OPPOSITIONAL DEFIANCE SYNDROME IN THE TRUMP ERA

A dramatic plea for help has come in response to “Oppositional Defiant Disorder” posted 2-18-12, which always gets more hits than most other posts on this blog.  In fact, I’ve been thinking about it again myself because of Trump, who makes a good illustration.

The person, calling herself “Raven Albatross” because I stopped accepting anonymous comments, tells a long story.  She is a perpetual student, caught in that terrible national vortex of going to school, finding the degree doesn’t lead to an income, going back for another degree, repeating the same experience until debt levels are too high to function.  She is clearly intelligent and researches her dilemmas, but she doesn’t say how or whom she has contacted in terms of research.  She has come to the attention of cops, which meant visiting a “shrink”.  Neither was helpful.

I’m not an expert.  I cannot cure ODD.  It’s a great temptation to create a term like ODD and then treat it as though it were something real, with clear boundaries.  Then the definition begins to suggest how to think about it and we get stuck.  Or someone comes up with a pet reason or cure and bends the evidence and results to match their original concept. It may be part of something bigger or it may be a big consequence of a small thing, or sometimes it’s a legitimate survival mechanism in a bad situation.  It’s important not to get captured by one idea so as to look from different angles. 

As they say,  it’s not paranoia if something is really after you.  Right now, everyone in the country is paranoid.  It’s a marketing strategy:  the two major themes are sex and danger, esp. economic danger.  No one will sleep with you and you’re bound to go broke and live on the street.

Lately we’ve all been fascinated by the brain mechanisms behind the forehead, the prefrontal cortex and its function as a dashboard for a multitude of perceptions, assumptions and judgements.  Also, a team headed by Joseph LeDoux is very interested in the amygdala which decides whether danger should be responded to by fight, flight or freeze actions.  It’s a little blob, often compared to an almond but turning out to be complex;  a problem there can definitely make you nutty.

When people begin to feel or act in atypical ways, sometimes inconvenient, authorities (since they are supposed to “know”) define a “syndrome” according to some psychiatric model or system devised by someone like Freud or Jung, which was only invented from reflection with no physical evidence.  Today’s psychological community uses thought experiments to discover unconscious functions of the brain and there are a LOT of them, sometimes very powerful.  These ideas get sucked up by the media, not entirely understood, and gradually turn into something approaching morality.  That is, people are blamed for narcissism or punished for being defiant or oppositional, sometimes criminalized and arrested for not accepting the commands of authority.  Jobs and marriages are lost.

Generally, most people accept the idea that a child goes through a stage of defiance, evidently in service to separation from care-givers so as to become their own identity.  Sometimes it’s funny.  (“Would you like some ice cream?”  Toddler, bellowing:  “NO!”)  If a child (meaning too young to turn away force) is afraid or enraged, punished to the point of trauma (which might be what came first), a cycle of defiance and force may develop that is life-threatening.  Even a surviving child may be too quick to throw up an impenetrable wall that could blight their life.

There is some thought, and probably research, into the coincidence of this emotional refusal with the time that toddler’s brains are being “pruned” by the withering of any neurological branches that are unused.  Sometimes very old people become oppositional in the same way.

When we get into the work of Joseph LeDoux, we are on new ground that doesn’t use philosophical constructs of what theoretical forces are clambering around in your unconscious.  Rather they look at the molecular and cell structures, how they interact, and what can be done about it.  Neuroresearch is evidence-based and not very well reconciled with the traditional “talking cure” psychoanalytic approaches so far.

The commenter was in a car accident, quite serious, but seemingly only suffered minor injuries.  She says, “I went into a traumatic like withdrawal from reality. Weird thing is for two months after the accident (when I became so reclusive that I ended up diagnosed agoraphobic as well as manic depressive, which is a form of bipolar).”  It was not LIKE trauma! A serious car accident IS trauma!  The withdrawal from reality might be called “dissociation” which offers another term to look up, though it’s not that well understood.  Sometimes it’s related to split personality.  Other times it’s seen as a way of coping with abuse.  PTSD is the acronym for combat dissociation: “post-traumatic stress disorder”.  Flashbacks, unwanted thoughts, difficulty in controlling mood,  going to violence easily, and a lot of other unpleasant things.

Agoraphobia, reclusiveness, manic depression, bipolar or ODD, general balkiness and refusal to agree, are all psychoanalytic concepts, labels about emotional and rational life that make a person anti-social, thus attracting treatment, adjustment, even incarceration.  They are REAL and there are a lot of people struggling with them.  They can serve an important purpose.  But that’s not the same thing as neurology, which is how the tissue of the body functions, actually DOES things at the cell level.

These syndromes can be triggered by drug episodes (legal or illegal) and by viral infections of the brain, which we begin to recognize are more common than we previously thought.  The brain had been thought to be protected by blood barriers but now we locate slippery little by-paths.

One of the major changes in the way we think about a person is in terms of identity, which was once seen as a steady state, a box with labels or a sculptured construct that stays the same through life.  It’s YOU and others recognize it that way, though each relationship is a little different. 

Now the idea that seems to fit the best is that a person is an interacting set of processes that is assembled from the unconsciousness of sleep into the consciousness of waking, subtly new every time because the work of sleep does memory sorting and makes new connections.  The “connectome” is the word for the networking (internal internet) of signals shuttling around, ESPECIALLY IN THE OLD PARTS OF THE BRAIN.  You might not be conscious of all the commotion, but it can be detected with special machines like the fMRI.  Even when asleep, the brain is still busy keeping heart, lungs, kidneys and so on operating or you won’t wake up.  The brain’s main work is NOT thinking, but rather the maintenance of homeostasis in the body for the purpose of survival.  

Concurrent with this paradigm shift from box to something more like music, is that there is no reality.  NO REALITY.  All the aspects of the world that impact our skins and organs are things like electromagnetic light waves or sound vibrations — so you’re right to suspect all the waves we’re producing as well as waves from the sun and the cosmos, but that’s not what I mean.  I mean that the brain does not receive faces or words or tunes — it composes them from whatever the nerves attached to sensory receivers produce in the way of code.  Not everyone has the same sort of receivers.  More than that, much of the “wet ware” in the brain will interpret what it receives in possibly inaccurate ways.  It can only work with the categories it already has, until something happens to create a new category.  

There is a LOT to read about neurological research and I think it is far more helpful than “shrink advice”.  A good shrink is more than a diagnostician, but also a companion and support as the search goes on.  (Everyone’s search always goes on.)  A psychiatrist can handle drugs because of also earning MD credentials, but a clinical psychologist might be warmer because of NOT earning MD credentials, which encourage a cold objective approach.

As I say, I’m no medical or psychological expert, but my opinion is that when your car rolled, you got a significant head blow and should be checked for clots, bleeds, and tearing.  It would take very little damage to create ODD if it were in the right place.  Look for people who know about “closed skull trauma,” meaning that the damage doesn’t include cracks in your skull but rather damage in the soft tissue.  Go to the nearest university medical school and ask them to find you the closest neurology research lab.  

There’s a ton of things to read in the research.  Do not trust Wikipedia, but google can be very helpful if you’re looking for definitions or the work of someone like Joseph LeDoux.  In fact, he’s on YouTube, giving lectures.  I sometimes have to watch them three times to “get it” or there is sometimes a transcription feature with the vid.

Your advice to turn off the television and limit the radio is probably wise even for someone who has no apparent problem.  Television is jammed with plots meant to be sensational, frightening, and addictive.  And that’s just the news!  (Jokes.)

If you give me an email address, I can communicate more privately.

CAN SCIENCE CHANGE RELIGION?

On Sunday I sorta try to post something “religious” -- whatever that is.  It’s just a conceit, esp. when you think that EVERYTHING is actually religious.  But we’ve got a three-way problem in almost everything that we’re struggling with these days.  In the past the best thinking about how one ought to live life has been based on observation, both watching society to see what works for the greater good and watching one’s own internal being to understand behavior.  We split out into two ends of the spectrum: one punishing and the other redeeming. 

The problem is not figuring out what people ought to do -- that’s pretty obvious.  The problem is that we don’t do it and we don’t know why or we just can’t help it.  We WANT to do what we shouldn’t. Some think it’s hereditary, some think it’s the result of psychological weakness, some think it’s a moral failing -- that takes it onto religious moral grounds.

Often the larger culture is crowding people into doing bad stuff, but building consensus about how that ought to be addressed is nearly impossible because of this three-way problem.  Left-right-scientific.   Pointing out that a few people are profiting from many people’s suffering is countered by the idea that their suffering is their own shortfalls, weakness, deficiency, and origins.  They are “different” lesser beings.  The liberal/conservative religious spectrum is now challenged by physical research, embodiment.

Most prescriptions and laws are simply a matter of advice and punishment.  Thinking and compassionate people are understanding and willing to do what works, if they can figure out what it is.  They are pressed by “morality” that demands response and obedience.  At last what we have figured out in the past and even used for centuries, is now challenged by new technology that clearly shows all theories so far were at best incomplete.  Everything is changed by our technical ability to perceive what wasn’t even known to exist until now.  But it’s hard to wrap one’s head around it.

Norm Holland

For instance, I subscribe to Discussion about the Arts PSYART@LISTS.UFL.EDU; a website owned by Norman Holland, who is the reason I signed up, since I admire his writing.  http://www.normholland.com  The list is centered on psychoanalysis and literature and therefore on older urban people, highly educated, sophisticated, strongly anchored, and mostly male.  They are also very busy and have had little reason or opportunity to keep up with things like brain research.  For the most part, they do not psychoanalyze young boys though they have a lot of theories about them.

Yesterday in other places I was reading about the effect of porn on the brain and also the investigation of trauma damage by looking directly at the brain.  Even drug use can be actually seen as structural damage. The problem for the Psyart folks is reconciling Freudian principles with the new understanding that comes out of direct (if via instruments) observation and physical interventions like removing tumors or implanting electrical stimulators.  It’s not just a question of accepting this new information, but it also means giving up a kind of theory poetry, as beautiful and beloved as lyric poetry or French Impressionist painting.  Even as they are pressed by their own desire to know and to help others, they are limited by their formal lives. 

A mask made by a veteran with PTSD to show what it feels like.

Today a high-level Manhattan prof asked the list if everyone traumatized will inevitably develop PTSD.  This is a question plentifully addressed with deprived kids, some of whom are considered “resilient.”  Not all soldiers in heavy combat will develop long term PTSD, though physical damage, esp. to certain structures, will change them.  In addition, people who “candle heads” -- as one shrink inelegantly put it to me -- do studies suggesting the possibility of redeeming even damaged brains.  I have time to look for this stuff and read it.  A big time Manhattan analyst does not.  Maybe they ought to engage readers the way lawyers have legal aides.

The porn study was molecular rather than from scanning, and the theory is that the molecule in question is a protein keystone of all addictions.  It’s called “Delta FosB.”  https://www.youtube.com/watch?v=wSF82AwSDiU&feature=share   Gary Wilson and his team were studying porn, specifically men who watch a lot of it, and the effect on them over a long period of time.  They claim that boys as young as ten are looking for porn and will easily get hooked because the Internet keeps up a steady stream of hot images, always new, maybe a little edgier all the time, or surprising, maybe spiced with a bit of violence or transgression.  

Gone are the days of studying the Sears catalog underwear pages.  Nor do many people bother to hide Playboy these days.  Instead, an adult who knows a kid is reading the mag might slip some condom packets among the pages.  But the appetite developed by escalating intense porn is not going to be sated by any mag at all.  http://yourbrainonporn.com/garys-research-neuroplasticity-addiction-deltafosb-lay

James Bond -- shaken.

Viewing porn that is highly stimulating over a long period of time leads finally to erectile disfunction.  Common sense would say,  “Well, heck, a person can have too much of anything!”  Indeed, there’s a close parallel to eating sweet, salty, spiced foods.  Overusing it leads to craving and then indiscriminate response.  So. . . lectures, attempts to impose control, blah blah blah.  That handsome guy in "Fifty Shades of Gray" will soon be impotent.  Just like a real life James Bond who drank as much as the movie version would by now be dead from alcoholism.

When the blood assayers got into studies of porn users, they found a molecule:  DeltaFosB.  High stimulus, repeated, increased in intensity and so on -- to the level of addiction -- will make the level of this stuff go up to the point where it is blocking normal function.  It takes a couple of months of abstinence for it to fall back down.  Those of us who work on our eating or exercise levels will recognize that span -- 6 to 8 weeks before the “habit” has formed or unformed.  The habit is molecular.

We come to the study of brain trauma through violent sports like football.  The molecular addiction is in the fans, the traumatic damage is in the players.  What was often thought to be merely macho brutish behavior natural to the kinds of people who would play such a game, has turned out since to be due to chasms in the brain tissue.  The good news is that the Jello-like tissue with its responsiveness is capable of regenerating in large part.  Without emotional analysis -- just starving out DeltaFosB.  Going cold turkey.

This study was about men, esp. boys, because their brains are just forming and could possibly build DeltaFosB into the underlying scaffolding of their brains, where it can’t be removed.  I’m thinking about what the results might be with women, who have their own porn addictions, esp. to the drama of it all, the rejection and reclaiming, the abuse.  In “Fifty Shades of Gray”  the female effect of the porn (and most readers of this book are female) is NOT pretending to be the dominating, all-knowing, wealthy man, but identifying with the innocent, submissive woman.  That’s also addictive, kicking up the endogenous drugs like adrenaline or serotonin. Soon, hooked people cannot leave men who beat them up.  In fact, that may be MORE powerful than the male idea of dominating women, even when transgressive violence is added.

So is addiction just a scientific medical problem?  Can we give up all the moral commandments about not taking drugs, not abusing people, not rejecting anyone who is struggling on the wrong side of society?  Just take a pill?  Even if we accept the science-based principles that everything is connected and everything is always changing, including one’s endogenous chemicals, the new information does not change conservative ministers who send women back into addiction to abusive husbands because of the “morality” of ownership notions of "divinely ordained" marriage.  That's gotta go.

A sense of justice would also help.

This is where we need the help of the heavyweight bigshot male urban authorities in their Manhattan offices.   They must help us embrace the addicted, not punish them.  Demonizing abusers and angelizing those abused is only Manicheism: outdated.  BOTH are addictive.  Addiction is NOT a moral issue.  Behavior towards people who are addicted IS a moral issue.  To get change, add science.

PS:  I'm told that Daniel Amen is not what he purports to be.  Part of science is checking out the experts carefully, which I didn't do.  Therefore, this is not a scientific blog.  More speculative.