In all kinds of healing practices, at least in West Africa, the idea is that knowledge is precious, and you learn it over a long period of time. In time, you become the custodian of that knowledge. Your greatest obligation, however, is to pass that knowledge onto the next generation. If the knowledge is correct, it will continue to be used. Everything that I’ve written about my teacher and my own experiences as his apprentice, has been an attempt to convey the wonder of the world he exposed me to. My hope is that my work will in some way ensure that this knowledge will not disappear. My hope is that Adamu Jenitongo’s wise practices will persevere and that they will be recognized, appreciated, and extended to the issues that we face today in the world.
The Sorcerer’s Apprentice, An anthropologist schooled in spiritual healing offers wisdom for troubled times. By Anna Badkhen
Scientists investigated the differences in genes for coat color of 31 ancient horse fossils from Siberia, Eastern and Western Europe and the Iberian Peninsula. The researchers found that a genetic mutation associated with the presence of white leopard-like spotting patterns on modern horses was present in six of the European horse fossils. Additionally, seven of the fossils had the genetic variation for black coat color, whereas 18 had bay coats.
As such, all the horse colors seen in these drawings have now been found to exist in prehistoric horse populations. The findings suggest that cave paintings of horses may be more realistic and less symbolic or fantastic than supposed.
Shrinkrants asks: Can anyone tell me where this is from? It came across my feed with no identifiers. It fascinates me.
I don’t have an answer, but looking around sure has been fun. Clearly the image draws on the 25,000 year-old "The Dappled Horses of Pech-Merle.”
The hand prints are a familiar aspect of rock paintings, but something about this piece reminded me of Plains Indian art. That led me down a rather delightful rabbit hole. Here are a few links:
For These Native American Artists, the Material Is the Message
A new exhibition traces the evolution of Plains tribes’ narrative art from the 18th century up through today’s contemporary works
Moving Pictures
Plains Indian art at the Metropolitan Museum.
SEATTLE ART MUSEUM PAST EXHIBITIONS
The Seattle Art Museum page put the exhibition the previous links reference in context with other exhibitions of indigenous art. One of the exhibitions was of Ledger Art and here are a couple of links about that:
Milwaukee Public Museum: The Ledger Art Collection
Warrior's view of the Battle of the Little Bighorn on display at Stanford's Cantor Arts Center
The Red Horse exhibition at the Cantor Arts Center provides a treasure trove of illustrations and insights on the Battle of the Little Bighorn in 1876.
Finally a couple of links about the rock paintings in the Colombian Amazon which were recently disclosed:
Archaeologists Uncover Trove Of Ice Age Paintings In Colombian Amazon
Amazon rainforest rock art 'depicts giant Ice Age creatures'
My sense is the hunt for the image Shrinkrants posted might propose a bunch of other rabbit holes to follow.
One of my joys of stumbling onto Tumblr has been encountering Shrinkrants. He's intellectually curious and humane; following his links has led me to some long threads which feel important to me.
Last week he wrote about encountering a link in a post, Psychiatry and Narrative Therapy and Jonella Bird. The link takes you to "two short, interesting testimonials–one by a psychiatrist, the other by a nurse–to to work of Johnella Bird, a first-generation narrative therapy practitioner and teacher who has inspired and prodded me at several key points in my own development as a therapist." One of the very intersting bits to me in following the links is that both clinicians work in the trenches so to speak.
There's a quotation from Buckminster Fuller frequently posted online:
You never change things by fighting the existing reality. To change somthing, build a new model that makes the exisiting model obsolete.
A new model doesn't pretend the existing models don't exist. Both clinicians work in the "existing reality" of modern hospitals with all the protocols that entails. They have been also integrating the ideas from Johnella Bird into their practices and have found the ideas have engendered positive movement.
When I was at University in the mid-seventies we watched a video of using operant conditioning in an introductory abnormal psychology course. The video involved an instructor offering positive or negative reinforcement in a learning task involving flashcards to a autistic boy. There were two sequences with different instructors. The first instructor offered positive reinforcement with comments like, "Yes, you've got it." Negative reinforcement was "no" with a neutral valence. It appeared a joyful exercise for both the boy and instructor. The second instructor offered positive and negative reinforcement saying. "good boy" and "bad boy." The exercise got stuck in when the boy meltdown.
I offered the comment about the video that the context of reinforcement was different between the two instructors. The first instructor's focus was about the performance of the exercise, whereas, the second instructor in saying "good boy/bad boy" turned the focus to the boy himself. The professor wasn't having it, both instructors were following an operant conditioning plan, and that's was what I needed to attend to.
I took two take-aways from this exchange. The first was that meaning is relational. And the second was that the lens, or perhaps more apt in this case, theoretical commitments, shape what we imagine reality to be.
One of my most common pitfalls in my life is failing to remember that I am experiencing reality through lenses and to consider that other ways of seeing things are possible and necessary.
The pages at the link Shrinkrants posted have relevance beyond psychiatry and therapy and can be useful to ordinary people as they engage in living. Something that interests me about the pages is they result from a collaboration between the two clinicians, Josephine Stanton and Tania Windelborn. That's implicit, but readers aren't privy to that process. In the same vein I'm intrigued by Shrinkrants’s formal writing with his partner; it's one voice that comes out of intimate conversations between the two of them, and probably conversations with many others. Of course they offer citations, but they’re not the process that intrigues me.
Online conversations often consists of people pointing to things, links, with others taking up the links and pointing to new ones. Most often we're strangers, but like direct conversations, the exchanging of links is affecting. I am so grateful to Shrinkrants and others who I engage in online conversation.
What's wrong with me? Must be something, some kind of deficit disorder--something. That's not a chain of reason, more just a hunch. But I wonder how was it that I typed into Google today "Magic Johnson circumcised"? What follows is a convoluted story.
My use of computers and particularly using computers to access the Internet is for the most part a self-taught affair. I hardly know at all how others do it. I've got one friend who allows me on her Mac sometimes when I visit. The most predominate difference isn't really a difference between operating systems, but rather user preference: she doesn't use tabbed browsing.
My memory is vague. I know that I used to not use tabbed browsing, but it is difficult to imagine not using it now. But one of the issues with tabbed browsing is I'm often at a loss to retrace my steps; how I got from A to B to C to E.
When I go online I check my email and then open some sites in a fairly predictable sequence. I open Talking Points Memo to see if some disaster or catastrophe happen while I was sleeping. I usually open Emptywheel to see what outrage Marcy Wheeler is on about. And I open The Old Reader to see my RSS feeds.
To give an idea about how bad I am at house keeping, the biggest category in my The Old Reader Feeds is labeled "Bloglines" a service I haven't used for many years. Every morning I've got more than a hundred new posts waiting for me. Even though the most I see of the majority is the header, I keep the tab open for browsing during the day.
And I open Shrinkrants. In so many ways sites like Twitter, Tumblr and blogs in general don't offer up conversation, but what goes on feels like conversation to me. I feel like I'm in an on-going discussion with Shrinkrants. Almost always he gives me a link that gives me something to think about, so I open his blog early on in my sequence.
In short order, I expose myself to a great deal of information. So I go about trying to digest it. One way I try to digest information is by asking questions.
I'm not always very clear what in the stream of information has prompted my questions. Today I was wondering: If corporations are people, how come the 13th Amendment hasn't come into play? And for the life of me I can't place what it was I saw in my first pass on the Internet that prompted that question. But anyhow I was off searching about that.
Shrinkrants today pointed to the first part of a two-part series at Mad in America by Rob Wipond entitled The Proactive Search for Mental Illnesses in Children. I rarely have contact with kids, still issues affecting children are very dear to my heart. Wipond's reports are going to take me a good long while to digest. One of the parts of Part One which jumped out was Dr. Mickey Nardo who writes the blog 1 Boring Old Man offering his expertise about the flawed Paxil 329 trial.
Through Shrinkrants, I've gotten hooked on Nardo's blog. So when Shrinkrants pointed to a post at 1 Boring Old Man, I'd already been ruminating about it. I think what's really got me hooked about Nardo's blog is he talks about wisdom, a topic there seems too little said. This link deals with clinical medicine, that is, treating patients at the bedside distinguished from theory and basic science. It matters a great deal that Dr. Nardo is a proficient scientist. So it's the intersection of science and particular patients which make Dr. Nardo's commentary so wise.
My working definition of "rhetoric" is "giving good reasons." There are probably lots of reasons for that definition being problematic, but it's what I work with. Issues having to do with rhetoric, especially rhetorical persuasion by drug companies, are a frequent theme in Dr. Nardo's posts.
It was thinking about medical rhetoric, prompted by two of Shrinkrants's link posts, that got me wondering about Magic Johnson's dick.
For many years I've followed some blogs hailing out of Africa, primarily ones from East Africa, with a special interest in Uganda. Studies have shown that male circumcision reduces the rate of HIV transmission. In Uganda and other countries in Africa efforts to convince adult men to be circumcised are on going. These efforts have prompted lots of discussion on blogs I follow. So when thinking of medical rhetoric, those discussions provide a worn track to follow. But I know from experience there are quagmires along that road, and hoping to avoid travelling right into them, I thought about what might keep me out of the ruts in the road, even just a little. I came up with searching: "Magic Johnson circumcised."
Looking around at the hits that came up, apparently there are lots of American guys nowadays who imagine that the risk of a guy contracting HIV from heterosexual sex is approximately zero.
I'm bad at math and worse with statistics. If there's anything good about that sorry state of affairs, it's that I'm cautious about jumping to conclusions based on my sketchy understanding of statistics. I'm not alone, whole industries are premised on people's poor intuition when it comes to statistics, e.g., the lottery.
Having begun with a rude and puerile search term, it would be hypocritical of me to call out the links I found as rude and puerile. The premise that the chances of an American guy being infected by HIV through heterosexual sex, in the context of my search, was put forward as reason to think that Magic Johnson contracted AIDS from homosexual sex. The tone in which this enthymeme is delivered only slightly more subtle than Vine's Nash Grier's rant. But there you go, rhetoric mostly plays down on the ground, is rough and tumble and messy.
The serious attempt for searching "Magic Johnson circumcised" was to try to get at medical rhetoric, its uses and abuses. Right out of the gate I hit a pothole. The trouble with the message, "AIDS is not a gay disease," is that the argument, "Oh yes it is," seems easy to support. Women are twice as likely to become infected with HIV by a male partner in heterosexual sex. But when sexism and homophobia are used as rejoinders they bypass the direct argument emphasized when dudes say, "Amirite?"
Almost ten years after my first attempt at gaining a college degree, I made a second attempt in the mid-1980's, beginning with a semester at my local community college. I took a speech course. One of our assignments was a panel discussion. Various topics were brainstormed and out of those topics, through self-selection, the whole class was divided up into panels of 4 or 5.
I'd put up, "AIDS testing should be confidential." Something as a shock to me, the panel filled quickly. I was an early participant in The Pitt Men's Study and had, I thought, some up-to-date information about AIDS. I knew that researchers believed that a novel retrovirus had been infecting AIDS patients, but the name HIV hadn't yet been settled upon.
The more I did research in preparation for the panel, the more frightened I became about doing the speech.
The panel participants had only a little time to coordinate with one another. I believe I shared some of the literature I'd gotten from The Pitt Men's Study, but primarily our research was independent. I prepared a fairly technical argument in favor of confidential testing. By the time it was our turn in the spotlight, I was sweating bullets.
All of the other participants on the panel argued from the perspective of fairness and human decency. Frankly my arguments seemed too clever by half in comparison.
This was late in the semester and by that time I'd heard a number of speeches. Overall my classmates expressed conservative views. So I was pleasantly surprised by the positive reaction to the panel's premise.
I'm way off in the weeds, and I hardly imagine anyone has followed. But I got out here wondering about Magic Johnson's penis, by trying to get a handle on Rob Wipond's articles about approaches to mental illness in children. The articles are very well written, Wipond weaves together many threads into a coherent narrative fabric. But they still are not easy to process.
The truth is I was shaken having read Wipond's articles. The article in two parts is something more than science journalism, it's medical rhetoric. And in his writing Wipond draws attention to other forms of medical rhetoric. At one point Wipond quotes Dr. Nardo, "That's just sales language."
I headed out into the weeds on the trail of Magic Johnson's penis, because in my lifetime, I've paid attention to medical rhetoric mostly in regards to AIDS. Magic Johnson courageously going public with his HIV status was crucial in shaping how people thought and talked about AIDS.
When AIDS was first named, I was extraordinarily gloomy in my predictions of how the public would talk and act. What actually happened was much better than I hoped.
I am hopeful that a more constructive conversation about responding to mental illness can be engaged. I'm grateful for Wipond's essay. I wish it gets shared widely. And I feel even more grateful to Dr. Mickey Nardo for his hard work to make the arguments right.
Resilience is more usefully conceptualized as a social, interpersonal process. It’s not a thing that a person “has.” It is a process of mutual support, education, reliance, trust, engagement, vision, labor, and the like that people participate in together.
ShrinkRants. A promising program for helping people with psychosis, but it needs some refinement
A friend's father was a professor of medicine. Often at holidays in their household they'd entertain students and interns who wouldn't be making it home for the holidays. That's so nice, but my friend would complain about how oblivious the guests sometimes seemed. Like not recognizing that talking in excruciating detail about treating a mother and child mauled by a bear wasn't the most appropriate dinner topic.
My friend has a point, but I'm sure she appreciates as much as I do that there are doctors who keep their heads on and their wits about them well enough to treat a mother and child mauled by a bear. Psychosis can present in horrific and frightening ways as much as a bear mauling.
I'm hooked on the 1 Boring Old Man blog. I'm no doctor, but the blog delves deeply into science in the service of the drug industry. I like the blog because it makes me think carefully about science and pitfalls. The series of posts that ShrinkRants points too began as a look at a study, typical of blog posts there. But the subsequent posts led to a more existential explorations on the practice of psychiatry.
While I found the series stimulating reading, I also felt a bit like an intruder--at least an outsider--in a way the critical post about drug trials don't make me feel.
I'm a huge fan of ShrinkRants's blog. His weighing in on the conversation among doctors at 1 Boring Old made me feel a little less like I was eavesdropping. ShrinkRants's comment made me try to imagine what treatment might look like coming from the useful perspective of "resilience" he suggests.
My approach was to think of existing programs that might be similar. The Brazelton Touchpoints Center came first to mind. Their work is to help children grow well. I thought of Persad, a local organization which offers counselling and services to LBGT people in my locale. Persad also does training an advocacy work. And I thought of ShrinkRants's own work with Narrative Therapy.
In so many ways we let children down in the USA. Sometimes I just want to scream! But, perhaps more so than with psychiatry, the perspective of resilience "conceptualized as a social and interpersonal process" seems more ingrained in those who work with children. To speak of "children's well being" just makes sense to most people.
I don't know the ins and outs of how it came about, but state data about children is well organised. New York State's Kid's Well-being Indicators Clearinghouse seems a particularly good example. Several non-governmental organizations contribute too, and the Annie E. Casey Foundation's Kid's Count is a good example on that front.
Anyhow, I was rather heartened that it wasn't so hard for me to imagine that the perspective ShrinkRants offers towards effective treatment of psychosis wasn't so hard to imagine after all.
Thumri: I like this post and think it is true, but from my experience, all of medical education is designed to help us avoid what you describe as the pain and shame of not knowing. I would be interested to know what you think would be a better way to summarize quickly and communicate about complicated patients.
ShrinkRants: ...I do wish standard medical practice were different. These tips, and the condensed presentations given as examples, are shot through and through with impersonal “objective” language. Such language hides the subjective nature of its collection. It works directly against any reflection on the discourses that shape what is included and excluded. It is all about knowing. The tips are offered in service of helping presenters look and feel knowledgable and avoid the shame of not knowing. The people the presentations describe are not present as people, as living breathing, hoping, fearing persons. They are reduced to a collection of facts, signs, and symptoms. This is not, cannot in this form be, “patient-centered medicine.” Until we as a profession change our everyday language, we will not be able to practice patient-centered medicine... (Read the rest at http://bit.ly/18M0bDz)
The shame of not knowing is pervasive but I would agree that it does not mean that it must remain an engrained part of this culture. There are positive ways of delivering feedback. It really depends on the doctor I work with. While subjectivity is generally excluded from these presentations, it helps bring the pertinent information to the forefront, the pieces that are most easily examined, investigated and followed. I always try my best to paint a picture of the person behind the presentation, to tell a story and not just a list of facts. From more descriptors to using a FIFE model to better understand this patient's subjective state, I try to keep them all intact, even if my audience is not completely interested. But the purpose is always to deliver concise presentation that informs enough for another doctor to draw his own conclusions and to do his job effectively. Having said that, some specialties simply do not lend well to subjective language at all in a presentation.
shrinkrants replied to your post: shrinkrants replied to your quote: She gets...
I’m sorry, I probably shouldn’t have said anything. I just get embarrassed when I think back on my residency days and remember saying things like this. They now seem to me to be making fun of people just because they don’t know a specialized jargon. It’s elevating of doctors…
I understand your concern, but I would never make fun of a patient in their presence or treat them in such a way as to make them feel stupid or "less than". And I really don't consider patient quotes as "making fun". I'm not posting quotes to call people ignorant or make them look bad--if I wanted to do that, I'd post their name. I think showing some of these pre-meds and med students how patients talk/think/act is a way to remind them to get on their patients' levels when interacting with them.
If I wanted to use this blog to elevate myself, I would. I'd write nothing but lies about perfect test scores and amazing accolades rather than write true posts about my struggles in medical school and residency. You of all people, as a shrink, would know that doctors need outlets just like everyone else, which is why I run this blog. And I keep it all anonymous in order to protect my patients. This blog is where I write and say all the things that I can't actually say out loud.
