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Blog | 10 February 2016
River's Rising Stars Shortlisted for Four PPA Awards
Awards | 23 min read
We know talent when we see it – and River's commitment to recruiting and developing the best raw talent in the industry has been recognised with an impressive four shortlisted nominations for the prestigious PPA Rising Stars Awards 2016.
The PPA Rising Stars Awards 2016 celebrate the next generation in magazine and business media. The winners will be announced at a black-tie ceremony held on 9th March 2016 – #PPANewTalent.
The Healthy and Healthy for Men team members feature strongly, with Hannah Emerson, Deputy Sales Manager, shortlisted for New Rising Sales Star, and Healthy and Healthy for Men's Francesca Specter shortlisted in the Most Promising Student of the Year – Postgraduate category. Healthy – eight issues a year – and Healthy for Men – six issues a year – are published for Holland & Barrett International. In December 2014, Healthy was also launched on the newsstand, where it continues a strong market performance.
On The Co-operative Food magazine, Editorial Assistant Kitty Aldis is shortlisted for Best Graduate/Intern of the Year. Co-operative Food is a bi-monthly print and digital magazine targeted at Co-op Food's convenience shoppers, with content extending to YouTube, social channels, radio broadcasts and website.
And PRO Hair & Beauty's Editorial Assistant, Fiona Ward, is in the running for New Consumer Specialist/Customer Journalist of the Year. PRO Hair & Beauty is the in-store magazine for Sally/Salon Services, available to trade-card holders only, and published bi-monthly.
'Creative and commercial innovation is about fresh thinking, great ideas and team collaboration – and developing new talent is a key part of this,' says Claire Irvin, River's Editorial Content Director and Chair of the British Society of Magazine Editors. 'We pride ourselves on developing the best talent in the industry – and it's fantastic to have this acknowledged at this level, for Kitty, Fiona, Hannah and Francesca as individuals, as well as River as an agency.'
'I'm delighted to be able to celebrate the hard work, clever minds and dedicated approach of River employees across the agency,' says Nicola Murphy, Chief Executive Officer. 'We're committed to developing talent – and it shows!
For more information on River, please contact Nicola Murphy, Chief Executive Officer, on 020 7420 7000 or email nmurphy@therivergroup.co.uk.
Pares Tailor
Head of Digital Content Experience
Pares is a digital native with two decades of experience. He currently heads the digital department at The River Group and an absolute nerd who loves to play with strategy, content, design, and data; @parestailor.

redpajama_set_name: RedPajamaCommonCrawl


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Noble Intentions by Andrew Grey | Cat's Audiobook Review & #giveaway @Dreamspinners @AndrewGreyBooks
5:28 PM 1 comment
Written by: Andrew Grey
Narrated by: Robert Nieman
Release Date:06-09-17
Publisher: Dreamspinner Press LLC
Robert Ashton is in for the surprise of a lifetime. His mother, a bit of a rebel, raised him away from the rest of the family, and it's not until he's contacted by his lawyer about an inheritance that he learns who he truly is: the new Earl of Hantford. His legacy includes ownership of the historic Ashton Park Estate - which needs repairs Robert cannot afford. He'll simply do what the nobility has done for centuries when in need of money. He'll marry it.
Tech wizard Daniel Fabian is wealthy and successful. In fact, he has almost everything - except a title to make him worthy in the eyes of the old-money snobs he went to prep school with. His high school reunion is looming, and he's determined to attend it as a member of the aristocracy.
That's where Robert comes in.
Daniel has the money, Robert has the name, and both of them know they can help each other out. But their marriage of convenience has the potential to become a real love match - unless a threat to Daniel's business ruins everything.
©2016 Andrew Grey (P)2017 Dreamspinner Press
Buy links: Dreamspinner | Amazon Audio | Audible | iTunes
Cat gives this one 4 & 1/2 Meows with a 3 Purr heat index...
"A business deal gone right"
If you could sum up Noble Intentions in three words, what would they be?
Sweet, sexy, fun.
What other book might you compare Noble Intentions to and why?
It is an Andrew Grey book that speaks for itself! Always a good story!
What does Robert Nieman bring to the story that you wouldn't experience if you just read the book?
I loved the accent Robert Nieman gave Robert. I did stay engaged in the story but at times I felt the reading was just a little choppy.
Did you have an extreme reaction to this book? Did it make you laugh or cry?
Yes. Roberts proposal was quite tearing jerking.I said AWE! out loud LOL I made my heart happy.
I thoroughly enjoyed the story. I love stories set in England and add in a rich American businessman you have the best of both worlds. The story does move fast but the storyline is sweet both character's intriguing and though the sex isn't overly hot it is perfect for the story. If you are looking for a book to kill a few hours and lift your mood this is a great choice.
Andrew Grey is the author of nearly 100 works of Contemporary Gay Romantic fiction. After 27 years in corporate America, he has now settled down in Central Pennsylvania with his husband Dominic and his laptop. An interesting ménage. Andrew grew up in western Michigan with a father who loved to tell stories and a mother who loved to read them. Since then he has lived throughout the country and traveled throughout the world. He has a master's degree from the University of Wisconsin-Milwaukee and now writes full time. Andrew's hobbies include collecting antiques, gardening, and leaving his dirty dishes anywhere but in the sink (particularly when writing) He considers himself blessed with an accepting family, fantastic friends, and the world's most supportive and loving partner. Andrew currently lives in beautiful, historic Carlisle, Pennsylvania.
Andrew Grey: http://www.andrewgreybooks.com
Be sure to leave a comment to be entered into the TTC Books and more monthly comment giveaway. EVERY comment that is relevant to the specific post will be entered. Prizes include various gift cards and swag donated by Publishers, Authors and blog Owner. REMEMBER TO LEAVE YOUR CONTACT INFO! How else will I notify you if you win?
Lisa August 1, 2017 at 6:38 PM
Thanks for the review. I did think this story sounded interesting.
legacylandisa(at)gmail(dot)com


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English Football
Who was the first french manager to take charge of a club in the premiership?
chú Chích Chòe Newcastle United
Newcastle United FC Reserves and Academy staff contact
Q: Who was the first french manager to take charge of a club in the premiership?
Who was the first foreign premiership manager?
Jozef Venglos
Who was the first premiership manager to be sacked in 2009?
Paul Hart
Who was the first foreign manager in the premiership?
Dr.Joseph Wengloss Dr.Joseph Wengloss
Who was the first premiership manager to be sacked in 2008 SEASON?
Juande Ramos
Chelsea sacked Ian Porterfield
Who was the first manager to get sacked in premiership 2012?
Andres Villas-Boas, managing Chelsea.
Who did kennydalgleish win premiership medal with?
I know he won the Premiership (or the First Division as it was known then) as a player at Liverpool , and I think he may have won it as a manager at Liverpool too
Who was the last English manager to win the first division before the premiership?
Howard Wilkinson Leeds Utd
When was the first premiership in nrl?
The first premiership in NRL was played in 1908.
Manchester united win their first premiership?
They did in 1993, the first season of the Premiership.
Who was Arsenal's first manager?
The first person in charge of first team affairs was Sam Hollis who was manager from 1894-1897 when the club was still called Woolwich Arsenal. The first professional manager was Thomas Mitchell, who was manager from 1897 to 1898.


The summer months often prove to be an added test to those who adorn hijab. Not only does the weather make a person more inclined to wear less, it also brings new questions from those intrigued by women who cover in the heat. How can sisters find strength during this time?
We live in our little bubble of working to live and living to work, that we lose the opportunity to achieve tranquillity and experience the other creations of Allah in a positive manner. How can we change the way we look at the outdoors? Should we be thinking in a certain way?
Overeating is something that plays a part in obesity. Allah tells us in the Quran to not be excessive in our eating. The key thing to remember is to eat what you need to fulfill your stomach, rather than indulge for the sake of eating something that tastes good.


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«Енергія» — український радянський футбольний клуб із Полтави. У 1940-1950-х роках команда брала участь у розіграшах Кубка та Чемпіонату Полтавської області й була одним із лідерів футболу Полтавщини, ставши володарем кубка в 1955 році та чемпіоном у весняному турнірі 1956 року.

Досягнення

Чемпіонат Полтавської області
 Чемпіон (1): 1956 (в)
 Срібний призер (4): 1952, 1953, 1954, 1955
 Бронзовий призер (1): 1957

Кубок Полтавської області
 Володар (1): 1955

Посилання

 «Енергія» (Полтава) на сайті FootballFacts

Футбольні клуби Полтави
Неіснуючі футбольні клуби України

redpajama_set_name: RedPajamaWikipedia


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Alpen Adria Energie ist ein unabhängiger Ökostromerzeuger aus Kötschach-Mauthen in Kärnten mit über 11000 Kunden (August 2011).

Geschichte
Vorläufer des Unternehmens erzeugen seit 1885 Ökostrom. 1998 wurde der Familienbetrieb in eine GmbH umgewandelt.

Stromerzeugung
Stromquellen sind vor allem Kleinwasserkraft, Biomasse, Wind und Sonne. Das Unternehmen arbeitet mit zahlreichen Kleinkraftwerksbetreibern im In- und Ausland zusammen.

Wasserkraft
Drei Stauseen unterhalb des Plöckenpasses (Grünsee, Valentinsee und Cellonsee) dienen als Wasserspeicher. Sie speisen die unterhalb gelegenen Kraftwerke. Beim Valentinsee zeigt das Schaukraftwerk Hydrosolar, eine Verbindung von erneuerbaren Energien, die Möglichkeiten ökologischer Stromerzeugung: Wind, Wasser, Biomasse und Sonne. Für dieses Projekt erhielt die Alpen Adria Energie den Eurosolarpreis.

Biogas
Im September 2005 ging eine Biogasanlage offiziell in Betrieb. Das Biogas gelangt in einer Leitung zur Biomassezentrale, wo Wärme und Strom erzeugt wird.

Windenergie
Am Plöckenpass, unmittelbar vor der Grenze zu Italien, steht eine Windturbine, zwei weitere sind geplant. Kürzlich ging sie eine Partnerschaft mit dem Windkraftbetreiber Oekoenergie Wolkersdorf ein.

Photovoltaik
Am Dach der Unternehmenszentrale, im ehemaligen Hotel Post, befindet sich eine Photovoltaikanlage ebenso eine 20-kWp-Anlage am Rathaus Kötschach/Mauthen. Weiteren Sonnenstrom liefern etwa 600 PV-Anlagen (August 2011) von Naturstrom-Kunden.

Besitzverhältnisse
Die AAE gehört zu 75 Prozent beteiligt der AAE Wasserkraft GmbH sowie zu 25 Prozent der Ökoenergie Beteiligungs-GmbH.

Auszeichnungen
Eurosolarpreis

Weblinks
 Offizielle Website

Einzelnachweise

Unternehmen (Erneuerbare Energie)
Elektrizitätsversorger (Österreich)
Unternehmen (Kärnten)
Kötschach-Mauthen
Gegründet 1998
Erneuerbare Energien (Österreich)


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/ Columbia Encyclopedia
/ Literature and the Arts
/ Art and Architecture
/ European Art to 1599: Biographies
/ Multscher, Hans
Multscher, Hans
Multscher, Hans häns mo͝ol´chər [key], c.1400–1467, outstanding German sculptor and painter of the Swabian school of Ulm. Early in life he traveled to the Netherlands and Burgundy. Probably influenced by the work of Claus Sluter, he developed a powerfully realistic figural style in both painting and sculpture. About 1427 Multscher settled in Ulm. For the east facade of the town hall he carved figures of Charles the Great and equestrian statues of the kings of Poland and Bohemia. In 1437 he painted the Wurzacher Altarpiece (partially lost; Berlin). He also worked on the famous altarpiece (1457) at Sterzing (now Vipiteno) in the Tyrol. For this work, a combination of painting and sculpture (now dispersed), he executed sculptures of the Virgin and saints, while the wings were painted by another artist.
See more Encyclopedia articles on: European Art to 1599: Biographies


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Follow live: "Dajte Muzika" on the Eurovision stage – let's vote for our heroes
Music 19.12.2021 / 16:30
MRT is broadcasting live from the Junior Eurovision Song Contest in Paris which started,at 4 p.m.
Kristina, Anastasija, Miha and Filip, the teenagers from the popular TV show "Dajte Muzika" on MRT, will represent Macedonia with the song "Green forces". These days they have already had their first rehearsal on the Eurovision stage, and the reactions to the song, whose authors are Robert Bilbilov, who wrote the music, and Robin Zimbakov, who wrote the lyrics, are great.
Artists from 19 countries will compete, and our country's representatives will be the penultimate. The winner this year, as well as the previous ones, will be chosen by the audience and the expert jury.
In the contest we can vote for our representatives on the web platform JuniorEurovision.tv after the end of the show.
Follow live on the following link
Junior Eurovision Song ContestDajte muzika
Macedonia wins 9th place at 2021 Junior Eurovision Song Contest
Bulgaria to perform at Junior Eurovision Song Contest with a song by a Macedonian-Bulgarian team led by Vasil Garvanliev
Macedonia's representative Vasil Garvanliev fails to qualify for Eurovision's Grand Final
Zaev: Vasil Garvanliev is proudly standing before us, so let us also proudly stand with him
Macedonia's representative Vasil Garvanliev releases his Eurovision 2021 entry "Here I Stand"
Serbian singer Gjorgje Balasevic dies of coronavirus
Placebo cancel Skopje concert amid coronavirus pandemic
Singer Pink says she had coronavirus, will donate $1 million


Arts Minister Michael Ellis launches £20 million fund for culture, heritage and the creative industries to benefit towns and cities across England.
Michael Ellis, Minister for Arts, Heritage and Tourism, said: "Cultural investment can have a transformative impact on communities. Creativity, culture and heritage is what makes places special for local people and visitors alike.


When entering a rainy season, the most common thing to be discussed is about harmony in a mix and match outfit. You certainly want to look fashionable even if you are in the rainy season, right? In choosing fashion item that can support your appearance yet still looks stylish and can protect the body from cold temperatures, you can choose a cape as item selection. This outwear originally was more popular for people who are in the country with four seasons. The function of the use of this cape is to protect the clothes from rain drops or falling leaves in autumn. Apparently, with the growth of fashion world today, this fashion item could be an attractive option to appear more stylish at various occasions.
Cape these days are more varied with models and materials so that these items can be used more diverse function. This fashion item can not only be an option for you who want to protect your clothes and body from bad weather, it also could be part of supporting your appearance to look more stylish and modern. This fashion item could be one option to replace the jacket, which is often wore in rainy season. By selecting and combining the appropriate cape, you will look so charming in this rainy season.
You may often see most people choose cape with formal colours such as brown, black, navy, or gray. It is indeed very reasonable because the cape is mostly combined with formal women clothing, especially for those who work in the office. However, if you want to wear it outside office, you can choose a cape with bright and stand out colours like yellow, red, etc. In addition, you should also consider the pattern of the cape. You should avoid cape with motives that are too big, as this will make your body look heavy. You should choose a cape with a simple design that will make you look much more stylish.
If you would like to wear a cape to look more stylish and modern, you can find some of the cape collections from many designer in HIJUP.com. Online shopping provides a lot of convenience for you to find a selection of fashion products that you need.


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XREALM
Humanistic Co-design
open indirect ophthalmoscope
Re-imaging indirect ophthalmoscopy for the era of open innovation
Indirect Opthalmoscopy is the most important technique in a ophthalmic clinician's toolbox, allowing them to view desired portions of a patient's retina (the inner tissue of the eyeball which is light sensitive and responsible for vision). This is an invaluable technique to rapidly look for irregularities, pathologies and any other conditions in the retina which may be potentially vision-threatening. These images are termed "fundus" images.
The clinician is able to see a 30 degree field of view at a time. Examination of the retinal tissue can reveal a great deal about the person's present state of health.
Where high-resolution images are required to be taken for diagnosing disorders in the retina, indirect ophthalmoscopy cannot be used. Instead, high-end benchtop devices exist (such as that shown on the right) which capture and record these images. These devices require the patient to be seated and to rest their chin on the device to keep their head in a fixed position relative to the device. A flash of light captures the image after proper alignment is achieved. This is called "fundus photography".
Most cardiovascular or metabolic disorders show up as vascular pathology on the retina. For instance, Diabetic retinopathy (DR). This is a potentially vision-threatening conditions, where patches of one's retina lose the ability to react to light. This causes patches in one's vision, and if left unchecked, can soon be an irreversible loss of vision. These disorders need to be picked up early and can be treated. However, they require two things - the ability to capture high quality photographs of one's retina, and the ability to interpret those images and diagnose conditions. The first one is done using extremely high quality machines in the market, which are usually very expensive. The second is usually done by a trained clinician (ophthalmologist). Both of these are extremely difficult to get access to in resource-constrained areas or part of large-scale public health screening programs, where they are needed the most.
On the left is a retinal (fundus) image of a normal healthy individual, taken using a high-end benchtop fundus imaging tool. Notice the bright white optic disk on the right, the blood vessels emanating from it (which supply blood to the retina) and the dark spot slightly off center, which is the fovea (responsible for central vision through which we do complex visual tasks like reading).
On the right we have a fundus image of an individual suffering from Diabetic retinopathy. Notice the flaky white spots all over the retina. These "exudates" are deposits which causes "patches" to form in one's vision. Diagnosing this condition is impossible without a good quality fundus imaging camera, which typically costs a few thousand dollars and is extremely large and heavy - definitely not a good solution for field screening programs.
What does this mean for the patient? Those small white spots lead to "blind spots" in one's field of view. The image on the left simulates vision for someone suffering from this condition. If left unchecked, this can lead to permanent vision loss and the inability to perform routine tasks. India, where we are building this product, has the dubious reputation of being the diabetes capital of the world - about 63 million people suffer from diabetes, with this figure likely to go upto 80 million by 2025. About 37% of urban south asians suffer from diabetes or pre-diabetes and are at risk of developing DR. Timely treatment can reduce risks by more than 90%, however symptoms of vision loss only present themselves after significant progression of the disease.
Our product - the Open Indirect Ophthalmoscope - brings all the advantages of the latest technologies into this age-old but elegant technique. The elegant and intuitive form factor brings a new dimension to this technique - portability and new possibilities for image post-processing. Our device enables clinicians to see the same features and level of detail that they are normally accustomed to with the additional portability which enables this powerful technique to be taken out into smaller clinics, field workers and the remotest of locations.
A high-quality PORTABLE IMAGING SOLUTION
A fundus image taken using state of the art clinical instruments
A fundus image taken using our device
PORTABLE AND ERGONOMIC FORM FACTOR
The device was envisioned as an intuitive handheld device which would require no complex instructions to the patient. Interaction is as straightforward as looking through a pair of binoculars.
integrated machine learning
The device integrates into a massive online grading system (theia) built by graduate students at MIT Media Lab. This system is able to grade the severity of DR in images on a scale of 0 (not present) to 4 (severe). The system uses a deep learning algorithm (convolutional neural networks) and a powerful GPU accelerated machine to be able to process images on cloud in a few seconds. This enables rapid screening and triage without the need for a trained expert to assess each and every image, a powerful tool for eye care clinics and public health programs.
We've put all the instructions to build one in the public domain! Check it out at our Hackaday Page and Instructables Page
order your own
We're still testing the device and it's not in the market yet. However, if you would like to be a beta tester, do get in touch with us!
Are you interested in helping us improve the device? Are you an engineer who's passionate about building open technology with big impact? Send us a mail and follow us on hackaday and github. Send us a mail at srujana [AT] lvpei.org with the subject Open Indirect Ophthalmoscope
Sandeep Vempati - Project Lead
Dr Jay Chhablani - Principal Investigator
Tristan Swedish
Dhruv Joshi
Devesh Jain


Beautiful, meticulously maintained executive home with 6 bedrooms, 5 full baths, finished basement, hardwood floors on a park-like lot in amenity-rich Seven Oaks. Stunning renovated kitchen with double gas range, stainless-steel appliances, exterior-venting hood, walk-in pantry, under-counter lighting, stainless steel apron sink and granite counter tops. Open family room with soaring ceilings. Master suite has a sitting area with a fireplace, his & hers closets, trey ceiling and bright, open master bath with vaulted ceiling and a Jacuzzi tub. Don't miss this beauty!
2. Family Room, Gas logs, Master Bedroom.
Creek, Garden. Paved Road, Level.
I am interested in 12300 Magnolia Circle, Johns Creek, GA 30005.


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eshrinkblog
advice and anecdotes from a retired psychiatrist (shrink)
DON'T MESS WITH GRETA!
If any of you are regulars on this beat, you may have noticed that in deference to our increasing susceptibility to Trump fatigue, I have suspended my analyses of the Donald's behaviors. You may rest assured however that they have not gone unnoticed, and that I have watched with great interest the current fruitless attempts to remove him from office.
It is appalling that, though judged obnoxious by most, his behaviors have been accepted and even admired by a large segment of the populace. His extreme repetition of lie after lie overwhelms truth. His cozy relationships with authoritarian rulers of the world is worrisome as is his impulsive and inconsistent decision making. He seems to find The Constitution to be inconvenient, and probably feels that without it, those pesky democrats could be forced to shut up and do as they are told. Meanwhile, those who praise him are granted the keys to the castle no matter their political leanings.
Those issues and others were bad enough, but now he has really pissed me off by attacking my heroine Greta Thunberg, a bona fide 21st century Joan of Arc. Although the Nobel Prize committee did not follow my advice by awarding the prize to Greta, she was named "Person of the Year" by Time Magazine.
Upon learning of that, Trump the tweet master, posted as follows: "So ridiculous, Greta must work on her anger management problem, then go to a good old-fashioned movie with a friend. Chill Greta, chill."
As one perfectly willing and able to take on the most powerful man in the world, Greta responded by changing her twitter profile to read:
"A teenager working to resolve her anger management problem. Currently chilling and watching a good old-fashioned movie with a friend."
He obviously did not know who he was "messing with." When asked if she would consider discussing her views on climate change with the president, Greta replied that in his case "It would be a waste of time."
Mr. Trump was named "Person of the Year" upon his election in 2016, and has complained that he was not similarly rewarded in subsequent years. He does have a valid point as Jim Kelly, managing editor of Time, has defined an honoree as: "the person who most affected events of the year for better or worse." For example, Hitler and Osama Bin Laden have been named in past years, so perhaps we should consider our dear leader for the dubious honor. I doubt he would care much as to which category he belonged as long as that magnificent head of hair was accurately depicted on the cover.
To be jealous of a teenage girl must be particularly difficult for a malignant narcissist. However, now that he has rid himself of those who did not always suck up and has surrounded himself with sycophants, he should recover. Meanwhile, in spite of my dismay, there is also some relief in hearing Senator McConnell guarantee that Trump will not be removed from office. As I mentioned in a previous blog, I am concerned as to the effect his being cornered could have on his already precarious mental state. The down side is that a not guilty verdict may well reinforce his conviction that Article II of The Constitution gives him the power to: "Do anything I want."
Since I was a latecomer to the "Greatest Generation," I confess that I have not always been enthusiastic about turning the keys over to today's crop of teenagers. However; I am in awe of the activism of Greta's generation (Click here to read Business Insider's definition of Gen Z). The movement she started was inspired by the "March for Our Lives" movement to end gun violence, which was organized by survivors of the Parkland Florida High School massacre. Their march on Washington produced a crowd rivaling the size of the crowd at Trump's inauguration (I trust he hasn't heard of that comparison).
Only months after Greta began her protests alone with a hand-made sign in front of the Swedish parliament building, this petite 16 year-old girl with Asperger's Syndrome has millions of followers in 150 countries, and is now the most recognizable climate change activist in the world. She has also been recognized in NATURE magazine as one of the 10 most influential people in science.
That millions of kids who chose to protest the inaction of we adults on the issues of gun violence and climate change could hardly be explained as simply an excuse to skip school. I have listened to excerpts from the speeches of several of these kids and have been incredibly impressed by their knowledge and vision. They demand action in place of platitudes. One of those high school kids from Parkland in an address at the D.C. rally made that clear when he stated in his speech: "Stand for us or beware. The voters are coming."
It all leads me to think the world will soon be in good hands. Go get em' kids! The Greatest Generation is counting on you!
Posted on December 23, 2019 by Eshrink Posted in children, climate change, current events, environment, Politics	Tagged Gen Z, Greta Thunberg, POTUS, The March for Our Lives, The Parkland Shooting, Time Magazine, trump	1 Comment
Greta and Global Warming
The recipients of this years Nobel prizes have recently been announced. My candidate, Greta Thunberg, a 16-year-old Swedish girl, was not among them. She received fleeting notice in the press following an impassioned address before the United Nations in which she shamed we "adults" for our failure to seriously address the issue of climate change. She was sharply critical of those who consider only economic factors in the face of 30 years of science warning of the consequences of greenhouse gas emissions, which she says has resulted in the world to be now in the "early stages of a mass extinction."
Greta was an unlikely person to become a world-famous climate activist. She was socially awkward and extremely shy, which is not unusual in cases of Asperger's syndrome, especially for Greta who was further afflicted with Selective Mutism. However, Greta has refused to see herself as disabled and regarding her diagnoses says: "It makes me see the world differently. I see through lies more easily. I don't like compromising. To be different is not a weakness. It's a strength in many ways, because you stand out from the crowd." This is a link to Greta's biography.
Indeed, this remarkable young person has stood out in a crowded world. In addition to her U.N. speech her accomplishments include inspiring children's uprisings throughout the world including the September 20th "School Strike for Climate" involving an estimated 4 million people world-wide which had preceded her address at the U.N.
Greta was born into an apparently supportive and relatively affluent family along with a younger sister. There is little information available as to her early childhood. However, one could assume there were the usual problems associated with the presence of an autistic spectrum child in the family. Her mother is an opera singer, who is famous throughout Europe, and her father is an actor. From what I could ascertain, it appears her parents have been supportive of Greta in her political activities. From the available history, it appears that Greta was not in special classes, but preferred to sit silently in the back of the classroom. At the age of 8, her class was shown a series of documentaries about climate change that would change her life.
She became obsessed with the climate issue, or in Greta's words: "those pictures were stuck in my head," which is a common problem for those with Asperger's Syndrome. Three years later, she had become severely depressed, and unable to function. "I kept thinking about it (climate change), and wondered if I am going to have a future." She was finally able to overcome her Selective Mutism, and confess to her Mother how the obsession had come to dominate her thinking and crowd out every other thought. Should Greta's mother ever lose her voice and be unable to sing, I suggest she might find a promising career as a psychotherapist as her response was exactly what was needed. She listened attentively, and acknowledged the seriousness of the issue without the hollow reassurances and platitudes we are often tempted to issue in such situations.
For Greta, this was an "ah-hah" moment. After listening to her recitation of all the facts that Greta had collected regarding climate change, her mom was converted on the spot to a full-fledged environmentalist. Eventually, she would even stop traveling by air, install solar panels on their home, and join Greta as a vegetarian. Apparently, Greta was inspired by her parents' response and began to think she might be able to influence others to share her concerns about climate change. "That's when I kind of realized that I could make a difference."
At age 15, Greta entered a climate writing competition held by the Swedish newspaper Svenska Dagbladet, and was declared a winner. Her essay titled 'We know – and we can do something now' was published which brought her to the attention of an activist who mentioned the strike by the Parkland Florida students who were seeking to change gun laws. She liked the idea of a school strike, and immediately set out to recruit fellow students. She was not deterred when none would join her, but found an old board on which she painted 'Skolstrejk for Klimatet' (school strike for climate). Equipped with her sign and some hand written flyers, she initiated her one-person strike by sitting alone outside the Swedish Parliament building.
One of the news people covering parliament paused to interview her and wrote a brief article. The following day Greta was joined by others in her strike and the numbers continued to grow for the next 21 days until the Swedish national elections took place. The story was picked up by other news outlets, and social media. As a result of her rapid rise
to fame, Greta was invited to speak at a climate rally in front of thousands of people. Her parents were reluctant to allow her to do it due to their concerns about her selective mutism. However; Greta was adamant that she must speak out and said of her disorder: "Basically it means I only speak when I think it's necessary. Now is one of those moments." The speech was delivered in flawless English and declared a rousing success.
Since that first debut, her speeches and interviews have gained huge audiences. As with this most recent rendering, she speaks on her subject with authority and nary a slip of the tongue. Her English is impeccable without a trace of an accent. The U.N. speech was a climax to the worldwide school strike, but she was not done yet for the next day she announced on twitter: "I and 15 other children from around the world filed a legal complaint against 5 nations over the climate crisis through the U.N. Convention on the Rights of the Child. These 5 nations (France, Germany, Brazil, Argentina, and Turkey) are the largest emitters that have ratified the convention." During that U.N. visit, she traveled to Washington, D.C., to speak to the U.S. Congress Committee on Climate Issues. She bluntly told them, I don't want you to listen to me, I want you to listen to the scientists and take real action as she explained why she was attaching the The Intergovernmental Panel on Climate Change Report on Climate Change to her testimony.
It appears to me that the world has taken little note of what Greta and her buddies have accomplished, but then I guess it is not considered as newsworthy as a Trump tweet. In like fashion, it seems that the climate gets little notice in spite of all the bad news that seems to confirm the accuracy of climatologists' frightening predictions. If anything, all that bad stuff they have been talking about for years is taking place more rapidly than predicted. In the U.S., our most recent crisis involved flooding in the northeast and fires in the west, but there is no place in the world left unscathed.
Some examples include Venice where the current flooding is the worst ever recorded.
There is also the Amazon rain forest still ablaze with nearly 3800 square miles destroyed in the past year compliments of Brazil's president Bolsonoro, a rightwing climate change denier. This is a triple whammy, for in addition to its role in producing oxygen, it sequestered large amounts of CO2 which is released back into the atmosphere as it burns.
We just experienced the warmest July ever recorded while 24 billion tons of ice melted in Greenland.
With an ice sheet in some places nearly 2 miles thick, there is enough ice there that when melted will raise sea levels 23 feet.
Michael Bevis, lead author of a recent publication by the Proceedings of the National Academy of Science states that we are now at a tipping point beyond which there will be no stopping the melt which is now increasing at 4 times the rate which had been predicted. If that trend is not reversed many coastal cities throughout the world will soon be immersed, resulting in mass migrations from our most densely populated areas.
It has recently been determined that the arctic permafrost is now melting much faster than had originally been predicted and liberating methane, an even more potent greenhouse gas than CO2. It has long been known that warming oceans contribute to more violent storms, but recent studies have shown that they are becoming acidic due to absorption of CO2, threatening not only reefs but all manner of marine life on which millions depend for sustenance. It has been said that the major grain producing areas of the world are particularly vulnerable to drought and even becoming deserts.
The news is not all bad however. I have heard that some renewable sources of energy are now less expensive than fossil fuels. How ironic it would be if pursuit of the mighty Dollar, which led us down this rabbit hole, would ultimately be our salvation. If we make more money using other energy sources, the fossil stuff will be left in the ground where it belongs. As for me, I put my hopes on Greta and her several million friends although She has said: "I don't want you to be hopeful, I want you to panic." Her wish may be coming true for Time has recently published a story about a world wide epidemic of "eco-anxiety."
Greta Thunberg: "I don't want you to be hopeful. I want you to panic"
Most would agree that Greta is different. Unfortunately, "different" is often used with a negative connotation. Perhaps, we should use another adjective, such as special, extraordinary, bold, courageous, dedicated, to describe those who are "different" for throughout history we have seen many who were saddled with the label of "different" accomplish amazing things. In some whom we call savants we witness areas of genius in the face of severe limitations. Greta, realized that she was not ordinary and said: "That's when I realized I could make a difference", and she has. You go Girl!
Editor's Note: While editing eshrink's blog, I found this blog post from Scientific American that previews a book written about scientists actually underestimating the rate of climate change and what can be done about it.
Global warming and climate change continue to affect our habitat. Mother Earth will survive. Humans may not. ALWAYS LOVE YOUR MOTHER!
Posted on November 24, 2019 November 25, 2019 by Eshrink Posted in children, climate change, current events, environment	Tagged climate change, environment, global warming, greenhouse gases, Greta Thunberg, Nobel Prize, school strike for climate	5 Comments
The High Life | Marijuana and Us
It appears that Marijuana use has now become a socially acceptable practice. Not only are states falling in line to legalize recreational use (I don't like that term for it seems to equate smoking weed to working out at the gym), but I was surprised the other day when I happened on to an interview with Liz Post who is the great granddaughter-in-law of Emily Post, the etiquette guru. Liz has taken up the etiquette banner and continued as director of Emily's foundation for the last 30 years. She has written her own books of etiquette, this latest of which caught my attention. It is titled Higher Etiquette, and is all about proper behavior in marijuana involved social situations.
A few days later, I was confronted with a full front-page spread in our local newspaper about our county's latest industry, a facility for growing marijuana on a large scale. It was hailed as a major success for the area and projected that it would eventually employ more that 100 people.
The story featured a half-page picture of the interior of a huge greenhouse inhabited by large plants. Apparently, since the owners realized potheads would see the photo as their idea of heaven on earth, they assured us that the facility would be heavily guarded. Medical marijuana (whatever that is) was legalized in our state in September 2016.
The new law only authorizes the use of cannabis orally or topically in the form of pills, elixers, tinctures, and lotions etc. Dispensaries were licensed by the state and product can be obtained with a note from a licensed physician confirming that the person is suffering from one of a list of 21 maladies; although the state medical board is authorized to add diagnoses to the list as they see fit. The law prohibits home growing of weed and smoking it, but allows inhalation through a vaporizer. (I would anticipate there will soon be a brisk business in vaporizers). Not only does this and similar laws across the country violate federal law governing the use of marijuana, it appears to me to bypass Federal Drug Administration procedures which require extensive testing for both efficacy and safety before any drug can go on the market.
Efficacy of Cannaboids
There is a great deal of anecdotal information concerning the efficacy of cannabinoids for a variety of medical problems. In the early 1800s an Irish physician found cannabis extracts helpful in relieving stomach pain and nausea in people suffering from cholera, and recently the FDA approved 2 drugs containing THC, Marinol and Syndros, for treatment of nausea and anorexia in patients undergoing chemotherapy for cancer. It is also said to be useful in the treatment of refractory epilepsy, chronic pain problems, glaucoma, and various neuromuscular diseases such as multiple sclerosis to name a few. Prior to the dawn of modern pharmaceuticals, cannabis extracts were widely sold as a treatment for stomach ailments. Now, nearly 200 years later we don't know much more about them than we did then.
Other Naturally Occurring Plants in Medicine
This is not the first time that a naturally occurring plant would be found to be useful in treating medical conditions. For example, back in the dark ages when I was a general practitioner, digitalis, which was extracted from the foxglove plant was the treatment of choice for a variety of cardiac problems. More recently, taxol, a substance extracted from the bark of the Pacific Yew tree has proven effective in the treatment of ovarian cancer.
The Problem with Pot
The fact that THC is a mood-altering drug complicates the issue of doing the proper research to discern its effectiveness, side effects, and dangers both in the short term and with prolonged use.
There is also the possibility of an enhanced placebo effect. Does drug-induced euphoria tend to mask symptoms, and if so is that bad thing?
The more significant reason for the lack of knowledge as to the effects of marijuania on the human body is due to Federal Drug Administration's reluctance to allow scientists to possess it in order to evaluate it properly.
In 1970 Nixon signed into law The Controlled Substances Act which listed marijuana as a Schedule 1 drug along with heroin, LSD, and other dangerous and /or highly addictive drugs. This was during the time of the War on Drugs, and the FDA was so uptight that they refused to allow possession of any of these drugs for research purposes. Of course, as usual they zigged when they should have zagged for this was a time when new tools were becoming available to researchers with which to evaluate the effect of drugs on the brain, and an opportunity to learn more about the drug was lost. With such information, they could have been in a position to inform us as to the possible consequences of their use, and perhaps more specifically define how or where they might be useful or harmful.
With one foot firmly planted in the door with the medical thing it is not surprising that the Marijuana Rights and Regulations Amendment will be on this fall's ballot. It would legalize the use, possession, and sale of marijuana for persons over the age of 21, and would allow the Ohio General Assembly to enact a tax on its retail sales. As nearly as I could tell there are no proposed restrictions and if passed, potheads can rejoice at their new found freedom. Likewise, entrepreneurs would like to see some of that drug cartel money stay right here in the US of A, and why shouldn't stoners throw a few bucks into state coffers for the privilege of getting high? Those who grow their own (in limited amount) will pay $50 for a license which is not a bad deal when one considers a cigarette smoker pays $1.97 in taxes for a pack of carcinogens.
If one follows the money, it would seem that the proposed bill would pass, and become law. According to one PR organization (ABCD Inc.) the potential profits are nothing to sneeze at. In their 2018 Cannabis Price Index, they project that in New York city alone 77.44 metric tons of pot was consumed in 2018 with a revenue of well over $8oo million, and if taxed at the same revenue as cigarettes $354 million for the city. I have no idea how they came up with those figures, but if true it is little wonder there appears to be an active campaign espousing the virtues of cannabis involving not only established stoners, but big business and politicians as well.
History of Pot
According to the DEA Museum, the oldest known written record on cannabis use is from the Chinese Emperor Shen Nung in 2727 B.C. There is some evidence that its psychoactive qualities were known then. However, the plant was used primarily for its fibers, which were used to make rope, cloth, and a variety of other products, and is thought to have been low in the concentration of psychoactive chemicals. Although hemp and marijuana are of the same species, i.e. cannabis, it is thought that one variety was developed over time with the goal of increasing the levels of tetrahydrocannabinol (THC), the chemical responsible for its mind-altering effects.
A Higher High
The process of increasing the potency of weed has continued and has accelerated during the last 20 years – not surprising since users are always looking for the "good stuff." One study found the average potency in Europe and the U.S. to have nearly doubled between 2008 to 2017. The THC levels had gone from 8.9% to 17.1% with one variety reaching 67%.
This same study compared rates of psychosis between areas with different levels of cannabis potency and found that indeed those cities with the more potent stuff reported more psychotic episodes. As a matter of fact, those who had used higher potency stuff were twice as likely to eventually have a psychotic episode compared to those who had never used. Even more worrisome was the stat that daily users of high potency weed were four times more likely to experience psychosis. This raises the question as to whether THC may have long term side effects. This is not at all surprising; after all THC has long been categorized as an hallucinogen even though until now a weak one.
Pot and the Teen Brain
With the frightening (to some of us), statistics as to the prevalence of pot smoking among adolescent and even younger children has come realistic concerns as to the effect of pot smoking on their brains. This has become increasingly worrisome with recent discoveries of the so-called "plasticity" of the developing brain i.e. the effect that various stimuli may have on its structure and function. Such changes may not become readily apparent until years later and to that end the National Institute of Health has instituted The Adolescent Brain Cognitive Development Study that will follow 10,000 children through adolescence hoping to find what sort of factors, including drugs, affect their brains. Unfortunately, it will take many years for the study to be completed.
Although such information is incomplete, I feel it is premature to judge cannabis to be an innocuous substance, as many would have us believe. I recall similar reassurances regarding cigarettes, e.g., that they were not addictive, harmless, and simply a relaxation aid. It was true those people on billboards, in the magazine ads, and the movies looked really cool with one between their fingers. I was one of those gullible slobs who tried looking cool for 50 years, and was rewarded with a couple of cancers. I was also left wondering how much damage I had done with all that second hand smoke. Of course, I knew that I was not addicted for I could quit anytime I wanted, it was just that I didn't want to (the same words I have frequently heard from my pot smoking patients).
We've Been Down This Road Before
At the beginning of the 20th century, cocaine was toted as a wonder drug with the potential to cure a potpourri of illnesses including drug addiction. Its health benefits were even extoled by adding small amounts to a soft drink which in honor of the presence of cocaine was named Coca Cola. Two of the best-known pioneers in their respective fields of medicine became addicted as a result of their experiments with the drugs. William Halsted who is credited with devising many of the surgical techniques still in use today became incapable of functioning due to his addiction as did Sigmund Freud who likewise became addicted by testing the use of cocaine for psychiatric illnesses. In the 1960s along comes Timothy Leary a Harvard psychologist who promoted more potent hallucinogens as treatment for depression, to increase awareness of otherwise untapped spiritual states of being and other kooky stuff. He was eventuallyHe was eventually disgraced when he was found to be using prisoners as subjects for his experiments.
Whenever there are discussions with anti-dopers about mood altering drugs, the question frequently arises as to "why they do it." Freud attempted to answer that question with his "pleasure principle" theory, an idea which was a couple of thousand years old having previously been described by the Greek philosopher Epicurus. This was the idea that the pursuit of pleasure and avoidance of pain are the essence of life, and therefore all behaviors can be explained by this instinct, furthermore conforming to societal norms is simply to delay gratification of those instincts.
The term addiction is not easily defined as it seems to be used in different contexts, but it is clear that the more pleasant the effects of a substance, the more likely it is that one moves on to an insatiable craving. With prolonged use physiologic changes occur as our body adjusts to the presence of the new substance and bad things happen when it is suddenly withdrawn. The extent of its effect on our body/brain is called its potency. A 2- pack-a-day cigarette smoker is apt to have some headaches and grumpy days for a week or so, but a very heavy use of alcohol over a long period of time can result in delirium tremors, a condition which carries a significant mortality rate when untreated. It appears that in some heroin users, the passage from craving to addiction is almost instantaneous.
Of course, the foregoing description of addiction is woefully simplistic for it is a very complex subject with much disagreement among the experts. My point is that without some regulation governing potency of cannabis we may be in for some unpleasant surprises. Having over the course of my career seen large numbers of marijuana smokers, I am convinced that it is by no means innocuous. I also question the conclusion of pot supporters that it is in no way addictive. I believe that it is especially dangerous in children and that many who are exposed at a young age may be permanently damaged.
So, What's the Answer
Many of you may be thinking: "OK smarty pants, if it is such a big problem, what can be done about it?" The answer is not much. It is clear that the current situation has not worked except to provide opportunities for criminals to make a buck and for addicts to sell in order to finance their habits. Apparently, we did not learn our lessons from the results of prohibition. As with alcohol, cannabis is easy to produce in most any climate and even more difficult to control than opiates, which must be imported. There are some steps I think would be helpful in minimizing the problem:
For the states to continue to have their own laws about pot causes confusion. The federal government should legalize the stuff.
The FDA should set standards and monitor compliance.
It took 100 years for the realization that tobacco companies were spiking cigs with extra nicotine, we should test cannabis for potency.
Anyone who gives or sells the stuff to kids should spend significant time in the slammer (I have seen instances where pot smoking is a family affair).
Many organizations saved lives with an all-out effort to make smoking uncool, let's give marijuana the same treatment.
With legalization will come more use, encourage NIMH to make research into the drug a priority
Please, please, no advertising. Think it couldn't happen? That's what the temperance union thought following the repeal of prohibition.
After pushing pills and other remedies for well over a half century I have concluded that there is usually a downside to whatever chemicals we put in our bodies regardless of their positive benefit. In spite of rigorous evaluations, clinical trials and such we often see unexpected side effects…sometimes years later. The current practice of prescribing cannabis based on anecdotal information without benefit of rigorous clinical testing is in my opinion irresponsible. Nevertheless there is little doubt we have a serious drug problem, and the consensus is that cannabis is safer than most other street drugs. Prohibition offered further proof that "the pleasure principle" thing would not be denied no matter the consequences. Legalizing alcohol did not solve the problem, but it was not as bad as the alternative, and following that model seems to me to be the more sensible approach in dealing with cannabis.
Posted on May 21, 2019 by Eshrink Posted in current events, mental health, psychology	2 Comments
A brief interruption of the "The Way It Was" Series as we return to "Shrink Stuff" | Personality Disorders 101
The other night while dining with friends, I was asked for my professional opinion as to the mental health of our President. My response was not very professional as I responded "I think he is nuts!" There is a caveat, especially important in our business, that one must carefully consider any pre-determined bias before rendering a diagnosis, and my response suggests that I had violated that rule.
In retrospect, I realize that my friend was asking for a less flippant answer to his question. Anyone who owns a TV (or uses Twitter) would probably agree that Mr. Trump's behavior is different from what we are accustomed to seeing in our politicians. His detractors suggest this is evidence of significant mental disorder while his supporters applaud him for being earthy and "unconventional."
I have previously written (click this link to read that post from 2016) about Mr. Trump in not very flattering terms concerning his mental status, and the non-position taken by the American Psychiatric Association of which I am a lifetime member. Those mental health professionals who insist that Trump is mentally impaired and therefore unfit to hold office in most cases make a case for the diagnosis of Narcissistic Personality Disorder. After the conversation with my friend, it occurred to me that most people might be unfamiliar with what signs and symptoms might lead to such an impression
In the first place, it may be helpful to explain what we in the shrink business mean by the term personality disorder as people sometimes overuse a term and its true meaning from a psychiatric standpoint gets watered down (for example: a person who might say upon having a bad day or disappointing day, "I'm so depressed" when in reality they aren't clinically depressed, just a little down).
Personality Disorders | Definition by Psychiatrists
The general criteria listed in the American Psychiatric Association's Diagnostic and statistical Manual of Mental Disorders or DSM which is now in its fifth edition. The definition of personality disorder as summarized in DSM IV is "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture" (not caused by such things as drug abuse, or other medical problems). Unfortunately, for me the criteria as listed in DSM V are more complex, and since I am a simple-minded person I will stick with DSM IV in my discussion (but perhaps more to the point I am reluctant to invest a hundred bucks in another 900 page dust collector for my bookshelf). In either case, it is clear that those who suffer from a personality disorder are very different.
Signs & Symptoms of Personality Disorders
Signs of personality disorders characteristically have been present for long periods usually from childhood. These patients are difficult to treat. Although some psychotropic medications may be helpful, the gold standard remains long-term intensive psychotherapy, a commodity which is in short supply these days. The symptoms usually serve a protective function. Consequently, patients in treatment have difficulty giving them up. An even bigger problem is that in many cases people who need treatment most are those lacking in insight. Consequently, they are convinced there is nothing wrong with them. This is especially true in cases of narcissistic and sociopathic personality disorders. They believe they are perfect in every way so why in the world would they need a psychiatrist?
Narcissism | Signs | Symptoms | Cause
The term narcissism is from the Greek myth about Narcissus who fell in love with his image while gazing into a pool of water. This did not work out too well for him for he eventually committed suicide when he realized his true love was himself. A bit of narcissism is not a bad thing…as a matter of fact most therapists would probably report that low self-esteem is one of the most common problems they see and that they spend a great deal effort trying to help their patients learn to like themselves. But as with most things in life, it is the extremes which cause us problems. We all know people who are arrogant and self-centered, but those with a narcissistic personality disorder take that to the level where their self-image is so far removed from reality that it approaches the delusional.
He/she of the narcissistic personality disorder is the master of the superlative. He is never simply good at something, he is the best. Others are not bad, they are the worst. Everything in life is measured against the perfection that only he possesses. The need to maintain this distorted image of himself dominates his life and leaves no time to consider the needs of others. He is convinced he is special, and deserves special treatment. He courts admiration or subservience in relationships, and is pathologically intolerant of criticism. This preoccupation with self, frequently distorts perceptions and may affect judgement.
As with many mental health problems, the causation is up for grabs. There may be some abnormality of brain function, environmental factors, or both. Some postulate that excessive adoration by parents is the cause, while others feel the opposite, namely that excessive criticism is the culprit. Whatever the cause, most agree that such extremes of narcissism serve the purpose of protecting a very fragile ego. His need for attention is never satisfied. Indeed, the tenacity with which the narcissist holds onto and nurtures these false opinions of himself leads one to suspect an underlying desperation at the core of his being. The most readable synopsis of narcissistic personality symptoms I have found lie in a pamphlet distributed by the Mayo Clinic as follows:
They have a sense of entitlement and require constant excessive admiration
Have an exaggerated sense of self importance
Expect to be recognized as superior even without achievements that warrant it
Exaggerate achievements and talents
Preoccupied with fantasies of success, power, brilliance, beauty or the perfect mate
Believe they are superior and can only associate with equally special people
Monopolize conversations and belittle or look down on people they perceive as inferior
Expect special favors and unquestioning compliance with their expectations
Take advantage of others to get what they want
Have an inability or unwillingness to recognize the needs and feelings of others
Be envious of others and believe others envy them
Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious
Insist on having the best of everything (for instance the best building, golf course, yacht, wife, etc.–the examples are my words NOT Mayo Clinic's example–they used car and office)
Narcissism & Trump
So, there you have it – all you need to make a diagnosis. You Trump watchers have certainly observed enough behaviors to decide if the shoe fits. If you conclude that the diagnosis of Personality Disorder fits, you should be concerned as to the fitness of POTUS to handle the job. Those so diagnosed are prone to react in irrational ways when their distorted view of themselves is threatened and consequently are very sensitive to any kind of criticism, often reacting with over-the-top rages. Mistakes are never acknowledged for to do so would shatter the myth of their perfection. They react poorly to stress and to change, and there is no doubt that POTUS must be under mountains of stress considering all the investigations currently underway with many of his former supporters on their way to jail.
While in the midst of writing this, I was directed by one of the friends I mentioned in my opening statement to a YouTube presentation by John Gartner, a Ph.D. psychologist at Johns Hopkins. Dr. Gartner is convinced that Trump is demented. Gartner is adamant in his diagnosis and convinced that he should be removed from office. In spite of Gartner's intensely verbalized political views, he does make a good case for an Alzheimer's type dementia. However, I believe the evidence he presents is not unusual for one afflicted with a narcissistic personality disorder who is under threat of losing that shield, which protects him from facing the reality of his deficiencies.
Narcissism Exposed ("s#@t hits the fan" time)
As I have mentioned in previous blogs, my major concern is that the current investigations will turn up things which he will not be able to deflect with his usual strategies of denounce, deflect, or deny. Recently, he has seemed less rational with a 2- hour long rant at the Conservative Political Action Conference, and the strange attempts to demonize John McCain months after his death. In the so-called Twitter storm from last week, he seems enraged at everyone within range. It appears that his only respite is the campaign rallies at which he is able to bask in the attention accorded him, confirming to him that he really is "The Greatest."
Some say our President is "crazy like a fox". It is true that he has turned self-promotion into a very successful career, even becoming the world's most powerful man. Those same talents have served the additional function of satisfying insatiable ego needs. I believe that Trump's narcissism governs every aspect of his life, and explains the "crazy" things he does and says. I believe that he is psychologically vulnerable and likely to demonstrate irrational and impulsive behaviors if his defenses are destroyed. With that in mind, I hope all these investigations do not burst the President's fragile ego for that could be disastrous.
Editor's Note: I was slow on the editing of Eshrink's post and so much has happened since he originally wrote this article. The Attorney General released a 4-page summary of the Mueller Report on a Sunday while many of us were watching our brackets bust during the NCAA basketball tournament. I kept asking why the full report wasn't being released to the public (the taxpayers paid for it, as POTUS continues to remind us in the context of money wasted) or at least released to Congress (it seems Nancy Pelosi wonders that, too.) However, Eshrink's post about Narcissistic Personality made me think maybe the inner circle knows more than we think about the stability of POTUS and his psychological vulnerability that could lead to an even worse outcome. History will tell the tale… I'm sure those working inside the Oval Office will have plenty of great material for books once this crazy time in our republic's history is behind us–if the Republic survives that is. God Bless America. We need all the help we can get!
Posted on March 29, 2019 March 30, 2019 by Eshrink Posted in current events, mental health, Mental Illness, Politics, psychology	Tagged Mueller Report, Narcissism, Personality Disorders, trump	1 Comment
CAN'T WE ALL JUST GET ALONG?
It has been 27 years since Rodney King, an alcoholic drug-addicted Los Angeles cab driver, tearfully uttered those words. Rodney was a troubled soul whose beating by police officers was filmed by a bystander and precipitated the L.A. race riots which resulted in the death of 63 people, hundreds of injuries and massive property damage. The answer to Rodney's question remains moot, for we are still not getting along very well. Perhaps we need to spend more energy on learning why this is still true.
REAL CHANGE OR WINDOW DRESSING?
It is true there has been progress in race relations, the issue of police brutality is being seriously addressed, and the "metoo" movement has garnered some traction, but we continue to expend a great deal of energy in fruitless debate which never seems to find resolution. This is especially true in our current political scene where vituperative language has become the norm, and both democrats and republicans cling so rigidly to their positions that compromise is impossible. Disagreements have become personal. Name calling and character assassinations are routine.
Not since the civil war has there been so much divisiveness or tribalism as is the currently fashionable term. It appears to me that there are multiple reasons why we can't "all just get along," one of which is the nature of our political campaigns. Somewhere along the way experts in such matters determined that so-called negative campaigns are the most effective strategy, and that has become the modus operandi for all kinds of kinds of candidates from dog-catcher to president. With the candidates continually trading insults and accusations, there is little relevance paid to issues and the undecided voter is left to decide which of the candidates is worse. Since his vote is based largely on his disdain for the character of his hero's opponent rather than issues he is likely to retain very negative feelings towards the one whom he voted against. Such feelings may be carried forward and make it more likely that when a discussion ensues between two on opposite sides of an election civility is less likely.
NEWS. ARE YOU KIDDING?
So-called cable TV news stations have also in my opinion contributed to this giant schism in our political discourse. I use the term so called for they can hardly be called news outlets, but are dominated by political commentary to be generous or perhaps more accurately political propaganda outlets. Fox News leads the pack with the most viewership and the most conservative commentary. Their current star Sean Hannity is said to be one of Trump's most trusted political advisors yet they have the temerity to call themselves "Fair and Balanced." At the other end of the political spectrum is MSNBC who no longer attempt to hide their pro democratic bias. Then comes CNN which makes a pretense of being neutral, but fails miserably. They do have some conservative consultants on their staff which they bring in on occasion for their group discussions.
WHERE IS THE MIDDLE?
One thing these networks have in common is their programming which consists mostly in bringing in groups of experts (there must be a lot of experts in Washington for they never seem to run out) and have a group discussion with participants representing more extreme positions on both sides of an issue. Consequently; a viewer is likely to choose a more radical position. The days of political reporting in which both sides of an issue are elaborated upon by a single person with no skin in the game seems to be long gone. Only PBS seems to follow that old-fashioned format of simply presenting the facts and allowing the viewer to draw his own conclusions.
GROUP THINK
During my career as a Psychiatrist my patients taught me much about our desire or perhaps more accurately said our need for validation. As such we are inevitably drawn to those who share our beliefs and perceptions, and therein lies the effect of today's dueling media outlets. Those of us who harbor conservative beliefs will be drawn to Fox while the more liberally oriented will stick with MSNBC or CNN, "and never the twain shall meet". The same phenomenon is operant with "talk radio" and with the internet which is becoming a news source for increasing numbers of people. As we continue to be immersed in one particular viewpoint and converse only with people of like mind we find ourselves rigidly attached to one particular political philosophy having convinced ourselves that we are the only custodians of truth.
LOGIC BE DAMNED
An argument can be defined as a person or group attempting to convince others that they are wrong. It is also true that political issues can have serious consequences therefore; political arguments can and often do become emotional. I recall as a child hearing the admonition that one should avoid discussions of politics or religion in polite company, and indeed these are the two subjects about which people are likely to have the most intense feelings. Since I am a peace-loving man and something of a wimp to boot I must admit that I tend to shy away from raising the issue of politics with friends whom I know to be on the opposite side of the fence. I submit that this same phenomenon exists throughout society and deters us from discussions of the issue that divide us and hopefully learn to compromise or at least respect the opinions of those with whom we disagree.
Advertisers have long proven that repetition in TV ads will sell everything from Viagra to Tylenol, so why not politicians. The Washington Post reports that $6.5 billion dollars were spent on the 2016 election much of which undoubtedly went to television ads leaving us drowning in a sea of powerful messages describing how terrible are all those candidates for office. Little wonder that elected officials now share the worst favorability ratings ever, and that disgusted citizens are so sickened they don't even bother to vote.
BAD GUYS EVERWHERE
Among the most powerful motivators are anger and fear, and those masters of propaganda who manage elections are adapt at using them as weapons. Naturally when one votes for a person because he is persuaded that the other candidate is a threat other issues will become irrelevant adding more fuel to that fire which inhibits reasonable discussion.
Our prevaricator in chief has proven himself to be a master at eliciting those feelings and continues to describe the press as "the enemy of the people" and members of the Democratic party as "evil". There are also the warnings about immigrants characterizing them as criminals, rapists, murderers, drug dealers and subversives. His talent for instilling such feelings is well demonstrated by the behavior of some of the attendees at his rallies. History shows us that a very effective way to unite a group of people is to find a common enemy, and his followers revel in chanting "lock her up".
THERE REALLY IS "FAKE NEWS"
Last but certainly not least is the effect of the internet and social media which held such promise in bringing people together has now become a powerful weapon to interfere in our elections primarily by propagating conspiracy theories and lies of all kinds so numerous that it is virtually impossible to rein them in. Artificial intelligence has further sharpened these tools so that individuals can be targeted with false information tailored to their own particular biases or prejudices, and can reach millions of people in short order with very little expense. Nearly everyone except Mr.Trump agree that the Russians were very involved in such shenanigans in our last election and although we are told the effects on the election cannot be determined there is little doubt that it has contributed to much confusion and misinformation designed to enhance our divisiveness.
The other day when I began writing this I thought there were signs of at least some yearnings for a coming together to work out problems. Niki Haley in her retirement announcement appeared to break from her boss and indicate that she did not think political opponents to be enemies. There was commentary on our need to come together, but those hopes were soon dashed with the pipe bombs, and now the senseless shooting of 2 black people in Kentucky followed by the mass murder of Jews in Pittsburg.
SOME BEHAVIOR IS PREDICTABLE
With such horrors filling the headlines you might think they would provoke serious talk about bridging the now toxic divide that separates, but after expressing regrets and sympathies yesterday our fearless leader is back on track today blaming the news media for causing the tragedies. Apparently, the false flag theory which named the Democrats as the perpetrators didn't fly so he was forced to go to his fall back strategy. Nevertheless, we once again hear talk of our need to come together in spite of our differences. Will we follow through this time? Hope springs eternal!
Posted on October 31, 2018 October 31, 2018 by Eshrink Posted in Advice, communication, current events, media, Politics	1 Comment
Rebuttal to Op/Ed
Hi eshrink blog readers: this is Maggie [yes, the original editor–eshrink's daughter– is back]. One thing too many people don't bother to do anymore is make their voice known. It seems many people would prefer to complain and bitch rather than write a letter (email) to a reporter, author, senator, congressional representative, etc. NOT ESHRINK. He read the following op/ed in the Zanesville Times Recorder. The email he sent the author follows the column.
When we officially abandon civil discourse | Christine Flowers
Hoping that a child will be raped is the vilest thought that can be formed in the civilized brain. There is no "larger picture," no justification, no explanatory context. You cannot say, "Well, yes, that's bad, but what I really meant to say was that the kids of any conservative who supports that bastard Brett Kavanaugh deserve to be treated the same way (she says she) was."
Hoping that a child will be raped is inhuman, but it is no longer out of bounds in social discourse. Recently, I came across a public posting on Facebook, which means the author wanted the world to have access to her thoughts. It was a jeremiad against Donald Trump, which is unexceptional these days, since he seems to turn certain people into human volcanoes that spew rivers of hateful prose. I avoid them when I see them scroll through my Facebook news feed.
But this one caught my attention because I love children, spend a lot of time with them, and used to teach them. I also represent them in immigration court, like the little girl whose hand I held as she told the judge the other day that she was from Honduras, and that she was 5, and that pink was her favorite color.
So when I saw these words, I froze:
"Time to burn everything to the [expletive] ground, when it comes to this vile, non-human garbage who by stealing and cheating ended up in the White House. Are we going to take as any kind of truth an 'investigation' that isn't one? Are we going to take his a–hole supporters who say 'lock her up' to Dr. Ford? I'm a good and nice person, a peace-loving person but let every one of them and their sons and daughters get raped, accosted by one of those 'boys will be boys.' "
It went on. I reported the post to Facebook, and as of this writing, it's still there. That's Mark Zuckerberg's problem now, because I've blocked the poster. But it was important for me to not simply shake my head as I used to do and move on, narrowing my group of friends to those with whom I could share photos of my sweet black Labs and funny anecdotes from my family along with political essays and ruminations. I've resigned myself, ruefully, to the realization that this political and social climate is choosing for me, without my permission, the comfortable echo chamber, where even though I hear kindred thoughts, I miss some of the kindred spirits who didn't share them.
In other words, I am becoming increasingly isolated from liberal ideas because it is much harder these days to have a civil conversation. And yet I have very good, very decent, liberal friends, like Robin and Donna, Jennie and David, John and Victor, who would never in a million years write about the rape of children in the same breath as they wish death on a president they can't stand. They make me realize that this is not a partisan disease, even though many of my conservative friends urge me to see "the other side" as the enemy.
I have to admit that these past two weeks, the "other side" has been Dixie to my Union, the Axis powers to my Allies, guillotine-wielding Jacobins to my aristocracy. The Democrats, for whom I have vowed to never again cast a vote, have morphed into a caricature of their former selves in their duplicitous crusade to destroy a man and his reputation. I see nothing there that reminds me of the party I belonged to for 37 years. But that is political, and I understand that there are just as many Democrats and liberals who read my words defending Brett Kavanaugh last week and felt the same revulsion for me that I feel for the despicable assault on the judge.
I would sincerely hope that even they, disgusted with our president and with the people he has chosen to represent him in the cabinet and now on the court, would recoil from the suggestion that my hypothetical children and the children of Kavanaugh supporters should be raped.
You might say that this is anger speaking, and of course it is. But the appropriate place for that anger to burn is in the deep and quiet recesses of the mind, hidden from view. That we have now reached the point that assaulted children are considered appropriate conversational tender sterilizes the soul and induces a nausea that can't be eliminated by blocking the person who dares to write the words.
And not even the confirmation of a Supreme Court justice will make it better.
Posted: October 4, 2018 – 6:09 PM
Christine M. Flowers | cflowers1961@gmail.com
http://www2.philly.com/philly/columnists/christine_flowers/facebook-social-media-civility-conversation-20181004.html
RESPONSE from ESHRINK
Dear Ms. Flowers:
Perhaps you are right that we should limit discourse on the subject of sexual assault on children, after all hiding such incidents has worked quite well for the Catholic church [editors note: the movie Spotlight is a peek into the importance of a free press and the commitment real reporters have to exposing the truth]. However; you should be congratulated on your effective use of the time honored strategy of blaming the victim, or even better to further politicize it by holding democrats responsible. Little wonder that you "feel revulsion for the….despicable assault on the judge." After all he has lived a life of privilege and as he frequently reminded us was an honor student at Yale, which should immunize him from any such accusations.
As a recently retired psychiatrist I have many memories of times spent with patients who have been unable to dismiss the pain from having been violated, often as children. That pain often results in a lifetime of impairment. Dr. Ford's story was very familiar to me as was Kavanaugh's response, which was to release an explosion of suppressed rage. His behavior has been excused by his supporters who suggest he has a right to be angry however; were he seen by me as a patient I would consider him a good candidate for anger management training. In the interest of full disclosure, I am one of those "liberal democrats" who would very much enjoy having that "civil conversation" which you say is lacking in your life.
Posted on October 11, 2018 by Eshrink Posted in current events, Politics	1 Comment
Not since the 1920s has there been more activism on the part of women in protest against male domination. Their current complaint is much different than that of the suffragettes, for it involves sex. This was a taboo topic for women of the '20s, who were products of the Victorian era. The unintended consequence of such societal restrictions gave men free rein to sexually harass, abuse, humiliate, and denigrate women who would be too embarrassed to publicly complain. She could also be subjected to the time-honored policy of blaming the victim.
There has been much news recently about a big-time movie mogul who is currently under the gun from a platoon of gals alleging not only harassment but assault. This brought up memories from my childhood when there was a lot of talk about how movie starlets "screwed their way to the top." It was said by those supposedly knowledgeable about the industry that the road to stardom was via a producer's couch (the "casting couch"), and of course, people said that it was the directors who were taken advantage of, for they were seduced. I don't recall ever hearing an actress, or anyone else for that matter, complain about sexual abuse. What suffering they may have endured was done silently.
Ah, but how times have changed. Women have come out of the closet en masse, determined to seek retribution in spite of their fears and embarrassment; they instantly changed from shamed to heroic. It doesn't hurt that one third of all judges in the country are now women and that women can no longer be depended upon to vote the same as do their husbands. Consequently, they have become a political force to be reckoned with.
Among the torrent of disclosures are stories of workplace abuse going back decades. Although I have always found physical abuse abhorrent, I must confess that in years past I was oblivious to the discomfort that even off-color remarks could actually inflict on a woman. Were she to complain, I would undoubtedly accuse her of lacking a sense of humor. When such situations evolved in social situations, Barb was usually there to set me straight. However, when such behaviors occur in the workplace it becomes much more complicated. Indeed, in any situation in which there is a hierarchical power structure, sexual harassment, or even unwanted physical contact, will be initiated by the more powerful person almost without exception.
Of course, this leaves the victim in an untenable position, often forced to choose between tolerating the abuse or putting his or her job in jeopardy. Defensiveness is likely to curry disfavor with her superior which could result in disaster. Not only could chances for promotion become limited, victims could even lose their jobs. They then could be labeled as troublemakers and carry that label with them as they search for a new job. Larger companies are likely to have a Human Resource department where one can lodge a complaint, but they may be more interested in protecting the company than the employee.
The increased number of harassment and abuse charges in the workplace is certain to provide another cash cow for the lawyers who could find such cases as lucrative as auto accidents. For many years, businesses have been concerned about the problem of sexual harassment in the workplace. Many have spent large sums on programs designed to educate employees regarding rules for interactions with fellow employees of the opposite sex. As a matter of fact, I was told by a person who had previously worked in a supervisory position for a fortune 500 company that he had been required to repeat such a course annually.
He also said that those accused of sexual improprieties were subject to immediate dismissal. In spite of these efforts, there continued to be complaints of harassment. Those complaints may have been exaggerated at times, for the company, apparently more concerned with reputation than money, initiated a policy of negotiating payments to these complainants in return for a pledge of secrecy without regard to the legitimacy of their complaints.
But, the most flagrant example of the payment of hush money was by the recently exposed Congressional Accountability Office. It was revealed in the November 15th, 2017 issue of USA Today that this office, under direct control of our elected representatives, had paid out over 17 million dollars of taxpayer money with the proviso that such payments remain secret. This had all occurred since the agency was established in 1995, and it got some attention since it involved dollars from the voter's pocketbook. The inherent assumption that these alleged perpetrators were falsely accused was exemplified by the the caveat that the victims, not the accused, must agree to engage in counseling, another example of blaming the victim without any attempts to confirm or negate the claims.
This reminded me of problems that similar policies caused during the height of the epidemic of medical malpractice suits several years ago. Nearly all physicians carried malpractice insurance, but many found that when they were sued, their insurance company found it cheaper to settle than to fund a court case. Doctors who felt the charges against them were unfounded wanted their "day in court," but found the terms of their policy did not give them that option unless they wanted to pay the expenses of a trial.
It was a tidy arrangement: the plaintiff could pick up a few thousand bucks, the lawyer would get 20 or 30% of the take for not much more effort than it takes to write a letter, the insurance company avoids the risk of getting one of those multimillion dollar judgments from an unusually sympathetic jury, and everyone is happy except for the doctor who will find himself registered in the National Practitioner Data Bank with a forever sullied reputation. He will be looked on with suspicion when applying for hospital privileges or virtually any professional activity, and if he is unfortunate enough to be sued for the second time, he will probably be forced to hang it up, as he will undoubtedly become uninsurable. I knew a physician whom I thought to be very competent who was forced to end his career prematurely this way. A few of the uninsured risked losing everything by "going bare" i.e. practicing without insurance.
None of this should be construed as to minimize the importance of this issue or to excuse the centuries in which women have been left powerless to defend themselves. It does appear to me that women are on the threshold of finding tools with which they can exert more control over their own lives, and defend themselves from those behaviors they find abhorrent. That is not only as it should be, but as it must be as women gain credibility and status. They may even prove themselves superior in areas previously exclusively occupied by men and, consequently, come to occupy positions of leadership in spite of long held exclusionary policies.
With leadership comes power. Let us hope women will use that power in a more judicious manner than have men, and the traditional "battle of the sexes" will no longer be played out in the workplace. This appears to me to be unlikely, as I believe the reasons for the continuation of the love-hate relationships between the sexes are deeply ingrained in our species, perhaps even in our DNA. This is an issue which I discussed in a previous blog. The women's movement has a stated goal of equality. After they achieve that goal, perhaps there would even be more problems should they move onto a quest for domination.
Workplace problems do not have a simple solution. There are people of both sexes who have longstanding anger towards members of their opposite gender. How can accusations be adjudicated? Does the policy of paying hush money give the rich license to violate as they please? On the other hand, does it allow those falsely accused to be legally blackmailed? How about flirting—when does it cross the line? When is a friendly attitude mistaken for an invitation to be intimate? It is reported that many office romances end in marriage—would they happen if all were able to ignore another's appeal? What about relationships between co-workers outside the workplace? What about the use of "feminine wiles" to advance one's position at the expense of another competing for favorable treatment?
If my assessment of the male's need to dominate is correct, those who attempt to solve these problems are in for an uphill struggle, for despite society's best efforts, there remains in mankind only a thin veneer of civilized behavior. Nevertheless, our culture is changing in ways which often conspire to make traditional male-female relationships dysfunctional. I read somewhere that some smart guy said change only occurs with revolution, and revolution is accompanied by chaos. We now appear to be in the midst of the next phase of a revolution that began over 100 years ago. Change is needed. Let us hope that the chaos will be limited and that the change pendulum will not swing too far.
Posted on January 14, 2018 January 28, 2018 by Eshrink Posted in current events, feminism, Politics, Sexual harassment, Work	Tagged #MeToo, communication, feminism	Leave a comment


"I began putting weight on 21 years ago when I got married. Pure contentment and happy married life meant we would eat whenever and whatever we wanted. However, I put most of my weight on when I was diagnosed with breast cancer in October 2010. I was rushed into having a mastectomy two months later in the December and, once I recovered from the operation, I began a course of chemotherapy then radiotherapy.
"Because of the cancer, I kept thinking to myself 'I could be dead tomorrow' so I would treat myself to that chocolate bar. But then it tuned in to a daily ritual, and then became four chocolate bars a day. I thought I was enjoying life by treating myself with food.
"However, I was far from enjoying life. Both my partner and I had been diagnosed with depression and were receiving counselling. I continued to comfort eat and I never seemed to be full. My portions were massive and I would finish the kids' meals as well.
"I began to think about losing weight during a shopping trip with my two beautiful daughters. I realised that I couldn't shop with them in the 'normal' shops they wanted to go in. It made me feel horrid. I wanted them to be proud of me, not the Mr Blobby I had turned in to. I also realised that, although my husband loved me and always will, I felt that he would prefer me If I was slimmer.
"Most importantly, my main reason for wanting to lose weight was to reduce my chances of the cancer recurring. I just wanted to protect myself and make sure I did everything I could to prevent the cancer from coming back by living a healthy lifestyle.
"I started on Step 1b and worked my way up the Steps. I found Step 3 the easiest and it suited my lifestyle better.
"Before I lost weight, I would never wear long trousers and they made me feel fat and frumpy but now I can wear them with confidence. I now exercise every day and really enjoy it. I ran a 5K for Race for Life in February 2016 and participated in a 1K outdoor swim to raise money for Cancer Research. Both the run and the swim were challenging but I trained with family and friends which made it fun. My daughter ran the Race for Life with me which allowed us to bond and has brought us even closer together.
"By losing weight with CWP, I have gained a full understanding of portion control and healthy food choices. Not only have I changed my own life, I have also changed my family's as they have all improved their diets and lifestyle as well.
Rate: 10 months *The weight lost and/or timeframes are particular to this slimmer. Everyone's weight loss journey is unique to them.


text:
'Hero' Dog Credited For Saving Family From House Fire
A 2-year-old dog named "Foxy" was called a hero after waking up a Santa Ana family as their home became engulfed in flames early Wednesday, according to the Orange County Fire Authority.
Fire crews were able to gain control over the blaze at around 2:15 a.m., but by then the structure was deemed a total loss, according to the Fire Authority.
Seven adults and a child were inside the residence at the time, but all made it out thanks to Foxy, who woke them up and alerted the family to the fire.
"She is the hero," OFCA tweeted.
Outside the home, as firefighters continued to work before dawn, resident Vera Mendez cradled Foxy, who kissed her cheeks.
"She started barking and barking, and woke up one of my sons, and he actually woke everybody else," Mendez said. "By the time we got up, the whole house was full of black smoke and you could see the fire. I was really scared."
Mendez said she had lost a grandmother and uncle in a fire, which made her particularly frightened. The whole family escaped without harm, she said.
She credited the little dog's barking with saving the family. No one heard smoke alarms inside the home, she said.
"If it hadn't have been because of her, I don't know what would have happened," Mendez said.
The American Red Cross was assisting the eight displaced residents, according to fire officials.
The blaze caused roughly $200,000 in damages to the structure and an additional $100,000 to the family's possessions.
It was not immediately known how the fire started.
Source: ktla.com