or mostly replace.

The argument goes that because we currently target money to those in need, by spreading out existing revenue to everyone instead, those currently targeted would necessarily receive less money, and thus would be worse off. Consequently, the end result of basic income could be theoretically regressive in nature by reducing the benefits of the poor and transferring that revenue instead to the middle classes and the rich.

Obviously a bad idea, right?

This new argument has been made most notably by the White House’s own chief economic adviser, Jason Furman, perhaps after himself reading the words of Robert Greenstein of the Center on Budget and Policy Priorities (CBPP).

The problem is that those who make this particular argument are building somewhat of a straw man, not only because of the blanket assumptions they are making around a very specific tax-neutral design, but also because they aren’t publicly acknowledging just how poorly our present means-tested programs are targeted by virtue of their applied conditions, and just how unequal one dollar can be to one dollar, however counterintuitive that may seem.

Assuming things work as we think they work is exactly one of the biggest obstacles we’ve always had to improving anything.

Basically, this particular argument would only make sense if we in no way altered our tax system to achieve UBI, and if our programs worked as we assume they work because that’s how they should work. The problem is they don’t work that way.

Assuming things work as we think they work is exactly one of the biggest obstacles we’ve always had to improving anything, because to fix something we first need to understand it’s broken. If it ain’t broke, don’t fix it, right? Well, guess what? Our safety net is broken, and it’s broken at such a fundamental level, there’s no fixing it, because it is by design.

A net full of holes must be replaced by a floor free of holes and that floor is unconditional basic income.

Nothing but net holes

In the United States today, on average, just about one in four families living underneath the federal poverty line receives what most call welfare, which is actually known as Temporary Assistance for Needy Families, or TANF. It gets worse. Because states are actually just written checks to give out as they please in the form of “block grants,” there are states where far fewer than one in four impoverished families receive cash assistance.

In Oklahoma, seven out of 100 families living in poverty receives TANF. In Wyoming, merely one in 100 of those living in poverty receives TANF.

Where does the money go instead?

It goes to educate the children of those earning over six figures.

It goes to programs trying to convince women to get married.

And it goes directly to state government treasuries so they can cut taxes on the rich.

The fact is that cash welfare, as it exists today, is not given to the overwhelming majority of those living in poverty who need it.

Single adults without children know this better than anyone. They even have their own moniker: ABAWDs (Able-Bodied Adults Without Dependents). ABAWDs have the lone distinction of being the only demographic in the U.S. to be literally taxed into poverty, all 7.5 million of them. Because they earn income and because they do not have the child necessary to qualify for virtually any assistance — even the earned income tax credit (EITC), which is meant as a boost for low-income workers through the tax code — those earning enough to be above the federal poverty line can end up beneath the poverty line after paying taxes. And those already beneath the poverty line are pushed even deeper, effectively punished for being childless and working.

Combine all of those without dependents with all of those with dependents but without sufficient income to qualify for EITC and living in states averse to cash assistance, and the reality is that tens of millions of adults and children fall straight through the net purportedly designed to catch them. Any net is mostly nothing but holes, and nowhere is that more true than in the United States.

Assumption: Everyone living beneath the poverty line receives cash assistance.

Observation: Most don’t.

The same is true of housing assistance. There is a belief that poor people galore are sitting on easy street with affordable living conditions, where housing vouchers are given away like Halloween candy to anyone with a hand out.

The truth is that 24 percent of those who qualify for housing assistance get it, and getting it can mean years of waiting on lists. Here in New Orleans, where I live, the wait list is opened about every seven years or so, and when it is, tens of thousands apply despite fewer than 1,000 people becoming new recipients of vouchers each year.

Additionally, vouchers are not at all “just like cash.” Cash is accepted in payment by all landlords everywhere. Section 8 vouchers, meanwhile, are accepted only by those who choose to accept them, which is few and far between, and certainly not in what are considered to be “high opportunity” neighborhoods. This is true even of “supervouchers” that are specifically designed for that purpose.

Assumption: Everyone living in poverty receives housing assistance.

Observation: Most don’t.

Food stamps, too, are not given to everyone living under the poverty line. About one-quarter of those living in poverty get no government food assistance, and of those who do, a third of them still need to visit food banks for added assistance because the amount given is nowhere close to being sufficient to get people through each month.

Estimates point to food stamps lasting on average about three weeks of every month. Worse yet, food stamps can even have harsh time limits (e.g. three months of SNAP every three years), growing restrictions on how they can be used (sorry, no seafood allowed) and work requirements (30 hours per week).

This is food we’re talking about. Why should any bureaucrat ever exist between the most basic human need of all — the need to eat — and access to food?

Assumption: Everyone living in poverty receives food assistance.

Observation: Some may temporarily, but the amount is insufficient and full of costly strings.

However, one of the best examples of all the vast differences between the assumption and the observation of how government benefits work is how we target those with disabilities. It has been estimated that 22 percent of adults in the U.S. have some form of disability. At the same time, 4.6 percent of adults age 18-64 in the U.S. are receiving disability income. So again, about one-quarter of those we say we should be targeting actually receive anything, while the bulk get nothing.

It’s not just apples and oranges. It’s rotten apples and ripe oranges.The absolute worst thing though, and what too few people seem to know, is that when it comes to disability income, you are essentially not even allowed to earn additional income. If you’re on SSDI and earn one dollar over $1,090 in a month, you are dropped from the program and lose 100 percent of your benefit. That is the steepest of “benefit cliffs” and it’s the equivalent of taxing those with disabilities at rates far greater than 100 percent as a reward for their labor. It’s also the exact opposite of a basic income that is never taken away.

It is this clawback of means-tested benefits with the earning of income that is possibly the single greatest flaw of all targeted assistance, and also the single most ignored detail when people defend the current system over the introduction of a basic income that would replace it.

Simply put, $1,000 per month in welfare is not at all the same thing as $1,000 per month in basic income. It’s not just apples and oranges. It’s rotten apples and ripe oranges.

With welfare, because it is targeted and therefore withdrawn as income is earned, people on welfare are effectively punished for working. Their total incomes don’t really increase with employment. Welfare functions in many ways as a ceiling.

With basic income, because it is unconditional and therefore never withdrawn as income is earned, people with basic incomes are always rewarded for working. Their total incomes always increase with any amount of employment. Basic income therefore functions as a floor.

Do you see the difference?

So when someone says the details matter when it comes to the idea of basic income and suggests the possibility that it could be regressive, and even increase inequality by taking money being targeted at the poor and giving it to the non-poor, understand that the details of the details matter even more than just the details.

Basic income is not some regressive conspiracy of the Silicon Valley elite to create a neo-serfdom. The regressive argument operates on the myth that for every four people living under the poverty line, four people get an amount of assistance that lifts them far above the poverty line, and that $1 of welfare is exactly equivalent to $1 in basic income.

The basic income argument operates on the reality that for every four people living under the poverty line, only about one person gets an amount of assistance that does more to trap them in poverty than to lift them out of it, and that $1 of welfare is worth far less than $1 of basic income.

It’s really important to understand this, so let’s zoom in a bit on a worst-case scenario. Let’s assume we replace all of our programs targeted at the poor with UBI, including even Medicaid (which I don’t recommend unless we replace it with universal healthcare instead), and that we provide the UBI to adults only, with nothing for kids (something else I don’t recommend).

Using an example of a single parent with two kids within the current system, we could regressively replace around $45,000 of benefits (if we also eliminate child care, which is yet another detail I don’t recommend) with $12,000 in cash. That is a worst-design scenario and totally regressive right? No. It’s actually partially regressive and mostly progressive.

Although true that one in four would be worse off in such an inferior UBI design, it’s also true that three of four would be far better off because they would no longer receive little to nothing. As an oversimplified example for the sake of clarity, that means instead of the distribution across four adults being $45,000/$0/$0/$0, it would be $12,000/$12,000/$12,000/$12,000. That is more progressive as a whole than it is regressive, and inequality is reduced overall, not increased, because the total at the bottom went from $45,000 across four people to $48,000 across four people. And that is for basically the worst possible, most unrealistic of UBI designs.

But again, those numbers cannot be compared dollar for dollar. Welfare dollars disappear with work and basic income dollars are kept with work. That same parent receiving $45,000 for nothing, if they got a job paying $30,000 right now would receive $20,000 in benefits. That would be a gain of $30,000 combined with a loss of $25,000. That’s a gain of $5,000 for a $30,000 job, or in other words, an income tax of 83 percent. Who else is taxed at 83 percent? No one. In fact, the richest are taxed the least because their income, which isn’t derived from work, is special. It’s simply capital gains, which is taxed at 20 percent.

Does this sound like a just and equitable system? Or does it sound more like a racist meat-grinder?

Even more troubling, welfare dollars themselves are not equivalent to each other. Despite it being against the law to vary welfare dollars along racial lines, that’s exactly what we do. How? It’s again due to the nature of block grants for states. When Bill Clinton signed his welfare reform into law, he agreed to write checks to the states and let them handle how they dish out welfare. As a result, just five years after welfare was reformed into what it is today, 63 percent of those in the programs with the least-harsh conditions were white and 11 percent were black, while 63 percent of those in the programs with the most-harsh conditions were black and 29 percent were white.

In other words, a dollar in welfare has about three to five times as many strings for someone who is black than someone who is white. These strings absolutely affect end results. Joe Soss, co-author of Disciplining the Poor: Neoliberal Paternalism and the Persistent Power of Race describes his findings thusly:

“The stringency of the rules matter tremendously for outcomes. The tougher the rules — and the more frequently people are punished for breaking them — the worse the outcomes are for people after they finish the program. In fact, in the toughest programs, people actually end up in worse shape after they get through them than they were before they got the benefits to begin with. And remember, they were in such a bad situation that they had to turn to a welfare program that’s been so stigmatized that pretty much everyone wants to avoid it. We also found that people who go through the toughest programs learn lessons about government that lead them to retreat from participating in politics. They become less likely to make their voices heard, and less likely to participate in elections and community organizations.”

Does this sound like a just and equitable system? Or does it sound more like a racist meat-grinder?

The bare naked truth of our present welfare system is a racially biased, overly paternalistic, unnecessarily controlling, grossly exclusionary system of punishment and blame that limits opportunity and taxes working beneficiaries more than any other worker in any income tax bracket.

It doesn’t abolish poverty. It helps sustain it. And this is the system establishment voices wish to improve upon in piecemeal fashion, possibly because they’re not the ones being chewed up and spit out by it, or even neglected by it entirely.

However, even if all of the above is clearly understood, there is one absolutely vital thing remaining to understand about basic income that cannot be replicated in any other way, by any other means.

Because basic income lacks conditions and is paid regardless of work, it provides recipients the power to refuse to work. This is the real fear of those who worry a basic income will result in people working less, but it is also its greatest strength.

The ability to say no to an employer provides people the bargaining power and the choice to determine how they work, where they work, for how much and for how long. No other policy does that. A minimum wage certainly doesn’t. Wage subsidies certainly don’t. Without basic income, the labor market is coercive, and that means people accept what they can get. With basic income, wages for low-demand jobs must go up and/or hours must go down in order to attract people with incomes independent of work to do them, or those same jobs must be automated to be performed by machines instead, whichever is cheaper.

A basic income is most simply a minimum income floor. It’s a new starting point above the poverty level instead of below it. There will still be jobs for people to earn additional income and those jobs can pay more if people hate doing them. Additionally, considering a potential future where there’s half as much employment, that also means just as many can be employed if we all work half as much so as to better share the remaining employment. And with the increased bargaining power basic income provides, that can also mean getting paid more for less work.

Basic income is not some regressive conspiracy of the Silicon Valley elite to create a neo-serfdom where the entire population only earns a maximum of $12,000 per year. That is the exact opposite of how it works. With basic income, $12,000 becomes the new absolute minimum for everyone and no one is a serf because everyone’s basic needs are covered. Poverty is eliminated. Inequality is reduced.

Additionally, everyone is free to earn any additional income, and on their terms. For the first time, everyone will have the individual negotiating power to dictate terms to employers that must be met. People who have this fundamental power are those who can then make further desired changes in the economy, in their businesses, in their governments and in their lives.

So you tell me. Would you prefer conditional welfare nets or would you prefer an unconditional basic income floor? Because one of these options is a relic of history, and the other is a road to the future.

Ending America’s Disastrous Role in Syria – Jeffrey D. Sachs.

America’s official narrative has sought to conceal the scale and calamitous consequences of US efforts to overthrow Syrian President Bashar al-Assad.

That is understandable, because US efforts are in blatant violation of international law, which bars UN member states from supporting military action to overthrow other members’ governments.

Much of the carnage that has ravaged Syria during the past seven years is due to the actions of the United States and its allies in the Middle East. Now, faced with an alarming risk of a renewed escalation of fighting, it’s time for the United Nations Security Council to step in to end the bloodshed, based on a new framework agreed by the Council’s permanent members.

Here are the basics.

In 2011, in the context of the Arab Spring, the US government, in conjunction with the governments of Saudi Arabia, Qatar, Turkey, and Israel, decided to bring down Syrian President Bashar al-Assad’s regime, even though overthrowing another country’s government amounts to a blatant violation of international law. We know that in 2012, if not earlier, President Barack Obama authorized the CIA to work with America’s allies in providing support to rebel forces composed of disaffected Syrians as well as non-Syrian fighters. US policymakers evidently expected Assad to fall quickly, as had occurred with the governments of Tunisia and Egypt in the early months of the Arab Spring.

The Assad regime is led by the minority Alawi Shia sect in a country where Alawites account for just 10% of the population, Sunni Muslims account for 75%, Christians make up 10%, and 5% are others, including Druze. The regional powers behind Assad’s regime include Iran and Russia, which has a naval base on Syria’s Mediterranean coastline.

Whereas America’s goal in seeking to topple Assad was mainly to undercut Iranian and Russian influence, Turkey’s motive was to expand its influence in former Ottoman lands and, more recently, to counter Kurdish ambitions for territorial autonomy, if not statehood, in Syria and Iraq. Saudi Arabia wanted to undermine Iran’s influence in Syria while expanding its own, while Israel, too, aimed to counter Iran, which threatens Israel through Hezbollah in Lebanon, Syria near the Golan Heights, and Hamas in Gaza. Qatar, meanwhile, wanted to bring a Sunni Islamist regime to power.

The armed groups supported by the US and allies since 2011 were assembled under the banner of the Free Syrian Army. In fact, there was no single army, but rather competing armed groups with distinct backers, ideologies, and goals. The fighters ranged from dissident Syrians and autonomy-seeking Kurds to Sunni jihadists backed by Saudi Arabia and Qatar.

While vast resources were devoted to overthrowing Assad, the effort ultimately failed, but not before causing massive bloodshed and displacing millions of Syrians. Many fled to Europe, fomenting Europe’s refugee crisis and a surge in political support for Europe’s anti-immigrant extreme right.

There were four main reasons for the failure to overthrow Assad. First, Assad’s regime had backing among not only Alawites, but also Syrian Christians and other minorities who feared a repressive Sunni Islamist regime. Second, the US-led coalition was countered by Iran and Russia. Third, when a splinter group of jihadists split away to form the Islamic State (ISIS), the US diverted significant resources to defeating it, rather than to toppling Assad. Finally, the anti-Assad forces have been deeply and chronically divided; for example, Turkey is in open conflict with the Kurdish fighters backed by the US.

All of these reasons for failure remain valid today. The war is at a stalemate. Only the bloodshed continues.

America’s official narrative has sought to conceal the scale and calamitous consequences of US efforts in defiance of international law and the UN Charter to overthrow Assad. While the US vehemently complains about Russian and Iranian influence in Syria, America and its allies have repeatedly violated Syrian sovereignty. The US government mischaracterizes the war as a civil war among Syrians, rather than a proxy war involving the US, Israel, Russia, Saudi Arabia, Iran, and Qatar.

In July 2017, US President Donald Trump announced the end of CIA support for the Syrian rebels. In practice, though, US engagement continues, though now it is apparently aimed more at weakening Assad than overthrowing him.

As part of America’s continued war-making, the Pentagon announced in December that US forces would remain indefinitely in Syria, ostensibly to support anti-Assad rebel forces in areas captured from ISIS, and of course without the assent of the Syrian government.

The war is in fact at risk of a new round of escalation. When Assad’s regime recently attacked anti-Assad rebels, the US coalition launched airstrikes that killed around 100 Syrian troops and an unknown number of Russian fighters. Following this show of force, US Secretary of Defense Jim Mattis disingenuously stated that, “Obviously, we are not getting engaged in the Syrian civil war.” In addition, Israel recently attacked Iranian positions in Syria.

The US and its allies should face reality and accept the persistence of Assad’s regime, despicable as it may be. The UN Security Council, backed by the US, Russia, and the other major powers, should step in with peacekeepers to restore Syrian sovereignty and urgent public services, while blocking attempts at vengeance by the Assad regime against former rebels or their civilian supporters.

Yes, the Assad regime would remain in power, and Iran and Russia would maintain their influence in Syria. But the US official delusion that America can call the shots in Syria by choosing who rules, and with which allies, would end. It’s long past time for a far more realistic approach, in which the Security Council pushes Saudi Arabia, Turkey, Iran, and Israel into a pragmatic peace that ends the bloodshed and allows the Syrian people to resume their lives and livelihoods.

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Jeffrey D. Sachs, Professor of Sustainable Development and Professor of Health Policy and Management at Columbia University, is Director of Columbia’s Center for Sustainable Development and of the UN Sustainable Development Solutions Network. His books include The End of Poverty, Common Wealth, The Age of Sustainable Development, and, most recently, Building the New American Economy.

Why Zebras Don’t Get Ulcers. The Stress Response System – Robert M. Sapolsky.

A primer about stress, stress related disease, and the mechanisms of coping with stress.

Preface

Perhaps you’re reading this while browsing in a bookstore. If so, glance over at the guy down the aisle when he’s not looking, the one pretending to be engrossed in the Stephen Hawking book. Take a good look at him. He’s probably not missing fingers from leprosy, or covered with smallpox scars, or shivering with malaria. Instead, he probably appears perfectly healthy, which is to say he has the same diseases that most of us have, cholesterol levels that are high for an ape, hearing that has become far less acute than in a hunter-gatherer of his age, a tendency to dampen his tension with Valium.

We in our Western society now tend to get different diseases than we used to. But what’s more important, we tend to get different kinds of diseases now, with very different causes and consequences. A millennium ago, a young hunter-gatherer inadvertently would eat a reedbuck riddled with anthrax and the consequences are clear, she’s dead a few days later. Now, the control of something else. Attention turned to the pituitary gland, sitting just underneath the brain. It was known that when the pituitary was damaged or diseased, hormonea young lawyer unthinkingly decides that red meat, fried foods, and a couple of beers per dinner constitute a desirable diet, and the consequences are anything but clear-a halfcentury later, maybe he’s crippled with cardiovascular disease, or maybe he’s taking bike trips with his grandkids. Which outcome occurs depends on some obvious nuts-and-bolts factors, like what his liver does with cholesterol, what levels of certain enzymes are in his fat cells, whether he has any congenital weaknesses in the walls of his blood vessels.

But the outcome will also depend heavily on such surprising factors as his personality, the amount of emotional stress he experiences over the years, whether he has someone’s shoulder to cry on when those stressors occur.

There has been a revolution in medicine concerning how we think about the diseases that now afflict us. It involves recognizing the interactions between the body and the mind, the ways in which emotions and personality can have a tremendous impact on the functioning and health of virtually every cell in the body. It is about the role of stress in making some of us more vulnerable to disease, the ways in which some of us cope with stressors, and the critical notion that you cannot really understand a disease in vacuo, but rather only in the context of the person suffering from that disease.

This is the subject of my book. I begin by trying to clarify the meaning of the nebulous concept of stress and to teach, with a minimum of pain, how various hormones and parts of the brain are mobilized in response to stress. I then focus on the links between stress and increased risk for certain types of disease, going, chapter by chapter, through the effects of stress on the circulatory system, on energy storage, on growth, reproduction, the immune system, and so on. Next I describe how the aging process may be influenced by the amount of stress experienced over a lifetime. I then examine the link between stress and the most common and arguably most crippling of psychiatric disorders, major depression. As part of updating the material for this third edition, l have added two new chapters: one on the interactions between stress and sleep, and one on what stress has to do with addiction. In addition, of the chapters that appeared in the previous edition, I rewrote about a third to half of the material.

Some of the news in this book is grim, sustained or repeated stress can disrupt our bodies in seemingly endless ways. Yet most of us are not incapacitated by stress-related disease. Instead, we cope, both physiologically and psychologically, and some of us are spectacularly successful at it. For the reader who has held on until the end, the final chapter reviews what is known about stress management and how some of its principles can be applied to our everyday lives. There is much to be optimistic about.

I believe that everyone can benefit from some of these ideas and can be excited by the science on which they are based. Science provides us with some of the most elegant, stimulating puzzles that life has to offer. It throws some of the most provocative ideas into our arenas of moral debate. Occasionally, it improves our lives. I love science, and it pains me to think that so many are terrified of the subject or feel that choosing science means that you cannot also choose compassion, or the arts, or be awed by nature. Science is not meant to cure us of mystery, but to reinvent and reinvigorate it.

Thus I think that any science book for nonscientists should attempt to convey that excitement, to make the subject interesting and accessible even to those who would normally not be caught dead near the subject. That has been a particular goal of mine in this book. Often, it has meant simplifying complex ideas, and as a counterbalance to this, I include copious references at the end of the book, often with annotations concerning controversies and sularge body of evidence suggests that stress-related disease emerges, predominantly, out of the fact that we so often activate a physiological system that has evolved for responding to acute physical emergencies, but we turn it on for months on end, worrying about mortgages, relationships, and promotions. btleties about material presented in the main text. These references are an excellent entrée for those readers who want something more detailed on the subject.

I am particularly grateful to the handful of people-friends, collaborators, colleagues, and eX-teachers-who, who took time out of their immensely busy schedules to read chapters. I shudder to think of the errors and distortions that would have remained had they not tactfully told me I didn’t know what I was writing about. I thank them all sincerely.

A number of people were instrumental in getting this book off the ground and into its final shape. Much of the material in these pages was developed in continuing medical education lectures. These were presented under the auspices of the institute for Cortext Research and Development, and its director, Will Gordon, who gave me much freedom and support in exploring this material.

I thank you all, and look forward to working with you in the future.

This book has been, for the most part, a pleasure to write and I think it reflects one of the things in my life for which I am most grateful, that I take so much joy in the science that is both my vocation and avocation. I thank the mentors who taught me to do science and, even more so, taught me to enjoy science.

Michelle Pearl, Serena Spudich, and Paul Stasi have wandered the basements of archival libraries, called strangers all over the world with questions, distilled arcane articles into coherency. In the line of duty, they have sought out drawings of opera castrati, the daily menu at Japanese American internment camps, the causes of voodoo death, and the history of firing squads. All of their research was done with spectacular competence, speed, and humor. I am fairly certain this book could not have been completed without their help and am absolutely certain its writing would have been much less enjoyable. And finally, I thank my agent, Katinka Matson, and my editor, Robin Dennis, who have been just terrific to work with. I look forward to many more years of collaborations ahead.

Parts of the book describe work carried out in my own laboratory, and these studies have been made possible by funding from the National Institutes of Health, the National Institute of Mental Health, the National Science Foundation, the Sloan Foundation, the Klingenstein Fund, the Alzheimer’s Association, and the Adler Foundation. The African fieldwork described herein has been made possible by the longstanding generosity of the Harry Frank Guggenheim Foundation. Finally, l heartily thank the MacArthur Foundation for supporting all aspects of my work.

Finally, as will be obvious, this book cites the work of a tremendous number of scientists.

Contemporary lab science is typically carried out by large teams of people. Throughout the book, i refer to the work of “Jane Doe” or “John Smith” for the sake of brevity-it, it is almost always the case that such work was carried out by Doe or Smith along with a band of junior colleagues.

There is a tradition among stress physiologists who dedicate their books to their spouses or significant others, an unwritten rule that you are supposed to incorporate something cutesy about stress in the dedication. So, to Madge, who attenuates my stressors; for Arturo, the source of my eustress; for my wife who, over the course of the last umpteen years, has put up with my stress-induced hypertension, ulcerative colitis, loss of libido, and displaced aggression. I will forgo that style in the actual dedication of this book to my wife, as l have something simpler to say.

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1 Why don’t zebras get ulcers?

It’s two o’clock in the morning and you’re lying in bed. You have something immensely important and challenging to do that next day, a critical meeting, a presentation, an exam. You have to get a decent night’s rest, but you’re still wide awake. You try different strategies for relaxing, take deep, slow breaths, try to imagine restful mountain scenery, but instead you keep thinking that unless you fall asleep in the next minute, your career is finished. Thus you lie there, more tense by the second.

If you do this on a regular basis, somewhere around two-thirty, when you’re really getting clammy, an entirely new, disruptive chain of thought will no doubt intrude. Suddenly, amid all your other worries, you begin to contemplate that nonspecific pain you’ve been having in your side, that sense of exhaustion lately, that frequent headache. The realization hits you-I’m sick, fatally sick! Oh, why didn’t I recognize the symptoms, why did I have to deny it, why didn’t I go to the doctor?

When it’s two-thirty on those mornings, I always have a brain tumor. These are very useful for that sort of terror, because you can attribute every conceivable nonspecific symptom to a brain tumor and justify your panic. Perhaps you do, too; or maybe you lie there thinking that you have cancer, or an ulcer, or that you’ve just had a stroke.

Even though I don’t know you, I feel confident in predicting that you don’t lie there thinking, “I just know it; l have leprosy.” True? You are exceedingly unlikely to obsess about getting a serious case of dysentery if it starts pouring. And few of us lie there feeling convinced that our bodies are teeming with intestinal parasites or liver flukes.

Of course not. Our nights are not filled with worries about scarlet fever, malaria, or bubonic plague. Cholera doesn’t run rampant through our communities; river blindness, black water fever, and elephantiasis are third world exotica. Few female readers will die in childbirth, and even fewer of those reading this page are likely to be malnourished.

Thanks to revolutionary advances in medicine and public health, our patterns of disease have changed, and we are no longer kept awake at night worrying about infectious diseases (except, of course, AIDS or tuberculosis) or the diseases of poor nutrition or hygiene. As a measure of this, consider the leading causes of death in the United States in 1900: pneumonia, tuberculosis, and influenza (and, if you were young, female, and inclined toward risk taking, childbirth). When is the last time you heard of scads of people dying of the flu? Yet the flu, in 1918 alone, killed many times more people than throughout the course of that most barbaric of conflicts, WWar 1.

Influenza pandemic, 1918.

Our current patterns of disease would be unrecognizable to our great-grandparents or, for that matter, to most mammals. Put succinctly, we get different diseases and are likely to die in different ways from most of our ancestors (or from most humans currently living in the less privileged areas of this planet). Our nights are filled with worries about a different class of diseases; we are now living well enough and long enough to slowly fall apart.

The diseases that plague us now are ones of slow accumulation of damage, heart disease, cancer, cerebrovascular disorders. While none of these diseases is particularly pleasant, they certainly mark a big improvement over succumbing at age twenty after a week of sepsis or dengue fever. Along with this relatively recent shift in the patterns of disease have come changes in the way we perceive the disease process. We have come to recognize the vastly complex intertwining of our biology and our emotions, the endless ways in which our personalities, feelings, and thoughts both reflect and influence the events in our bodies. One of the most interesting manifestations of this recognition is understanding that extreme emotional disturbances can adversely affect us. Put in the parlance with which we have grown familiar, stress can make us sick, and a critical shift in medicine has been the recognition that many of the damaging diseases of slow accumulation can be either caused or made far worse by stress.

In some respects this is nothing new. Centuries ago, sensitive clinicians intuitively recognized the role of individual differences in vulnerability to disease. Two individuals could get the same disease, yet the courses of their illness could be quite different and in vague, subjective ways might reflect the personal characteristics of the individuals. Or a clinician might have sensed that certain types of people were more likely to contract certain types of disease.

But since the twentieth century, the addition of rigorous science to these vague clinical perceptions has made stress physiology, the study of how the body responds to stressful events-a real discipline. As a result, there is now an extraordinary amount of physiological, biochemical, and molecular information available as to how all sorts of intangibles in our lives can affect very real bodily events. These intangibles can include emotional turmoil, psychological characteristics, our position in society, and how our society treats people of that position. And they can influence medical issues such as whether cholesterol gums up our blood vessels or is safely cleared from the circulation, whether our fat cells stop listening to insulin and plunge us into diabetes, whether neurons in our brain will survive five minutes without oxygen during a cardiac arrest.

This book is a primer about stress, stress related disease, and the mechanisms of coping with stress.

How is it that our bodies can adapt to some stressful emergencies, while other ones make us sick? Why are some of us especially vulnerable to stress-related diseases, and what does that have to do with our personalities? How can purely psychological turmoil make us sick? What might stress have to do with our vulnerability to depression, the speed at which we age, or how well our memories work? What do our patterns of stress-related diseases have to do with where we stand on the rungs of society’s ladder?

Finally, how can we increase the effectiveness with which we cope with the stressful world that surrounds us?

Some Initial Concepts

Perhaps the best way to begin is by making a mental list of the sorts of things we find stressful. No doubt you would immediately come up with some obvious examples traffic, deadlines, family relationships, money worries.

But what if I said, “You’re thinking like a speciocentric human. Think like a zebra for a second.” Suddenly, new items might appear at the top of your list, serious physical injury, predators, starvation. The need for that prompting illustrates something critical, you and l are more likely to get an ulcer than a zebra is. For animals like zebras, the most upsetting things in life are acute physical crises. You are that zebra, a lion has just leapt out and ripped your stomach open, you’ve managed to get away, and now you have to spend the next hour evading the lion as it continues to stalk you. Or, perhaps just as stressfully, you are that lion, half-starved, and you had better be able to sprint across the savanna at top speed and grab something to eat or you won’t survive. These are extremely stressful events, and they demand immediate physiological adaptations if you are going to live. Your body’s responses are brilliantly adapted for handling this sort of emergency.

An organism can also be plagued by chronic physical challenges. The locusts have eaten your crops, and for the next six months, you have to wander a dozen miles a day to get enough food. Drought, famine, parasites, that sort of unpleasantness, not the sort of experience we have often, but central events in the lives of nonwesternized humans and most other mammals. The body’s stress-responses are reasonably good at handling these sustained disasters.

Critical to this book is a third category of ways to get upset, psychological and social disruptions. Regardless of how poorly we are getting along with a family member or how incensed we are about losing a parking spot, we rarely settle that sort of thing with a fistfight. Likewise, it is a rare event when we have to stalk and personally wrestle down our dinner.

Essentially, we humans live well enough and long enough, and are smart enough, to generate all sorts of stressful events purely in our heads.

How many hippos worry about whether Social Security is going to last as long as they will, or what they are going to say on a first date? Viewed from the perspective of the evolution of the animal kingdom, sustained psychological stress is a recent invention, mostly limited to humans and other social primates. We can experience wildly strong emotions (provoking our bodies into an accompanying uproar) linked to mere thoughts? Two people can sit facing each other, doing nothing more physically strenuous than moving little pieces of wood now and then, yet this can be an emotionally taxing event: chess grand masters, during their tournaments, can place metabolic demands on their bodies that begin to approach those of athletes during the peak of a competitive event.

Or a person can do nothing more exciting than sign a piece of paper: if she has just signed the order to fire a hated rival after months of plotting and maneuvering, her physiological responses might be shockingly similar to those of a savanna baboon who has just lunged and slashed the face of a competitor. And if someone spends months on end twisting his innards in anxiety, anger, and tension over some emotional problem, this might very well lead to illness.

This is the critical point of this book: if you are that zebra running for your life, or that lion sprinting for your meal, your body’s physiological response mechanisms are superbly adapted for dealing with such short-term physical emergencies.

For the vast majority of beasts on this planet, stress is about a short-term crisis, after which it’s either over with or you’re over with.

When we sit around and worry about stressful things, we turn on the same physiological responses, but they are potentially a disaster when provoked chronically. A large body of evidence suggests that stress-related disease emerges, predominantly, out of the fact that we so often activate a physiological system that has evolved for responding to acute physical emergencies, but we turn it on for months on end, worrying about mortgages, relationships, and promotions.

This difference between the ways that we get stressed and the ways a zebra does lets us begin to wrestle with some definitions. To start, I must call forth a concept that you were tortured with in ninth-grade biology and hopefully have not had to think about since-homeostasis. Ah, that dimly remembered concept, the idea that the body has an ideal level of oxygen that it needs, an ideal degree of acidity, an ideal temperature, and so on. All these different variables are maintained in homeostatic balance, the state in which all sorts of physiological measures are being kept at the optimal level. The brain, it has been noted, has evolved to seek homeostasis.

This allows us to generate some simple initial working definitions that would suffice for a zebra or a lion. A stressor is anything in the outside world that knocks you out of homeostatic balance, and the stress-response is what your body does to reestablish homeostasis.

But when we consider ourselves and our human propensity to worry ourselves sick, we have to expand on the notion of stressors merely being things that knock you out of homeostatic balance. A stressor can also be the anticipation of that happening. Sometimes we are smart enough to see things coming and, based only on anticipation, can turn on a stress-response as robust as if the event had actually occurred.

Some aspects of anticipatory stress are not unique to humans whether, you are a human surrounded by a bunch of thugs in a deserted subway station or a zebra face to face with a lion, your heart is probably racing, even though nothing physically damaging has occurred (yet). But unlike less cognitively sophisticated species, we can turn on the stress-response by thinking about potential stressors that may throw us out of homeostatic balance far in the future. For example, think of the African farmer watching a swarm of locusts descend on his crops. He has eaten an adequate breakfast and is not suffering the homeostatic imbalance of starving, but that farmer will still be undergoing a stress-response. Zebras and lions may see trouble coming in the next minute and mobilize a stress-response in anticipation, but they can’t get stressed about events far in the future.

And sometimes we humans can be stressed by things that simply make no sense to zebras or lions. It is not a general mammalian trait to become anxious about mortgages or the Internal Revenue Service, about public speaking or fears of what you will say in a job interview, about the inevitability of death. Our human experience is replete with psychological stressors, a far cry from the physical world of hunger, injury, blood loss, or temperature extremes. When we activate the stress-response out of fear of something that turns out to be real, we congratulate ourselves that this cognitive skill allows us to mobilize our defenses early. And these anticipatory defenses can be quite protective, in that a lot of what the stress-response is about is preparative. But when we get into a physiological uproar and activate the stress-response for no reason at all, or over something we cannot do anything about, we call it things like “anxiety,” “neurosis, paranoia,” or “needless hostility.”

Thus, the stress-response can be mobilized not only in response to physical or psychological insults, but also in expectation of them. It is this generality of the stress-response that is the most surprising, a physiological system activated not only by all sorts of physical disasters but by just thinking about them as well. This generality was first appreciated about sixty-five years ago by one of the godfathers of stress physiology, Hans Selye. To be only a bit facetious, stress physiology exists as a discipline because this man was both a very insightful scientist and lame at handling lab rats.

In the 1930s, Selye was just beginning his work in endocrinology, the study of hormonal communication in the body. Naturally, as a young, unheard-of assistant professor, he was fishing around for something with which to start his research career. A biochemist down the hall had just isolated some sort of extract from the ovary, and colleagues were wondering what this ovarian extract did to the body. So Selye obtained some of the stuff from the biochemist and set about studying its effects. He attempted to inject his rats daily, but apparently not with a great display of dexterity. Selye would try to inject the rats, miss them, drop them, spend half the morning chasing the rats around the room or vice versa, flailing with a broom to get them out from behind the sink, and so on. At the end of a number of months of this, Selye examined the rats and discovered something extraordinary: the rats had peptic ulcers, greatly enlarged adrenal glands (the source of two important stress hormones), and shrunken immune tissues. He was delighted; he had discovered the effects of the mysterious ovarian extract.

Being a good scientist, he ran a control group: rats injected daily with saline alone, instead of the ovarian extract. And, thus, every day they too were injected, dropped, chased, and chased back. At the end, lo and behold, the control rats had the same peptic ulcers, enlarged adrenal glands, and atrophy of tissues of the immune system.

Now, your average budding scientist at this point might throw up his or her hands and furtively apply to business school. But Selye, instead, reasoned through what he had observed. The physiological changes couldn’t be due to the ovarian extract after all, since the same changes occurred in both the control and the experimental groups. What did the two groups of rats have in common? Selye reasoned that it was his less than trauma free injections. Perhaps, he thought, these changes in the rats’ bodies were some sort of nonspecific responses of the body to generic unpleasantness. To test this idea, he put some rats on the roof of the research building in the winter, others down in the boiler room. Still others were exposed to forced exercise, or to surgical procedures. In all cases, he found increased incidences of peptic ulcers, adrenal enlargement, and atrophy of immune tissues.

We know now exactly what Selye was observing. He had just discovered the tip of the iceberg of stress-related disease. Legend (mostly promulgated by Selye himself) has it that Selye was the person who, searching for a way to describe the nonspecificity of the unpleasantness to which the rats were responding, borrowed a term from physics and proclaimed that the rats were undergoing “stress.” In fact, by the 1920s the term had already been introduced to medicine in roughly the sense that we understand it today by a physiologist named Walter Cannon. What Selye did was to formalize the concept with two ideas:

1. The body has a surprisingly similar set of responses (which he called the general adaptation syndrome, but which we now call the stress-response) to a broad array of stressors.

2. If stressors go on for too long, they can make you sick.

Appropriate Concept of Allostasis

The homeostasis concept has been modified in recent years in work originated by Peter Sterling and Joseph Eyer of the University of Pennsylvania and extended by Bruce McEwen of Rockefeller University. They have produced a new framework that I steadfastly tried to ignore at first and have now succumbed to, because it brilliantly modernizes the homeostasis concept in a way that works even better in making sense of stress (although not all folks in my business have embraced it, using “old wine in a new bottle” imagery).

The original conception of homeostasis was grounded in two ideas. First, there is a single optimal level, number, amount for any given measure in the body. But that can’t be true, after all, the ideal blood pressure when you’re sleeping is likely to be different than when you’re ski jumping. What’s ideal under basal conditions is different than during stress, something central to allostatic thinking. (The field uses this Zen-ish sound bite about how allostasis is about “constancy through change.” I’m not completely sure I understand what that means, but it always elicits meaningful and reinforcing nods when I toss it out in a lecture.)

The second idea in homeostasis is that you reach that ideal set point through some local regulatory mechanism, whereas allostasis recognizes that any given set point can be regulated in a zillion different ways, each with its own consequences. Thus, suppose there’s a water shortage in California. Homeostatic solution: mandate smaller toilet tanks; Allostatic solutions: smaller toilet tanks, convince people to conserve water, buy rice from Southeast Asia instead of doing water-intensive farming in a semi-arid state. Or suppose there’s a water shortage in your body. Homeostatic solution: kidneys are the ones that figure this out, tighten things up there, produce less urine for water conservation. Allostatic solutions: brain figures this out, tells the kidneys to do their thing, sends signals to withdraw water from parts of your body where it easily evaporates (skin, mouth, nose), makes you feel thirsty. Homeostasis is about tinkering with this valve or that gizmo. Allostasis is about the brain coordinating body-wide changes, often including changes in behavior.

A final feature of allostatic thinking dovetails beautifully with thinking about stressed humans. The body doesn’t pull off all this regulatory complexity only to correct some set point that has gone awry. It can also make allostatic changes in anticipation of a set point that is likely to go awry. And thus we hark back to the critical point of a few pages backwards, don’t get stressed being chased by predators. We activate the stressresponse in anticipation of challenges, and typically those challenges are the purely psychological and social tumult that would make no sense to a zebra. We’ll be returning repeatedly to what allostasis has to say about stress-related disease.

What Your Body Does to Adapt To an Acute Stressor

Within this expanded framework, a stressor can be defined as anything that throws your body out of allostatic balance and the stress-response is your body’s attempt to restore allostasis. The secretion of certain hormones, the inhibition of others, the activation of particular parts of the nervous system, and so on. And regardless of the stressor, injured, starving, too hot, too cold, or psychologically stressed, you turn on the same stress-response.

It is this generality that is puzzling. If you are trained in physiology, it makes no sense at first glance. ln physiology, one is typically taught that specific challenges to the body trigger specific responses and adaptations. Warming a body causes sweating and dilation of blood vessels in the skin. Chilling a body causes just the opposite, constriction of those vessels and shivering. Being too hot seems to be a very specific and different physiological challenge from being too cold, and it would seem logical that the body’s responses to these two very different states should be extremely different. Instead, what kind of crazy bodily system is this that is turned on whether you are too hot or too cold, whether you are the zebra, the lion, or a terrified adolescent going to a high school dance? Why should your body have such a generalized and stereotypical stress-response, regardless of the predicament you find yourself in?

When you think about it, it actually makes sense, given the adaptations brought about by the stress-response. If you’re some bacterium stressed by food shortage, you go into a suspended, dormant state. But if you’re a starving lion, you’re going to have to run after someone. If you’re some plant stressed by someone intent on eating you, you stick poisonous chemicals in your leaves. But if you’re a zebra being chased by that lion, you have to run for it.

For us vertebrates, the core of the stress-response is built around the fact that your muscles are going to work like crazy. And thus the muscles need energy, right now, in the most readily utilizable form, rather than stored away somewhere in your fat cells for some building project next spring. One of the hallmarks of the stress-response is the rapid mobilization of energy from storage sites and the inhibition of further storage. Glucose and the simplest forms of proteins and fats come pouring out of your fat cells, liver, and muscles, all to stoke whichever muscles are struggling to save your neck.

If your body has mobilized all that glucose, it also needs to deliver it to the critical muscles as rapidly as possible. Heart rate, blood pressure, and breathing rate increase, all to transport nutrients and oxygen at greater rates.

Equally logical is another feature of the stress response. During an emergency, it makes sense that your body halts long-term, expensive building projects. If there is a tornado bearing down on the house, this isn’t the day to repaint the garage. Hold off on the long-term projects until you know there is a long term. Thus, during stress, digestion is inhibited-there isn’t enough time to derive the energetic benefits of the slow process of digestion, so why waste energy on it? You have better things to do than digest breakfast when you are trying to avoid being someone’s lunch. The same thing goes for growth and reproduction, both expensive, optimistic things to be doing with your body (especially if you are female). If the lion’s on your tail, two steps behind you, worry about ovulating or growing antlers or making sperm some other time. During stress, growth and tissue repair is curtailed, sexual drive decreases in both sexes; females are less likely to ovulate or to carry pregnancies to term, while males begin to have trouble with erections and secrete less testosterone.

Along with these changes, immunity is also inhibited. The immune system, which defends against infections and illness, is ideal for spotting the tumor cell that will kill you in a year, or making enough antibodies to protect you in a few weeks, but is it really needed this instant? The logic here appears to be the same, look for tumors some other time; expend the energy more wisely now. (As we will see, there are some major problems with this idea that the immune system is suppressed during stress in order to save energy. But that idea will suffice for the moment.)

Another feature of the stress-response becomes apparent during times of extreme physical pain. With sufficiently sustained stress, our perception of pain can become blunted. It’s the middle of a battle; soldiers are storming a stronghold with wild abandon. A soldier is shot, grievously injured, and the man doesn’t even notice it. He’ll see blood on his clothes and worry that one of his buddies near him has been wounded, or he’ll wonder why his innards feel numb. As the battle fades, someone will point with amazement at his injury-didn’t it hurt like hell? It didn’t. Such stress-induced analgesia is highly adaptive and well documented. If you are that zebra and your innards are dragging in the dust, you still have to escape. Now would not be a particularly clever time to go into shock from extreme pain.

Finally, during stress, shifts occur in cognitive and sensory skills. Suddenly certain aspects of memory improve, which is always helpful if you’re trying to figure out how to get out of an emergency (Has this happened before? Is there a good hiding place?). Moreover, your senses become sharper. Think about watching a terrifying movie on television, on the edge of your seat at the tensest part. The slightest noise, a creaking door, and you nearly jump out of your skin. Better memory, sharper detection of sensations-all quite adaptive and helpful.

Collectively, the stress-response is ideally adapted for that zebra or lion. Energy is mobilized and delivered to the tissues that need them; longterm building and repair projects are deferred until the disaster has passed. Pain is blunted, cognition sharpened.

Walter Cannon, the physiologist who, at the beginning of the century, paved the way for much of Selye’s work and is generally considered the other godfather of the field, concentrated on the adaptive aspect of the stress-response in dealing with emergencies such as these. He formulated the well-known “fight-or-flight” syndrome to describe the stress-response, and he viewed it in a very positive light. His books, with titles such as The Wisdom of the Body, were suffused with a pleasing optimism about the ability of the body to weather all sorts of stressors.

Yet stressful events can sometimes make us sick. Why?

Selye, with his ulcerated rats, wrestled with this puzzle and came up with an answer that was sufficiently wrong that it is generally thought to have cost him a Nobel Prize for all his other work.

He developed a three-part view of how the stress response worked. In the initial (alarm) stage a stressor is noted; metaphorical alarms go off in your head, telling you that you are hemorrhaging, too cold, low on blood sugar, or whatever.

The second stage (adaptation, or resistance) comes with the successful mobilization of the stressresponse system and the reattainment of allostatic balance.

It is with prolonged stress that one enters the third stage, which Selye termed “exhaustion,” where stress-related diseases emerge. Selye believed that one becomes sick at that point because stores of the hormones secreted during the stress-response are depleted. Like an army that runs out of ammunition, suddenly we have no defenses left against the threatening stressor.

It is very rare, however, as we will see, that any of the crucial hormones are actually depleted during even the most sustained of stressors. The army does not run out of bullets. Instead, the body spends so much on the defense budget that it neglects education and health care and social services (okay, so I may have a hidden agenda here).

It is not so much that the stress-response runs out, but rather, with sufficient activation, that the stress-response can become more damaging than the stressor itself, especially when the stress is purely psychological. This is a critical concept, because it underlies the emergence of much stress-related disease.

That the stress-response itself can become harmful makes a certain sense when you examine the things that occur in reaction to stress. They are generally shortsighted, inefficient, and pennywise and dollar-foolish, but they are the sorts of costly things your body has to do to respond effectively in an emergency. And if you experience every day as an emergency, you will pay the price.

If you constantly mobilize energy at the cost of energy storage, you will never store any surplus energy. You will fatigue more rapidly, and your risk of developing a form of diabetes will even increase. The consequences of chronically activating your cardiovascular system are similarly damaging: if your blood pressure rises to 180/100 when you are sprinting away from a lion, you are being adaptive, but if it is 180/100 every time you see the mess in your teenager’s bedroom, you could be heading for a cardiovascular disaster.

If you constantly turn off long-term building projects, nothing is ever repaired. For paradoxical reasons that will be explained in later chapters, you become more at risk for peptic ulcers. In kids, growth can be inhibited to the point of a rare but recognized pediatric endocrine disorder, stress dwarfism, and in adults, repair and remodeling of bone and other tissues can be disrupted. If you are constantly under stress, a variety of reproductive disorders may ensue. In females, menstrual cycles can become irregular or cease entirely; in males, sperm count and testosterone levels may decline. In both sexes, interest in sexual behavior decreases.

But that is only the start of your problems in response to chronic or repeated stressors. If you suppress immune function too long and too much, you are now more likely to fall victim to a number of infectious diseases, and be less capable of combating them once you have them.

Finally, the same systems of the brain that function more cleverly during stress can also be damaged by one class of hormones secreted during stress. As will be discussed, this may have something to do with how rapidly our brains lose cells during aging, and how much memory loss occurs with old age.

All of this is pretty grim. In the face of repeated stressors, we may be able to precariously reattain allostasis, but it doesn’t come cheap, and the efforts to reestablish that balance will eventually wear us down.

Here’s a way to think about it: the “two elephants on a seesaw” model of stressrelated disease. Put two little kids on a seesaw, and they can pretty readily balance themselves on it. This is allostatic balance when nothing stressful is going on, with the children representing the low levels of the various stress hormones that will be presented in coming chapters. In contrast, the torrents of those same stress hormones released by a stressor can be thought of as two massive elephants on the seesaw. With great effort, they can balance themselves as well. But if you constantly try to balance a seesaw with two elephants instead of two little kids, all sorts of problems will emerge:

– First, the enormous potential energies of the two elephants are consumed balancing the seesaw, instead of being able to do something more useful, like mowing the lawn or paying the bills. This is equivalent to diverting energy from various long-term building projects in order to solve short-term stressful emergencies.

– By using two elephants to do the job, damage will occur just because of how large, lumbering, and unsubtle elephants are. They squash the flowers in the process of entering the playground, they strew leftovers and garbage all over the place from the frequent snacks they must eat while balancing the seesaw, they wear out the seesaw faster, and so on. This is equivalent to a pattern of stress-related disease that will run through many of the subsequent chapters: it is hard to fix one major problem in the body without knocking something else out of balance (the very essence of allostasis spreading across systems throughout the body). Thus, you may be able to solve one bit of imbalance brought on during stress by using your elephants (your massive levels of various stress hormones), but such great quantities of those hormones can make a mess of something else in the process. And a long history of doing this produces wear and tear throughout the body, termed allostatic load.

– A final, subtle problem: when two elephants are balanced on a seesaw, it’s tough for them to get off. Either one hops off and the other comes crashing to the ground, or there’s the extremely delicate task of coordinating their delicate, lithe leaps at the same time. This is a metaphor for another theme that will run through subsequent chapters, sometimes stress-related disease can arise from turning off the stress response too slowly, or turning off the different components of the stress response at different speeds. When the secretion rate of one of the hormones of the stress response returns to normal yet another of the hormones is still being secreted like mad, it can be the equivalent of one elephant suddenly being left alone on the seesaw, crashing to earth?

The preceding pages should allow you to begin to appreciate the two punch lines of this book:

The first is that if you plan to get stressed like a normal mammal, dealing with an acute physical challenge, and you cannot appropriately turn on the stress-response, you’re in big trouble. To see this, all you have to do is examine someone who cannot activate the stress-response. As will be explained in the coming chapters, two critical classes of hormones are secreted during stress. In one disorder, Addison’s disease, you are unable to secrete one class of these hormones.

In another, called Shy-Drager syndrome, it is the secretion of the second class of hormones that is impaired. People with Addison’s disease or Shy Drager syndrome are not more at risk for cancer or diabetes or any other such disorders of slow accumulation of damage. However, people with untreated Addison’s disease, when faced with a major stressor such as a car accident or an infectious illness, fall into an “Addisonian” crisis, where their blood pressure drops, they cannot maintain circulation, they go into shock. In Shy-Drager syndrome, it is hard enough simply to stand up, let alone go sprinting after a zebra for dinner-mere standing causes a severe drop in blood pressure, involuntary twitching and rippling of muscles, dizziness, all sorts of unpleasantness.

These two diseases teach something important, namely, that you need the stress-response during physical challenges. Addison’s and Shy-Drager represent catastrophic failures of turning on the stress-response. In coming chapters, I will discuss some disorders that involve subtler undersecretion of stress hormones. These include chronic fatigue syndrome, fibromyalgia, rheumatoid arthritis, a subtype of depression, critically ill patients, and possibly individuals with post-traumatic stress disorder.

That first punch line is obviously critical, especially for the zebra who occasionally has to run for its life. But the second punch line is far more relevant to us, sitting frustrated in traffic jams, worrying about expenses, mulling over tense interactions with colleagues. If you repeatedly turn on the stress-response, or if you cannot turn off the stress-response at the end of a stressful event, the stress-response can eventually become damaging.

A large percentage of what we think of when we talk about stress related diseases are disorders of excessive stress-responses.

A few important qualifications are necessary concerning that last statement, which is one of the central ideas of this book. On a superficial level, the message it imparts might seem to be that stressors make you sick or, as emphasized in the last few pages, that chronic or repeated stressors make you sick. It is actually more accurate to say that chronic or repeated stressors can potentially make you sick or can increase your risk of being sick. Stressors, even if massive, repetitive, or chronic in nature, do not automatically lead to illness. And the theme of the last section of this book is to make sense of why some people develop stress-related diseases more readily than others, despite the same stressor.

An additional point should be emphasized. To state that “chronic or repeated stressors can increase your risk of being sick” is actually incorrect, but in a subtle way that will initially seem like semantic nit-picking. It is never really the case that stress makes you sick, or even increases your risk of being sick. Stress increases your risk of getting diseases that make you sick, or if you have such a disease, stress increases the risk of your defenses being overwhelmed by the disease. This distinction is important in a few ways.

First, by putting more steps between a stressor and getting sick, there are more explanations for individual differences, why only some people wind up actually getting sick. Moreover, by clarifying the progression between stressors and illness, it becomes easier to design ways to intervene in the process.

Finally, it begins to explain why the stress concept often seems so suspect or slippery to many medical practitioners, clinical medicine is traditionally quite good at being able to make statements like “You feel sick because you have disease X,” but is usually quite bad at being able to explain why you got disease X in the first place. Thus, medical practitioners often say, in effect, “You feel sick because you have disease X, not because of some nonsense having to do with stress; however, this ignores the stressors’ role in bringing about or worsening the disease in the first place.

With this framework in mind, we can now begin the task of understanding the individual steps in this system. Chapter 2 introduces the hormones and brain systems involved in the stress response: which ones are activated during stress, which ones are inhibited? This leads the way to chapters 3 through 10, which examine the individual systems of your body that are affected.

How do those hormones enhance cardiovascular tone during stress, and how does chronic stress cause heart disease? How do those hormones and neural systems mobilize energy during stress, and how does too much stress cause energetic diseases (chapter 4)?

Chapter 11 examines the interactions between stress and sleep, focusing on the vicious circle of how stress can disrupt sleep and how sleep deprivation is a stressor.

Chapter 12 examines the role of stress in the aging process and the disturbing recent findings that sustained exposure to certain of the hormones secreted during stress may actually accelerate the aging of the brain. As will be seen, these processes are often more complicated and subtle than they may seem from the simple picture presented in this chapter.

Chapter 13 ushers in a topic obviously of central importance to understanding our own propensity toward stress-related disease: why is psychological stress stressful? This serves as a prelude to the remaining chapters.

Chapter 14. reviews major depression, a horrible psychiatric malady that afflicts vast numbers of us and is often closely related to psychological stress.

Chaptrr 15 discusses what personality differences have to do with individual differences in patterns of stress-related disease. This is the world of anxiety disorders and Type A-ness, plus some surprises about unexpected links between personality and the stress-response.

Chapter 16 considers a puzzling issue that lurks throughout reading this book, sometimes stress feels good, good enough that we’ll pay good money to be stressed by a scary movie or roller-coaster ride. Thus, the chapter considers when stress is a good thing, and the interactions between the sense of pleasure that can be triggered by some stressors and the process of addiction.

Chapter 17 focuses above the level of the individual, looking at what your place in society, and the type of society in which you live, has to do with patterns of stress-related disease. If you plan to go no further, here’s one of the punch lines of that chapter:

If you want to increase your chances of avoiding stress-related diseases, make sure you don’t inadvertently allow yourself to be born poor.

In many ways, the ground to be covered up to the final chapter is all bad news, as we are regaled with the evidence about new and unlikely parts of our bodies and minds that are made miserable by stress.

The final chapter is meant to give some hope. Given the same external stressors, certain bodies and certain psyches deal with stress better than others. What are those folks doing right, and what can the rest of us learn from them? We’ll look at the main principles of stress management and some surprising and exciting realms in which they have been applied with stunning success. While the intervening chapters document our numerous vulnerabilities to stress-related disease, the final chapter shows that we have an enormous potential to protect ourselves from many of them. Most certainly, all is not lost.

*

2 Glands, Gooseflesh, and Hormones

In order to begin the process of learning how stress can make us sick, there is something about the workings of the brain that we have to appreciate. It is perhaps best illustrated in the following rather technical paragraph from an early investigator in the field:

As she melted small and wonderful in his arms, she became infinitely desirable to him, all his blood vessels seemed to scald with intense yet tender desire, for her, for her softness, for the penetrating beauty of her in his arms, passing into his blood. And softly, with that marvelous swoon-like caress of his hand in pure soft desire, softly he stroked the silky slope of her loins, down, down between her soft, warm buttocks, coming nearer and nearer to the very quick of her. And she felt him like a flame of desire, yet tender, and she felt herself melting in the flame. She let herself go. She felt his penis risen against her with silent amazing force and assertion, and she let herself go to him. She yielded with a quiver that was like death, she went all open to him.

Now think about this. If D. H. Lawrence is to your taste, there may be some interesting changes occurring in your body. You haven’t just run up a flight of stairs, but maybe your heart is beating faster. The temperature has not changed in the room, but you may have just activated a sweat gland or two. And even though certain rather sensitive parts of your body are not being overtly stimulated by touch, you are suddenly very aware of them.

You sit in your chair not moving a muscle, and simply think a thought, a thought having to do with feeling angry or sad or euphoric or lustful, and suddenly your pancreas secretes some hormone. Your pancreas? How did you manage to do that with your pancreas? You don’t even know where your pancreas is. Your liver is making an enzyme that wasn’t there before, your spleen is text-messaging something to your thymus gland, blood flow in little capillaries in your ankles has just changed. All from thinking a thought.

We all understand intellectually that the brain can regulate functions throughout the rest of the body, but it is still surprising to be reminded of how far-reaching those effects can be. The purpose of this chapter is to learn a bit about the lines of communication between the brain and elsewhere, in order to see which sites are activated and which are quieted when you are sitting in your chair and feeling severely stressed.

This is a prerequisite for seeing how the stressresponse can save your neck during a sprint across the savanna, but make you sick during months of worry.

Stress and the Autonomic Nervous System

Outline of some of the effects of the sympathetic and parasympathetic nervous systems on various organs and glands.

The principal way in which your brain can tell the rest of the body what to do is to send messages through the nerves that branch from your brain down your spine and out to the periphery of your body. One dimension of this communication system is pretty straightforward and familiar. The voluntary nervous system is a conscious one. You decide to move a muscle and it happens. This part of the nervous system allows you to shake hands or fill out your tax forms or do a polka.

It is another branch of the nervous system that projects to organs besides skeletal muscle, and this part controls the other interesting things your body does, blushing, getting gooseflesh, having an orgasm. In general, we have less control over what our brain says to our sweat glands, for example, than to our thigh muscles. (The workings of this automatic nervous system are not entirely out of our control, however; biofeedback, for example, consists of learning to alter this automatic function consciously. Potty training is another example of us gaining mastery. On a more mundane level, we are doing the same thing when we repress a loud burp during a wedding ceremony. The set of nerve projections to places like sweat glands carry messages that are relatively involuntary and automatic.

It is thus termed the autonomic nervous system, and it has everything to do with your response to stress. One half of this system is activated in response to stress, one half is suppressed. The half of the autonomic nervous system that is turned on is called the sympathetic nervous system. Originating in the brain, sympathetic projections exit your spine and branch out to nearly every organ, every blood vessel, and every sweat gland in your body. They even project to the scads of tiny little muscles attached to hairs on your body. If you are truly terrified by something and activate those projections, your hair stands on end; gooseflesh results when the parts of your body are activated where those muscles exist but lack hairs attached to them.

The sympathetic nervous system kicks into action during emergencies, or what you think are emergencies. It helps mediate vigilance, arousal, activation, mobilization. To generations of firstyear medical students, it is described through the obligatory lame joke about the sympathetic nervous system mediating the four F’s of behavior -flight, fight, fright, and sex. It is the archetypal system that is turned on at times when life gets exciting or alarming, such as during stress. The nerve endings of this system release adrenaline. When someone jumps out from behind a door and startles you, it’s your sympathetic nervous system releasing adrenaline that causes your stomach to clutch. Sympathetic nerve endings also release the closely related substance noradrenaline. (Adrenaline and noradrenaline are actually British designations; the American terms, which will be used from now on, are epinephrine and norepinephrine.)

Epinephrine is secreted as a result of the actions of the sympathetic nerve endings in your adrenal glands (located just above your kidneys); norepinephrine is secreted by all the other sympathetic nerve endings throughout the body. These are the chemical messengers that kick various organs into gear, within seconds.

The other half of the autonomic nervous system plays an opposing role. This parasympathetic component mediates calm, vegetative activities everything but the four F’s. If you are a growing kid and you have gone to sleep, your parasympathetic system is activated. It promotes growth, energy storage, and other optimistic processes. Have a huge meal, sit there bloated and happily drowsy, and the parasympathetic is going like gangbusters. Sprint for your life across the savanna, gasping and trying to control the panic, and you’ve turned the parasympathetic component down.

Thus, the autonomic system works in opposition: sympathetic and parasympathetic projections from the brain course their way out to a particular organ where, when activated, they bring about opposite results. The sympathetic system speeds up the heart; the parasympathetic system slows it down. The sympathetic system diverts blood flow to your muscles; the parasympathetic does the opposite. It’s no surprise that it would be a disaster if both branches were very active at the same time, kind of like putting your foot on the gas and brake simultaneously. Lots of safety features exist to make sure that does not happen. For example, the parts of the brain that activate one of the two branches typicaliy inhibit the other.

Your Brain: The Real Master Gland

The neural route represented by the sympathetic system is a first means by which the brain can mobilize waves of activity in response to a stressor. There is another way as well-through the secretion of hormones.

If a neuron (a cell of the nervous system) secretes a chemical messenger that travels a thousandth of an inch and causes the next cell in line (typically, another neuron) to do something different, that messenger is called a neurotransmitter. Thus, when the sympathetic nerve endings in your heart secrete norepinephrine, which causes heart muscle to work differently, norepinephrine is playing a neurotransmitter role. If a neuron (or any cell) secretes a messenger that, instead, percolates into the bloodstream and affects events far and wide, that messenger is a hormone. All sorts of glands secrete hormones; the secretion of some of them is turned on during stress, and the secretion of others is turned off.

What does the brain have to do with all of these glands secreting hormones? People used to think, “Nothing.”

The assumption was that the peripheral glands of the body, your pancreas, your adrenal, your ovaries, your testes, and so on, in some mysterious way “knew” what they were doing, had “minds of their own.” They would “decide” when to secrete their messengers, without directions from any other organ. This erroneous idea gave rise to a rather silly fad during the early part of the twentieth century. Scientists noted that men’s sexual drive declined with age, and assumed that this occurs because the testicles of aging men secrete less male sex hormone, testosterone. (Actually, no one knew about the hormone testosterone at the time; they just referred to mysterious “male factors” in the testes. And in fact, testosterone levels do not plummet with age. Instead, the decline is moderate and highly variable from one male to the next, and even a decline in testosterone to perhaps 10 percent of normal levels does not have much of an effect on sexual behavior.)

Making another leap, they then ascribed aging to diminishing sexual drive, to lower levels of male factors. (One may then wonder why females, without testes, manage to grow old, but the female half of the population didn’t figure much in these ideas back then.) How, then, to reverse aging? Give the aging males some testicular extracts.

Soon, aged, monied gentlemen were checking into impeccable Swiss sanitariums and getting injected daily in their rears with testicular extracts from dogs, from roosters, from monkeys. You could even go out to the stockyards of the sanitarium and pick out the goat of your choicejust like picking lobsters in a restaurant (and more than one gentleman arrived for his appointment with his own prized animal in tow).

This soon led to an offshoot of such “rejuvenation therapy,” namely, “organotherapy”, the grafting of little bits of testes themselves. Thus was born the “monkey gland” craze, the term gland being used because journalists were forbidden to print the racy word testes. Captains of industry, heads of state, at least one pope, all signed up. And in the aftermath of the carnage of World War I, there was such a shortage of young men and such a surfeit of marriages of younger women to older men, that therapy of this sort seemed pretty important.

Advertisement, New York Therapeutic Review, 1893.

Naturally, the problem was that it didn’t work. There wasn’t any testosterone in the testicular extracts-patients would be injected with a waterbased extract, and testosterone does not go into solution in water. And the smidgens of organs that were transplanted would die almost immediately, with the scar tissue being mistaken for a healthy graft. And even if they didn’t die, they still wouldn’t work, if aging testes are secreting less testosterone, it is not because the testes are failing, but because another organ (stay tuned) is no longer telling them to do so. Put in a brand-new set of testes and they should fail also, for lack of a stimulatory signal. But not a problem. Nearly everyone reported wondrous results anyway. If you’re paying a fortune for painful daily injections of extracts of some beast’s testicles, there’s a certain incentive to decide you feel like a young bull. One big placebo effect.

With time, scientists figured out that the testes and other peripheral hormone-secreting glands were not autonomous, but were under the control of something else. Attention turned to the pituitary gland, sitting just underneath the brain. It was known that when the pituitary was damaged or diseased, hormone secretion throughout the body became disordered. In the early part of the century, careful experiments showed that a peripheral gland releases its hormone only if the pituitary first releases a hormone that kicks that gland into action.

The pituitary contains a whole array of hormones that run the show throughout the rest of the body; it is the pituitary that actually knows the game plan and regulates what all the other glands do. This realization gave rise to the memorable cliché that the pituitary is the master gland of the body.

This understanding was disseminated far and wide, mostly in the Reader’s Digest, which ran the “I Am Joe’s” series of articles (“I Am Joe’s Pancreas,” “I Am Joe’s Shinbone,” “I Am Joe’s Ovaries,” and so on). By the third paragraph of “I Am Joe’s Pituitary,” out comes that master gland business. By the 1950s, however, scientists were already learning that the pituitary wasn’t the master gland after all.

The simplest evidence was that if you removed the pituitary from a body and put it in a small bowl filled with pituitary nutrients, the gland would act abnormally. Various hormones that it would normally secrete were no longer secreted. Sure, you might say, remove any organ and throw it in some nutrient soup and it isn’t going to be good for much of anything. But, interestingly, while this “explanted” pituitary stopped secreting certain hormones, it secreted others at immensely high rates. It wasn’t just that the pituitary was traumatized and had shut down. It was acting erratically because, it turned out, the pituitary didn’t really have the whole hormonal game plan. It would normally be following orders from the brain, and there was no brain on hand in that small bowl to give directions.

The evidence for this was relatively easy to obtain. Destroy the part of the brain right near the pituitary and the pituitary stops secreting some hormones and secretes too much of others. This tells you that the brain controls certain pituitary hormones by stimulating their release and controls others by inhibiting them.

The problem was to figure out how the brain did this. By all logic, you would look for nerves to project from the brain to the pituitary (like the nerve projections to the heart and elsewhere), and for the brain to release neurotransmitters that called the shots. But no one could find these projections.

In 1944, the physiologist Geoffrey Harris proposed that the brain was also a hormonal gland, that it released hormones that traveled to the pituitary and directed the pituitary’s actions. in principle, this was not a crazy idea; a quarter-century before, one of the godfathers of the field, Ernst Scharrer, had shown that some other hormones, thought to originate from a peripheral gland, were actually made in the brain. Nevertheless, lots of scientists thought Harris’s idea was bonkers. You can get hormones from peripheral glands like ovaries, testes, pancreas-but, but your brain oozing hormones? Preposterous! This seemed not only scientifically implausible but somehow also an unseemly and indecorous thing for your brain to be doing, as opposed to writing sonnets.

Two scientists, Roger Guillemin and Andrew Schally, began looking for these brain hormones. This was a stupendously difficult task. The brain communicates with the pituitary by a minuscule circulatory system, only slightly larger than the period at the end of this sentence. You couldn’t search for these hypothetical brain “releasing hormones” and “inhibiting hormones” in the general circulation of blood; if the hormones existed, by the time they reached the voluminous general circulation, they would be diluted beyond detection. Instead, you would have to search in the tiny bits of tissue at the base of the brain containing those blood vessels going from the brain to the pituitary.

Not a trivial task, but these two scientists were up to it. They were highly motivated by the abstract intellectual puzzle of these hormones, by their potential clinical applications, by the acclaim waiting at the end of this scientific rainbow. Plus, the two of them loathed each other, which invigorated the quest. Initially, in the late 1950s, Guillemin and Schally collaborated in the search for these brain hormones. Perhaps one tired evening over the test tube rack, one of them dissed the other in some way, the actual events have sunk into historical obscurity; in any case a notorious animosity resulted, one enshrined in the annals of science at least on a par with the Greeks versus the Trojans, maybe even with Coke versus Pepsi. Guillemin and Schally went their separate ways, each intent on being the first to isolate the putative brain hormones.

How do you isolate a hormone that may not exist or that, even if it does, occurs in tiny amounts in a minuscule circulation system to which you can’t gain access? Both Guillemin and Schally hit on the same strategy. They started collecting animal brains from slaughterhouses. Cut out the part at the base of the brain, near the pituitary. Throw a bunch of those in a blender, pour the resulting brain mash into a giant test tube filled with chemicals that purify the mash, collect the droplets that come out the other end. Then inject those droplets into a rat and see if the rat’s pituitary changes its pattern of hormone release. If it does, maybe those brain droplets contain one of those imagined releasing or inhibiting hormones. Try to purify what’s in the droplets, figure out its chemical structure, make an artificial version of it, and see if that regulates pituitary function. Pretty straightforward in theory. But it took them years.

One factor in this Augean task was the scale. There was at best a minuscule amount of these hormones in any one brain, so the scientists wound up dealing with thousands of brains at a time. The great slaughterhouse war was on. Truckloads of pig or sheep brains were collected; chemists poured cauldrons of brain into monumental chemical-separation columns, while others pondered the thimblefuls of liquid that dribbled out the bottom, purifying it further in the next column and the next…. But it wasn’t just mindless assembly-line work. New types of chemistry had to be invented, completely novel ways of testing the effects in the living body of hormones that might or might not actually exist. An enormously difficult scientific problem, made worse by the fact that lots of influential people in the field believed these hormones were fictions and that these two guys were wasting a lot of time and money.

Guillemin and Schally pioneered a whole new corporate approach to doing science. One of our clichés is the lone scientist, sitting there at two in the morning, trying to figure out the meaning of a result. Here there were whole teams of chemists, biochemists, physiologists, and so on, coordinated into isolating these putative hormones.

And it worked. A “mere” fourteen years into the venture, the chemical structure of the first releasing hormone was published; Two years after that, in 1971, Schally got there with the sequence for the next hypothalamic hormone, and Guillemin published two months later. Guillemin took the next round in 1972, beating Schally to the next hormone by a solid three years. Everyone was delighted, the by-then deceased Geoffrey Harris was proved correct, and Guillemin and Schally got the Nobel Prize in 1976.

One of them, urbane and knowing what would sound right, proclaimed that he was motivated only by science and the impulse to help mankind; he noted how stimulating and productive his interactions with his co-winner had been. The other, less polished but more honest, said the competition was all that drove him for decades and described his relationship with his co-winner as “many years of vicious attacks and bitter retaliation.”

The master gland

So hooray for Guillemin and Schally; the brain turned out to be the master gland. It is now recognized that the base of the brain, the hypothalamus, contains a huge array of those releasing and inhibiting hormones, which instruct the pituitary, which in turn regulates the secretions of the peripheral glands. In some cases, the brain triggers the release of pituitary hormone X through the action of a single releasing hormone. Sometimes it halts the release of pituitary hormone Y by releasing a single inhibiting hormone. In some cases, a pituitary hormone is controlled by the coordination of both a releasing and an inhibiting hormone from the brain-dual control. To make matters worse, in some cases (for example, the miserably confusing system that I study) there is a whole array of hypothalamic hormones that collectively regulate the pituitary, some as releasers, others as inhibitors.

Hormones of the Stress-Response

As the master gland, the brain can experience or think of something stressful and activate components of the stress-response hormonally. Some of the hypothalamus-pituitary-peripheral gland links are activated during stress, some inhibited.

Two hormones vital to the stress-response, as already noted, are epinephrine and norepinephrine, released by the sympathetic nervous system. Another important class of hormones in the response to stress are called glucocorticoids. By the end of this book you will be astonishingly informed about glucocorticoid trivia, since I am in love with these hormones.

Glucocorticoids are steroid hormones. (Steroid is used to describe the general chemical structure of five classes of hormones: androgens, the famed “anabolic” steroids like testosterone that get you thrown out of the Olympics, estrogens, progestins, mineralocorticoids, and glucocorticoids.) Secreted by the adrenal gland, they often act, as we will see, in ways similar to epinephrine. Epinephrine acts within seconds; glucocorticoids back this activity up over the course of minutes or hours.

Outline of the control of glucocorticoid secretion. A stressor is sensed or anticipated in the brain, triggering the release of CRH (and related hormones) by the hypothalamus. These hormones enter the private circulatory system linking the hypothalamus and the anterior pituitary, causing the release of ACTH by the anterior pituitary. ACTH enters the general circulation and triggers the release of glucocorticoids by the adrenal gland.

Because the adrenal gland is basically witless, glucocorticoid release must ultimately be under the control of the hormones of the brain. When something stressful happens or you think a stressful thought, the hypothalamus secretes an array of releasing hormones into the hypothalamic-pituitary circulatory system that gets the ball rolling.

The principal such releaser is called CRH (corticotropin releasing hormone), while a variety of more minor players synergize with CRHF Within fifteen seconds or so, CRH triggers the pituitary to release the hormone ACTH (also known as corticotropin). After ACTH is released into the bloodstream, it reaches the adrenal gland and, within a few minutes, triggers glucocorticoid release. Together, glucocorticoids and the secretions of the sympathetic nervous system (epinephrine and norepinephrine) account for a large percentage of what happens in your body during stress. These are the workhorses of the stress-response.

*

from

Why Zebras Don’t Get Ulcers

by Robert M. Sapolsky

get it at Amazon.com

Dear America, This weekend we will bury my niece – Abbie Youkilis MD.

Dear America,

We buried my brother, Dr. Michael Guttenberg, this past October. He was a 9/11 hero and 16 years later he died of a 9/11 related cancer. Our country came together after the 9/11 terrorist attacks to overcome evil. We fought two wars, we subjected ourselves to onerous changes in air travel security, and we willingly gave up civil liberties to give ourselves the illusion of safety.

But we are not safe.

Jaime was in the 9th grade. She was a pretty girl with the world’s best smile and her soul was sensitive and compassionate. She was intelligent and feisty and she danced with beauty and grace. She always looked out for the underdog and the bullied and she probably had been kind to the student who shot her. She planned to grow up and become a mommy and an occupational therapist.

Fred and Jen are the world’s most loving and over-protective parents but they could not protect Jaime from the sickness that has gripped our country. Unless we change, nobody can protect us. My friends and fellow citizens, your guns are not protecting you. Your guns are killing our kids.

Why is your hunting hobby more important than my niece’s life? Don’t you see that your “second amendment” rights have been twisted and distorted beyond any rational interpretation? Why should my niece have been sacrificed at the altar of your “freedoms?”

Why don’t you trust our police to protect us from crime? Don’t you realise that mental illness has been and always will be a part of the human condition and that weapons of war should not be available to those among us who dream of mayhem and death? Don’t you see the blood on all of our hands?

I don’t care that Nikolas Cruz did this. If it had not been him, it would have been some other sad sick young man. I do care that he was able to legally purchase an assault weapon. I do care that the NRA and our so-called political leaders enabled him.

I don’t care if Nikolas spends the rest of his life in jail or gets the death penalty. That will not bring back Jaime and it won’t stop your kids from being the next victims of a “versatile, customizable” deadly weapon of war. I do care that the National Rifle Association (NRA) is dismantled. I do care that our Congress and our President (need to) outlaw these technologically sophisticated tools of murder just like every other civilised country on this planet. Failure to act will make our politicians complicit in Jaime’s murder. I want them to face charges and I want them brought to justice.

My family does not want your hopes and prayers. We want your action. Join us in fighting the NRA. Join us in deposing any politician who cares more about campaign contributions than my beautiful Jaime. Join us in supporting leaders who will bravely fight for our children’s lives.

Don’t tell me not to politicise this. Jaime would want me to. This is political and now this is personal. If not now, when? If not us, who? If we don’t finally ACT, the sickness of gun violence will kill us all.

Sincerely yours,
Abbie Youkilis MD

Political economy, social policy, the coming end of Neoliberalism . . . and other facts of our times.