Friday, July 18, 2025

Mentalizing, Mindfulness, and the Drive for Evidence

 In reading about attachment theory, David Wallin's description of Peter Fonagy's work was intriguing, so I went down that rabbit hole. 

Fonagy developed Mentalization-Based Treatment (MBT) to improve emotional regulation, as distinct from Jon Kabat-Zinn's Mindfulness-Based Stress Reduction (MBSR). Fonagy sees our mental development as relational, but in order to have empathy for others, we need awareness of our own feelings, which can be helped with mindfulness work. However, in looking at the evidence of efficacy of these separate modalities, I question the attempt, since Freud, to make psychology into a natural science. Each of the various ways to help are useful, but there's an element of the unknowable in the way when we treat them scientifically.

According to Wallin, Fonagy's focus was on developing the understanding of the mental states of others, which he calls mentalizing, to let us understand the depths of ourselves and others. For instance, it can help heal old wounds if we understand that dad's rejection of us might be due to his depression and not our behaviour as a child. Other people's reactions to us aren't just caused by us, but there are always multiple factors at play affecting how people behave. It seems very similar to Theory of Mind. He met Bowby in the 1980s, and studied adults' behaviour relative to their own descriptions of childhood attachment, and found, when comparing severely deprived to well-connected adults, that a weak attachment was correlated with a weak "reflective functioning" (the ability to understand behaviours in terms of their thoughts, feelings, and mental states). From this, he says psychotherapy should be the "effort to restore or kindle patients' capacity to mentalize," to simultaneously feel our feelings and reflect on their meaning. To help people develop mentalizing requires a relationship that mirrors and guides emotional responses.

His description of mirroring is specific: it must be "contingent and marked." The reaction has to be accurate and not our own reaction to the other person's upset, but an empathetic reaction with them. For example, if a child is angry, we effectively mirror it by getting mad with them at whatever frustration they're having, without bringing in any of our own anger or frustration about the situation or that our kid is pitching a fit, or else "the child can feel overwhelmed by the contagious nature of his distress." This follows the work of Winnicott: "Only the child who expresses anger and finds the other survives (neither retaliating nor withdrawing) who has the opportunity to learn that the other is a separate subject, not an object." They have to be allowed to try this. Once we mirror them, then we can calm ourselves down, so they can copy our regulation then move towards determining if the problem is best resolved with acceptance or change.

In a therapy situation, this appears to be a call for therapists to stop being a neutral container, sitting completely unreactive while their client emotes, but instead to react with the client. (It also brings into question some applications of "gentle parenting" that don't register the child's frustration but instead present instructions like a broken record.) The movement away from neutrality is reminiscent of Carl Rogers' view that therapists shouldn't try to be detached and robotically unresponsive, merely watching emotions unfolding with a steely resolve.

However, Rogers described the complexity of reflecting feelings in 1975 and raised a concern back then:

"It became quite natural to lay more stress upon the content of the therapist's response than upon the empathic quality of the listening. … This tendency to focus on the therapist's responses had consequences which appalled me … complete distortions of our approach."

He takes on the distortions to clarify his approach, first defining empathy: 

"The state of empathy, or being empathic, is to perceive the internal frame of reference of another with accuracy and with the emotional components and meanings which pertain thereto as if one were the person, but without ever losing the 'as if' condition. … If this 'as if' quality is lost, then the state is one of identification."

And that made me rethink this bit of Epictetus (Enchiridion, ch. 16), who also wrote at length about what we should accept or change: 

"When you see anyone weeping in sorrow because his son has gone abroad, or is dead, or because he has suffered in his affairs, be careful that the appearance may not misdirect you. Instead, distinguish within your own mind, and be prepared to say, "It's not that which has happened that distresses this person., because it doesn't distress another person; it is the judgment which he makes about it." As far as words go, then, do not be unwilling to show him sympathy, and even if it happens so, to lament with him. But take care that you do not lament internally also."

I had originally read it as a cold directive to be unaffected by others, but now I wonder if he had actually nailed empathy.

Rogers goes on to explain that we can understand other people's feelings by checking our own "psycho-physiological flow" within ourselves, which he assures us is "a very real thing." We feel sad when we see someone sad, and we can look to our own internal feelings to help to elucidate the other person's feelings for them. He writes,

"To be with another in this way means that for the time being you lay aside the views and values you hold for yourself in order to enter another's world without prejudice … voicing meanings in the client's experience of which the client is scarcely aware. … He moves into feelings and experiences that are only hinted at by the client and does so with sensitivity and accuracy."

In an interview with Victor Yalem (Irvin's son), Wallin clarifies, 

"I also tend to assume that what we can't allow into our awareness of our experience--which also means what we can't talk about, what we can't think about--we tend to evoke in other people. So I'm inclined to believe that by paying attention to what's going on inside myself, I may get some clues as to what's going on that is most salient inside them."

It might bring some relief to those in the profession that this is outside the realm of AI, which can merely mimic feeling with others. As a recent Rolling Stone article explains a further concern,

“AI, unlike a therapist, does not have the person’s best interests in mind, or a moral grounding or compass in what a ‘good story’ looks like. A good therapist would not encourage a client to make sense of difficulties in their life by encouraging them to believe they have supernatural powers. Instead, they try to steer clients away from unhealthy narratives, and toward healthier ones. ChatGPT has no such constraints or concerns.”

To understand others by looking at our own internal state, Fonagy suggests, we have to be aware of these inner feelings, which is helped by someone mirroring back to us. Rogers also expressed this: "Empathy is correlated with self-exploration," and "an empathic way of being can be learned from empathic persons. … The more the therapist or teacher is sensitively understanding, the more likely is constructive learning and change." It's mirroring all the way down!

Rogers believes empathy between us is key to dissolving alienation as people feel more seen, valued, and accepted, so it's vital to help one another get in touch with a wider range of experiencing. It's how we feel understood and better able to develop a distinct identity. And it's all a domino effect in that the more empathy we demonstrate with others, being non-judgmentally receptive to their feelings, the more empathetic others can become, and the less alienated we'll all be.

Back to Wallin, it's interesting to me how mentalizing is contrasted to mindfulness because in places they seem identical. It seems necessary to our awareness of emotional states. He explains that Fonagy places mentalizing between states of embeddedness and mindfulness. There's an optimal place of connecting to others between enmeshment (or Rogers' state of identification) and what he describes as "bare attention" or a "single-minded awareness of what happens to us … a non-judgmental observation of the ongoing stream of internal and external stimuli." It's being fully present, but with another, and not losing ourselves in the process.

There's an intersubjective relatedness to mentalizing as it requires another person, but more than that, Wallin clarifies, mentalizing is a route to establishing a coherent self, whereas mindfulness is the path to transcend the self, to "undo self-imposed suffering caused by clinging to an illusory image of the self." Mentalizing frees us from the past as we make sense of the specific contents of our experiences, but mindfulness directs our awareness to the process of experience in general. There's still a place for embeddedness and mindfulness, though. Embeddedness is the beautifully immersive experience we have when we lose ourselves while listening to music or during sex. Mindfulness helps in developing our sense of attention as something we're able to direct so we can choose what to focus on and strengthen our internal observations in the moment to be able to better tolerate our emotional content. In that Yalem interview, Wallin adds, "I'd refer sort of fancifully to mentalizing and mindfulness as the double helix of personal liberation or psychological liberation."

A somewhat extraneous issue this raises is the variability with which "mindfulness" is defined. Just in this brief exploration we slipped between it being a present-moment awareness, which could include our awareness to the other person, a tool for stress reduction, and a path to transcend the self, which feels conflated with meditation. It might be all three, but, as Fonagy implies, as a path to transcend the self, it's less effective to connect with others. Research on mindfulness has been marred by this range of definitions as well as the range of techniques that "count" as mindfulness tools.

Mindfulness's use in stress reduction has been studied, but often without clear measurement criteria, attempts to optionalize specific qualities of whichever definition they're using, adequate randomized control, precise methodologies (e.g using an app or taking a class treated as the same), and/or being separated from other modalities (e.g. within MBCT or DBT), so the studies have been widely criticized (Bishop, 2002. Van Dam et al, 2019, Stefan & David, 2020, Goldberg et al, 2023). Van Dam et al points out a general concern that "statistically 'significant' differences have repeatedly been equated with clinical and/or practical significance." Bishop says of MBSR specifically, "There is insufficient evidence based on rigorous scientific methods to strongly recommend it at this time. … Clinicians are cautioned against attempting to use this approach as a 'cure all'." The questionable results have been promoted regardless, and we're all about it in many psychotherapy courses. Fonagy et al (2023) also acknowledges there are too few studies on mentalization to establish strong conclusions. The critiques offer suggestions for studying these techniques more rigorously, so it's possible. However, I wonder about the push for evidence-based techniques in psychotherapy in the first place. The brain can be explored with significant reliability, but the mind is a different sort of thing.

We know about the replication crisis in social sciences already, and, as much as we try to make therapy into an objective science, the complexity and variability of our minds seems to get in the way. In the soft sciences, it's difficult to isolate variables and hard to make exact predictions based on data anyway.

When being prescribed medications for mental disorders or illnesses, despite all the research, people are still their own guinea pig. We know generally what helps and what harms, and that's life-saving, absolutely, yet we still can't know for sure which will best help a specific person until they try the drug. The difference between meds and mindfulness and other modalities within talk therapy is that they have far fewer risks, although Goldberg notes, "to our knowledge, no systematic evaluation of harm and adverse effects of information mindfulness" exists, and Stefan & David caution that, "detachment may decrease motivational relevance in the face of personal goals and may encourage low intensity affect in cases where this would not be either needed or desirable." We don't want to make people so chill that they can't get their work done.

Mark Solms' fascinating book, The Hidden Spring, describes in clear detail what happens when we're experiencing consciousness, and ends with a final chapter on how close we are to being able to replicate a brain, neuron by neuron. There's tons of science in it and a sense of certainty in it all as he verifies the vital role of emotions: "This way of feeling our way through life's unpredicted problems, using voluntary behaviour, is the biological function of consciousness." So, we know a lot about the brain and consciousness, and yet, we still can't tell precisely which intervention will help a specific patient suffering from a mental illness without trying it on that individual. That part is still a matter of best guesses and painful trial and error. We are too variable and complex. A psychological intervention that really helps one person today might not help as well tomorrow, and might not help their identical twin at all.

Solms also theorized on the origin of empathy through play, which "gives rise to the formation of social rules. … PLAY might well be a biological precursor of thinking in general … psychotherapy - a form of 'continuous reciprocal prediction' - is also a form of PLAY." This "developmental achievement" of empathy can be narrowed down to a specific brain region, but that doesn't help explain how to do it or what it feels like to the uninitiated. Fonagy found a correlation between lack of empathy in adults and severe deprivation in childhood, and goes down the path of one-on-one re-connection with a trained therapist. (I'd be excited to pursue what the education system could do with this if provided adequate resources.) However, there's always a feeling out process to that work that depends to some extent on the therapeutic alliance.

A book on Motivational Interviewing (2012) is clear about this: unlike other medical fields, 

"One of the better replicated findings in psychotherapy research is that therapists with many years of practice have no better client outcomes on average than those who are recently trained." 

They suggest the problem is from a lack of immediate, direct, and reliable feedback on their efforts (implying that the client's self-assessment is unreliable), but I think the lack of noticeable improvement might be because there is no straight and consistent line between technique X and result Y no matter how much we assert that this new acronym is the real solution. I think all of these modalities are useful and "work," but only for some people at some times. We have far less certainty that we'd like to have, but we can still work with that. We've been working with these various methods for centuries.

So maybe it's acceptable if psychotherapy modalities are used without quite the same level or type of evidence as other fields of medicine. Freud and Jung have also been written off in some circles for the lack of scientific validity of their methods, yet they're foundational to many currently accepted theories. Perhaps some modalities are better seen as philosophies that guide the process of connecting with another human being alongside ancient Stoic and Buddhist texts, rather than a set of instructions to follow to provide a felt sense of optimizing progress. The science around things gives us a sense of certainty that feels comfortable and sturdy even when it's illusory. We crave that certainty. The alternative is recognizing the art of helping one another as a dance of trying and correcting over and over. We might not be certain about the effectiveness of mindfulness or mentalizing, but it might still be helpful and even virtuous to lament with others, taking care that we don't lose ourselves in the process.

Tuesday, July 1, 2025

Vaccinate Against Variant Soup

Some weird new federal SARS-CoV-2 vaccine guidance - in layman's terms.

Variant soup ingredients from April 2025

But first, remember that, when it comes to vaccinations, Covid is like the flu, not like measles or polio. It's not one and done because the virus mutates so easily and quickly. Every few months we permit new variants to add to the mix by letting them spread and mutate, and only sometimes does anyone important mention the variety of variants out there. (By contrast, for rates of illness and death, Covid is a lot like measles and polio in the unvaccinated death and disability rate. It's a serious disease!) 

Like the flu, we need regular access to vaccinations. If people ask how many Covid shots you've had, ask them how many flu shots they've had. It's the same silly question.

If you've never been vaccinated for it, get two shots this year.

If you have been getting shots, the guidelines say you should get one a year if you're pregnant, over 65, in congregated living, a health care worker, part of a listed racialized group, or have an underlying medical condition that's associated with more severe infection, which includes diabetes and cancer and other medical conditions, but also obesity, and disabilities like ADHD, and mental health disorders like depression (but not anxiety).

Luckily, you don't have to prove you have an underlying condition because anyone may (is allowed to) get one shot. They'll come out with a new shot this fall, but who knows when that will be!

The vaccination is protective for less than six months, so you might want two shots a year. But good luck with that! 

According to their collective wisdom, you should get two shots if you're over 80, in congregated living, or moderately to severely immunocompromised due to an underlying condition. I don't think claiming severe ADHD will work, but no harm trying! You may get two shots if you're 65 to 79. 

So despite that most infections come from schools, all those kids spending their days in a school building, from junior kindergarten to university, can get a shot in September, but then are just sitting ducks come February. Make it make sense!

A good N95 is still your best bet to avoid this preventable disease!

Sunday, June 15, 2025

The Necessity of Feeling Seen

Attachment theory is part of the vernacular now. Even the Norwegian show Porni mentions it, and the dramatic eldest daughter blames her mom for her “relational damage”! We’ve largely accepted the questionable idea that mom’s attentiveness in childhood creates our attachment patterns for life — the gist of the theory as it’s largely understood, but what’s usefully generalizable from the actual studies? There are many criticisms of the theory, yet some university psych courses applaud it without reservation. I’m dubious about it, but I also don’t want to entirely throw this baby out with the bathwater.

 This is a huge topic, and I’ll hardly do it justice here. There are a few excellent books on it, but part of the problem with how we understand the studies might be that the most nuanced books seem to be the most academically written, and likely the least read. As it morphed into popular consumption it may have strayed further from the original intention. On top of the reading, I went to a couple workshops on attachment to find the magic solution to all our relationship ills, and my big takeaway is this (for free!): if you’re a bit distant, consider being open to getting closer, and if you’re a bit clingy, try to step back a bit. It’s good advice to notice and change patterns that are a problem, absolutely, but I’m not sure it merits the number of workshops, courses, and self-help books that it’s provoked. At worst, some books actually counsel people to avoid any “avoidant or disordered people” as if there’s no saving them from their dastardly origins. Therapeutic discussions of childhood misconnections definitely have helped people better understand themselves, but I think this theory produces such volumes of celebration and condemnation because, in difficult relationships, it feels like the answer, but to parents, it feels like blame.

Attachment Theory Criticisms 

Heidi Keller’s The Myth of Attachment Theory (2022) is an extremely thorough takedown of the theory. If attachment notions make you feel like a crappy parent, this book is vindicating. She explores the offense of putting it all on moms both because of the narrow focus on a single person as well as on singular causation, but her best work is in exploring the creation of a norm of interaction from upper-middle class, western assumptions around what it means to be sensitive to a baby’s needs, an analysis that was made at the time as well: 

Friday, June 6, 2025

Losing Our Democracy in Ontario

For a little while, Trump's mess made me über proud to be Canadian, and even a little bit okay with Ford. But that was short lived! 

If anything, the US disaster has been a distraction for us as the provincial majority government pushed through several anti-democracy policies. They're using Trump's trade war to try to justify these policies, but we all know that's bullshit. 

Bill 33: Supporting Children and Students Act, which passed second reading yesterday. It will give Ford more control over school boards and universities and colleges. It could mandate police presence in schools and mandate university admission policies. From OPSEU President JP Hornick:

"Stripping away access-focused admissions pathways threatens the socio-economic mobility of entire communities. They want to surveil and criinalize our kids from a young age and then make it even harder to access post-secondary education later on in their academic careers. Ontario's future depends on an inclusive education system, not one that intentionally keeps people out. ... It is clearly intended to defund these services in our colleges."

Thursday, June 5, 2025

Covid Causes Clots!!

 A headline in the New York Post: "Why so many people are having strokes in their 20s, 30s, and 40s: We've never had patients so young." 

They report that, "Between 2020 and 2022, there was a 14.6% increase of strokes among people aged 18 to 44." Many of whom were "by all common standards, healthy." Their theories about the increase include birth control pills, stress, long working hours, physical inactivity, caffeine especially from energy drinks, and Adderall (although they add that most studies don't show a strong association between Adderall use and strokes). None of these have been shown to have increased that dramatically since 2020, but something else has. I stupidly read the comments on the article, which are all about "the jab" killing us. IT'S NOT THE VACCINE!!

There is, of course, absolutely no mention about an unmitigated brain-invasive virus doing the very type of damage researchers and doctors warned us about years ago. We knew that Covid stays in the body and forms blood clots since at least 2021, and it became widespread in 2022, which is why some wise doctors ask for a D-dimer test after a patient has problems post-Covid infection to check for clotting issues. Here are just a few: 

Thursday, May 29, 2025

Protect Your Neurons from Nimbus!

The latest Covid variant has the same name as a big looming rain cloud. The more we let Covid spread, the more it will continue to mutate, and this one is even more easily transmissible. 

It's provoking people to mask up in parts of Asia, and governments are encouraging updated vaccinations in parts of Europe, and it's definitely in the states, but they're not doing much to stop it. Will we?? My kids and I still can't get another Covid shot until it's been a year since our last, and we can't access Paxlovid if we need it. But thankfully there are no mask bans being proposed here.

In the states, the FBI is treating Covid as a crime to be investigated instead of a public health matter to be mitigated:

Wednesday, May 28, 2025

Still Blooming!

Another milestone to reflect on life a bit today: my 60th birthday. It sounds so old, but I biked 60k total on Monday and Tuesday (didn't have time for it in one go), and played pickleball today, and I'm regularly writing 3,000 word essays, so I appear to still be reasonably sound in body and mind.  

I was hoping my crabapple would bloom for my birthday, but everything bloomed early this year. A couple years ago I wrote about some people who randomly walk by, loudly insisting my crabapple is dead. It's still not dead yet! These are the very last of the lilac blooms from my garden. Such a weird year.

Tuesday, May 27, 2025

New Covid Strain Causing Razor Blade Throat

Several news venues have been reporting on Covid in the last few days. An ABC News headline says: "Why are more than 300 people in the US still dying from Covid every week?" 

The article explains,

"Public health experts told ABC News that although the U.S. is in a much better place than it was a few years ago, Covid is still a threat to high-risk groups. 'The fact that we're still seeing deaths just means it's still circulating, and people are still catching it.' ... The experts said there are a few reasons why people might still be dying from the virus, including low vaccination uptake, waning immunity, and not enough people accessing treatments."

That last sentence is infuriating because vaccines wane in effectiveness after a few months, and vaccinations here are restricted to yearly except for people over 65 and anyone moderately to severely immunocompromised, such as organ transplant recipients, anyone HIV+, and anyone taking immunosuppressants. Furthermore Paxlovid, our only treatment option here, is only available to people over 60 or at high risk of complications from Covid. Otherwise, you're on your own.

Sunday, May 25, 2025

On Approaching Death

 CW: As the title suggests, there will be discussion of death and dying and some mention of suicide in this post.

I thought nothing of following up my last post on Irvin Yalom on the meaning of life with Yalom on the meaning of death, until I started writing here. The very reality of being a bit wary of broaching the subject reveals the strength of societal taboos against admitting that we’re all going to die. Until it’s staring us in the face, we delude ourselves into thinking we will get better and better, mentally and physically, despite that our brain starts to shrink in our 30s, and our joints and organs will start to give out not so long after. We work hard to keep death clean and sanitized so the reality doesn’t seep in too much, and we try to do all the right things to keep death at bay: exercise, various special diets, wearing masks to avoid viruses. We can fix some evidence of erosion with meds and surgeries, sometimes miraculously, but some people even hope to keep their brain going long after their body dies.


Wednesday, May 14, 2025

Dancing with Viruses

There are several measles cases in Waterloo Region. As of last week there were currently over 60 cases in nearby Wellington/Guelph, and over 1,300 in Ontario since October.

Measles is like Covid in that there's an incubation period in which people have no symptoms but are contagious. Viruses are stealthy! For measles, it's 7-12 days from exposure to symptoms like fever or cough, so it's really important to track cases and isolate if potentially exposed. For Covid, it can be 5-7 days before it's picked up by a rapid test, and you can have it and spread it without any symptoms at all. Both cause serious complications, including brain infection, and leads to death in about 1 or 2 in 1,000 people. 

Both can be prevented with an N95.

The biggest difference between these viruses is that getting vaccinated is extremely good protection for measles, but not for Covid. If you got your measles shots, you're very likely completely protected. Unfortunately, vaccination rates are plummeting. We need to have at least 94% of the population vaccinated to create herd immunity and keep measles at bay, and Ontario has been hovering in the 70s since Covid started and anti-vaxx nonsense got a platform. Vaccination against Covid does a lot to keep people out of the hospital, but it doesn't prevent getting and spreading the disease because, like the flu, Covid mutates all the flippin' time. Measles is just measles, but Covid could be delta, or alpha, or one of many omicron variants, or whatever's going on now. It changes so much I stopped keeping track. The more it spreads, the more it mutates, and we're doing nothing to stop the spread. 

Sunday, April 27, 2025

Please Vote!!

Let's see if we can avoid our own Timbit Trump tomorrow!! If you're not sure of the best candidate to beat the cons in your riding, check out Smart Voting!  

Prime Minister Carney said of Poilievre yesterday, 

"It's easy to be negative when you've never fixed anything. It's easy to be negative when you've never built anything. It's easy to be negative when you're a career politician who has never accomplished anything." 

Taylor Noakes, agrees that Poilievre has accomplished nothing during his twenty years in Parliament:

"This isn't as much a political party as it is a ChatGPT-based slogan-generating algorithm speaking through the mouth of everyone's least favourite muppet. . . . The Conservatives have essentially made 'Fuck Trudeau' their ideology, and the average Conservative voter has made it their core identity. ... The Conservative Party have placed strict limits on who is allowed to ask him questions, and have further tried to prevent journalists from talking to party supporters and local candidates. ... According to a report by LaPress, Poilievre seems to have the loosest grasp on facts and the truth, as the publication found that he lied, embellished or misled far more than any of the other candidates during last week's debate. ... He has voted against the environment and climate 400 times ... against the Canadian Dental Care Plan, $10 a day daycare, the National School Food Program, the Canada Child Benefit, and raising the federal minimum wage ... against a proposed first-home savings account and a proposal to build four million new homes."

Friday, April 25, 2025

The Rise of Unreason

The Ontario Health Coalition put out a press release a couple weeks ago about the sharp increase in people infected with measles here. There were 816 cases from October 2024 to April, then 155 new cases from April 3-11. Our immunization rates are lower than most of Europe -- only 70% of kids have typical childhood vaccinations. Vaccination rates were reduced dramatically in 2020. "This is a Public Health failure that must be addressed with the utmost urgency." 


David Fisman recently wrote about it: 

Balancing Individual Rights and Community Health Requires Knowledge of History

Ontario is in the midst of a measles outbreak, and our Chief Medical Officer of Health (CMOH) is taking a “you do you” approach. No mandates. No strong guidance. Just a gentle suggestion that people make informed decisions…if they choose to. It’s a startling response given public health’s long history of collective action, and at times, authoritarianism. 

That authoritarianism wasn’t a bug of early public health. It was a feature. Modern public health emphasizes individual rights, but those rights can come into tension with the community’s right to health, especially during outbreaks of communicable diseases. Institutional public health grew out of fear. 

Monday, April 21, 2025

Yalom on Approaching Meaning

About 45 years ago, psychiatrist Irvin Yalom estimated that a good 30-50% of all cases of depression might actually be a crisis of meaninglessness, an existential sickness, and these cases require a different method of treatment. We experience this lack of purpose as boredom, apathy, or emptiness. We are "not told by instinct what one must do, or any longer by tradition what one should do. Nor does one know what one wants to do," so we feel lost and directionless. Instead of addressing meaninglessness as the problem, though, we've been merely addressing the symptoms of it: addictions, compulsions, obsessions, malaise. In today's context, it might suggest that even social media issues could be problems with a lack of meaning. 

The last sentences of his lengthy tome, Existential Psychotherapy, sum up his solution: "The question of meaning in life is, as the Buddha taught, not edifying. One must immerse oneself in the river of life and let the question drift away." How he lands here is an intriguing path through a slew of philosophers and psychiatrists. Even without symptoms of a problem, attention to meaning is necessary as it gives birth to values, which become principles to live by as we place behaviours into our own hierarchy of acceptability. 

"One creates oneself by a series of ongoing decisions. But one cannot make each and every decision de novo throughout one's life; certain superordinate decisions must be made that provide an organizing principle for subsequent decisions." 

Yalom doesn't, however, suggest coming up with a list of values that can become meaningful to us, but that we immerse ourselves in life to become more aware of which values we already have


WHAT'S THE POINT? IT'S FOR US TO DECIDE


According to Yalom, we've hit this crisis point in meaninglessness because we have the leisure to think and because our work is no longer clearly purposeful, both of which are relatively recent experiences for such a large proportion of civilization. It's no longer just the philosophers of the day asking, What's it all for? What's the point of it all? He takes the existential position that it's up to us to figure it out. 


Monday, April 7, 2025

Orange Monday or MAGA Monday?

Time will tell which name will go down in history books. But April 7, 2025 will be up there with Black Monday (October 19, 1987) and Black Thursday (October 18, 1929).

Trump wants everyone to just calm down, already, in his own ever-weirdly worded way. But he said this just before millions of Americans died of Covid, too. 

Thursday, April 3, 2025

So, Tariffs, Amiright?

Round of tariffs for all, except Russia.

I have a friend in the states who isn't worried about any of this stuff. "Big businesses will stop it," she says. She expects 3-6 months of wavering, max, then corporations will push back enough that things will settle down. It's all just posturing. She has a lot of faith in the markets and in this administration's willingness to be pushed. But okay. Maybe.

I suggested the tariff threats have already changed everything, and she was surprised to hear about American products being taken off the shelves or indicated in some way to help us avoid purchasing them, and that travel between our countries is down 70%. We don't want American stuff anymore, and we'll avoid it as much as we can. 

One analogy that rings true: 

"Imagine one of your friends points a loaded handgun at your face, and then immediately goes, 'nah man, just joking lol'. No matter how short a time that was, you're still not gonna ever trust that motherfucker again. It will have permanently altered your relationship. Anyway, tariffs on penguins."

Monday, March 31, 2025

Public Health Needs to be Independent

 David Fisman posted a thread yesterday about problems when big money gets involved in public health.

"During Covid, I experienced firsthand how political pressure twisted science—and nearly destroyed reputations. A short thread on conflict-of-interest theatre, redacted emails, and lessons we still haven’t learned. 

In January 2021, I was publicly accused by Ontario’s Premier of having a conflict of interest due to paid consulting work I did for the Elementary Teachers’ Federation of Ontario (ETFO). The suggestion was that I’d influenced school closure advice. What wasn’t shared? Internal emails—later released via FOI—show this was a manufactured controversy. The allegations didn’t reflect what officials knew privately. And that story deserves to be told. 

On Jan 26, 2021, Heather Watt (Chief of Staff to Health Minister Christine Elliott) drafted messaging about the “conflict.” She sent it to Steini Brown—my dean at the University of Toronto, and chair of the Science Advisory Table—for input. Steini replied carefully. He pushed back, noting: “There’s no direct line between David working for ETFO, us giving you advice to close schools, and you following it.” His reply was initially redacted in FOI responses. Journalist Jack Hauen appealed the redaction—and won. He sent me the full, unredacted email when requesting comment. It showed that the internal view did not support the public claims being made about me. Steini also wrote: “He is merely one of dozens of scientists working on a volunteer basis and does not speak for the group in his work for ETFO.” That’s a very different story than what was spun publicly. 

Sunday, March 30, 2025

Disappearance of the Rule of Law

Charlie Angus talked about Canada-US relations on Meidas Touch: "We're thinking, if we go down the road with this regime, we're talking about the disappearance of the rule of law, and that's deeply offensive to us." 

Rule of law goes at least as far back as the Magna Carta over 800 years ago. It means that everyone is under the law, including the king. Even a president! Even in the US they overtly seek "the government of laws and not of men," and make that clear in the 5th and 14th amendments. John Adams feared the "vulgar rich": To ennoble the new regime, the most talented must be made to serve their country, rather than their selfish desires. Adams thought offering fancy titles would satiate their quest for power, taking a page from Rousseau: "the role of illustrious offices and signs of rank in countering the popular passion for material wealth." But that's not enough for this crew. They have no respect for rule of law. 

Human rights will always be pushed by those who hope to exploit a situation or group of people, and we need to be there to push back. Over and over and over again. I used this 5 minute explanation of the history of human rights in my grade 10 civics classes:


The important bit is at the end, that we have to KEEP fighting for our rights. There will always be people trying to amass power and override the law, and we have to be ready for that, en masse, to stop it. 

Friday, March 28, 2025

Monbiot on Capitalism vs Commerce

 George Monbiot wrote today, 

"One of capitalism's greatest successes is to shut down our imaginations. With the help of its favoured tools - neoliberalism and fascism - it persuades us that 'there is no alternative'. Our first task is to re-ignite our moral imaginations and name our alternatives. I cannot count the number of times I've been told, 'if you're against capitalism, you must be a communist,' or 'you must be a feudalist'. In fact, as in my case, you can be fiercely oopposed to capitalism, to communism, and to feudalism. It helps if you undertstand what capitalism is. This means recognizing that it's true nature is endlessly disguised. It's a distinct economic system which arose around 600 years ago. In The Invisible Doctrine, we give this definition:

Capitalism is not the same as commerce. The Dutch VOC and the British East India Company were not trading with the people whose land, labour and resources they seized. Nor were the slavers in the Caribbean and the Americas. Nor is investor-state dispute settlement (ISDS) commerce: nations are forced to surrender resources to corporations or pay compensations. Nor is conversion of rainforests to cattle ranches or  extraction of deep-sea minerals. No one's freely trading or being properly remunerated in such cases. Yes, colonial looters might then trade the wealth they steal: capitalism can intersect with commerce, and can overrun commerce, but it is not the same. 

Thursday, March 27, 2025

Bearing Witness

 Brandon Friedman wrote an important thread about what we do now. Here it is in full:

"This is a German woman being marched past the bodies of Holocaust victims. After World War II, it was common refrain among German civilians: They just didn't know. For that reason, many were forced by Allied troops to bear witness. Like this. 

I bring this up because fascism is now here, in America. 

If you're thinking, "but it doesn't feel like fascism, nothing in my life seems amiss," then congratulations, you have discovered what fascism is like. 

Wednesday, March 26, 2025

Avoiding the Sausage Machine

click to read
I attended an excellent masterclass on "Trans-Inclusive Philosophy" with Sophie Grace Chappell last week, put on by The Philosopher magazine. She wrote Epiphanies and Transfigured, and this paper will be coming out in a collection soon. She discussed system-building in a way that lit some lightbulbs for me. I was waiting for the video to be posted before writing about it, but, in lieu of that, here's my transcription of it. 

She starts by responding to a call to build a theory of what gender, transgender, and gender identity are, and she clarifies the problems with gate-keeping off the bat. People will demand that before anyone's allowed to claim they're trans, they first have to define male and female, and she likens this to saying before you can sit on a chair and drink some tea, you first need to establish the necessary and sufficient conditions for chair and for tea, which is just ridiculous and very dangerous.

More interesting to me is her second argument, that defining what counts as transgender butts up against bigger problems with any system building. She prioritizing experience over theory because any attempt at an overarching trans theory will inevitably leave someone out. She has her own idea of what fits her, but it won't fit everyone, and other people might have great definitions for themselves, but they don't entirely fit her, either. 

Monday, March 24, 2025

Things May Appear Bleak, And Yet...

Byung-Chul Han's The Spirit of Hope is a beautiful book, the kind you want to treat with care and won't dare dog-ear a page. Anselm Kiefer's illustrations throughout provide a place for contemplative moments between ideas. It's more immediately accessible than The Burnout Society, which took me weeks to wrap my head around, yet no less profound. 

A REVOLUTIONARY POLITICS OF HOPE

We like a secure illusion of control over the world, yet that hasn't gotten us much further along. We recognize something's missing. Han writes, "Amid problem-solving and crisis management, life withers. It becomes survival. … It is hope that opens up a meaningful horizon" (2). 

Han explains how a lack of hope furthers the current neoliberal capitalist trajectory: 

"Fear and resentment drive people into the arms of the right-wing populists. They breed hate. Solidarity, friendliness and empathy are eroded. … Democracy flourishes only in an atmosphere of reconciliation and dialogue. … Hope provides meaning and orientation. Fear, by contrast, stops us in our tracks. … Hope is eloquent. It narrates. Fear, by contrast, is incapable of speech, incapable of narration" (2-3). 

Monday, March 17, 2025

The Flies Have Conquered the Flypaper

Steinbeck's The Moon is Down was first published in 1942, before he was sent off to fight. As a journalist, he enlisted in order to be in the thick of thing to write with authenticity. This may be a book for our times, unfortunately. It's about a town invaded by enemy forces.


It's a short read, but also captured fairly well in the movie, made just the following year, with Henry Travers (Clarence in It's a Wonderful Life). Of course it's a hopeful read as the town fights back, but it's also terrifying for what they endure. 

 

And then I watched Shame, which might be a more realistic depiction of what it is to live with the beginnings of invasion as sides get confusing and people betray one another.  

Possibly I'm looking for instruction of how to be when another country threatens invasion, what it looks like to be courageous in the face of real danger, but I may well be just torturing myself! I'm also reading Byung-Chul Han's The Spirit of Hope as a healthy antidote to the gloom.

Thursday, March 13, 2025

Still Not at the Finish Line

Jon Douglas, who wrote In It for the Long Haul, shared a series of papers that were discussed at the Conference on Retroviruses and Opportunistic Infections (CROI) that just wrapped up this week. A few caught my eye, but Douglas summarized tons at that link:

French researchers analyzed blood samples from 100 Long Covid patients, 60 recovered Covid cases, and 60 uninfected controls to identify immune and metabolic biolmarkers that diagnosed Long Covid with 99% accuracy. 

Researchers in the Netherlands treated 16 severely immunocompromised patients with persistent Covid-19 using off-label nirmatrelvir/ritonavir, and 75% had viral clearance within 28 days. 

Barcelona researchers studied 130 children and young people three months after Covid-19 and found that those with Long Covid had more autoantibodies and inflammatory markers, suggesting immune system involvement. 

Researchers in another study used brain MRI to compare 23 people with cognitive Long Covid to 19 without symptoms, and they found less gray matter in regions tied to memory, speech, and executive function, plus white matter changes in key memory pathways.

Beyond the conference, Pfizer is testing a new Covid-19 antiviral, Ibuzatrelvir, and is currently in Phase 3 trials. It doesn't taste as bad as Paxlovid, has fewer drug interactions, and is designed to be more stable, so easier to prescribe. Hopefully that means more than just those over 65 can access it in Ontario.

Wednesday, March 12, 2025

Never Again?

All this tariff talk is provoking a recession, which seems to be a feature, not a bug. As the economy falls, companies go bankrupt and are cheap to take over by the wealthy. The very rich will be able to take advantage of desperate times to buy businesses and property, and then are even further ahead when (or if) the economy rebounds. More power. More control. More stuff. The suffering of the citizens is not a concern. At all. 

This entire scheme was kick-started back in 1971 by the Powell Memorandum. Chomsky and Chris Hedges have been talking about this forever. And, of course, Ralph Nader. It's the precursor to disaster capitalism. Supreme Court Justice Lewis Powell wrote a memo attacking "extremists" like Nader who was doing things like trying to get cars to add seatbelts to improve traffic safety. The Memorandum is a push to allow unfettered capitalism without any regulations because, as far as Powell was concerned, businessmen really own the country. They pushed for more business involvement in colleges and universities way back then.  

A couple days ago, Senator Chris Murphy clearly outlined the corruption in the White House. It's all out in the open BECAUSE THEY CAN. Like in Russia, few in positions of power dare call them on it. 

"Trump and Elon Muck and their billionaire friends have engaged in a stunning rampage of open public corruption. It's not fundamentally different than what happened in Russia. These are efforts to steal from the American people to enrich themselves, and their strategy is to do it all out in the open. ...  

Thursday, March 6, 2025

Over Five Years of Covid

David Wallace-Wells has a piece in the New York Times about hitting the five-year mark with Covid (although it started in 2019, and the first case in the US was reported on January 21st). 

He seems to blame Covid for making America more divisive, but that didn't happen everywhere. Curious. He says Covid turned Americans into hyper-individualists: 

"Isolated, we saw one another first as threats and then as something less than real. Covid unfolded on screens for most Americans, and although the experience was in many ways collective, everyone's screens were different: Some showed overflowing morgues, others revealing a sham. Soon, we began to worry less about how our actions affected others and more about how their affected us--a sense of interdependence giving way to anomie, atomization and entitlement."

Wednesday, March 5, 2025

On Weaponizing Empathy

Lots of people struggle with boundaries; luckily there are many little sayings along the lines of "not my circus, not my monkey" that help people remember not to get worked up about someone else's problems.

It's a useful strategy to notice when you're getting too invested in other people's lives. It's really handy to be able to let go of how people perceive you or whether or not they like you. We have a strong need for belonging, and we can sometimes be easily guilted into taking on the burdens of others just to get a little taste of perceived connection. So, sure, if it's not your fault or responsibility, then it's not your problem. 

There's a "Let Them" poem (by Cassie Phillips) that blew up then got somewhat plagiarized into a book deal for Mel Robbins. (I actually only clicked on that video because I somehow thought it was about the very funny comedian Mel Giedroyc! The thumbnail looked a bit like her, and, apparently, I didn't actually know her last name! But then I got hooked by the content.) Robbins' daughter used the phrase "let them" to talk her mom out of nosing in to her son's plans for prom. This is a great philosophy to shut down the busybodies in your life, but I can't imagine those two words flushed out into an entire book, and you could get this, and so much more, from books on Buddhism or Stoicism. I'm clearly not the target audience.

Sunday, March 2, 2025

Accepting Difference

I recently watched the lovely film, A Real Pain, about two cousins (played by Jesse Eisenberg and Kieran Culkin) who travel to Poland to visit their departed grandmother’s home. In the first 20 minutes of the movie we’re shown two dramatically different personalities, both neurotic in their own way, but one more inward and the other laser focused on other people. It’s in our vernacular to understand the characters as introverted and extraverted, but there is still disagreement over what that means and, more importantly, what to do with that information.

I think we’ve veered off course since Jung’s Psychological Types, now over a century old, the precursor to the Myers-Briggs Type Indicator (MBTI) and more recently the Five-Factor Model (FFM) or “Big Five.” There are lots of other personality inventories like John Holland’s six Personal-Orientation types, Arthur Brooks’ mad scientistscheerleaderspoets, and judges, and Martin Seligman’s top five strengths, but MBTI and FFM seem to have sticking power.