Saturday, December 08, 2012

Gregory Desilet - Derrida and Wilber at the Crossroads of Metaphysics

From Integral World, this is an interesting look at the ways Ken Wilber may misunderstand postmodernism, and in this specific article, how he may misunderstand Jacques Derrida, the (in)famous French philosopher who gave us deconstructionism.
Despite his dissatisfaction with the term postmodern, this analysis will use the late Jacques Derrida as the exemplary postmodernist and will center primarily on comparing and contrasting elements of Wilber's views with those of Derrida. The pairing of Wilber and Derrida is featured because Wilber offers a reading of Derrida and because, in my view, Derrida provides the most cogent lines of argument pertinent to a critical examination of Wilber's positions.
This is pretty interesting - hope you might think so, too.

Full Disclosure: I have long thought that Wilber misunderstands certain aspects of postmodernism, and specifically in the interpersonal and intersubjective realms. There is no recognition (as far as I have ever seen) of the work of Jerome Bruner, Kenneth Gergen, or others who work with social constructionism/constructivism.

Gregory Desilet is author of various writings on language and culture, such as Cult of the Kill: Traditional Metaphysics of Rhetoric, Truth, and Violence in a Postmodern World and Our Faith in Evil: Melodrama and the Effects of Entertainment Violence. See also:, which hosts an eulogy for Derrida. In his Misunderstanding Derrida Desilet questions Ken Wilber's understanding of postmodernism.

Derrida and Wilber at the Crossroads of Metaphysics

Gregory Desilet

This essay has been written originally to be included in the book Dancing with Sophia: Integral Philosophy on the Verge. Published with permisson of the author. This is an extension of the argument found in "Misunderstanding Derrida and Postmodernism" (FV)

My descriptions of the views of Wilber and Derrida are offered in a spirit of provocative inquiry rather than a posture of authoritative insistence on the correctness of Derrida's views. 
Over several decades Ken Wilber has consistently addressed the task of modernizing and postmodernizing perennial philosophy. According to Wilber, advances in modern science and postmodern theory have been sufficiently validated to necessitate their inclusion in any scheme of understanding aimed at taking into account the full quality of human experience as currently measured among various world class philosophers, theologians, and spiritual practitioners. Admiring science and its emphasis on methods of verification, Wilber wants to make a science of spiritual wisdom. And, following postmodern epistemological critique and 20th century developments in science, he wants to upgrade that science to accord with current knowledge, including relativity theory in physics. Nevertheless, he wants to distance his views from certain aspects of postmodern theory—specifically all those views construing language as an endless play of signifiers untethered to anything outside the signifiers themselves. Wilber includes language theory among the many fields of theory in which he travels in his spiritual quest because the problem of meaning is analogous to the problem of spirit. Issues of meaning and spirit involve the interior and intangible side of experience and these qualities have proven difficult to render unto science due to the difficulty they present to measurement. But Wilber's efforts of analysis and theory construction have enabled him to arrive at a philosophy of integral spirituality he believes overcomes the difficulties posed by the interior and the intangible so that this realm now opens itself to access and management comparable to the tangible realm. And, if his work were indeed to accomplish such a task, it would be fair to say he has made it possible to pursue a science of spirituality. 

This study argues instead that Wilber fails to formulate a science of spirituality consistent with his claims for the potential of such a science to relieve problems of verification and uncertainty. More specifically it maintains that Wilber's claim to have ventured into the realm of post-metaphysical thinking overreaches, that his spiritual orientation remains grounded in classical metaphysics, and that his belief in the post-metaphysical nature of his spirituality and philosophy depends on questionable assumptions about both metaphysics and postmodernism. 

Despite his dissatisfaction with the term postmodern, this analysis will use the late Jacques Derrida as the exemplary postmodernist and will center primarily on comparing and contrasting elements of Wilber's views with those of Derrida. The pairing of Wilber and Derrida is featured because Wilber offers a reading of Derrida and because, in my view, Derrida provides the most cogent lines of argument pertinent to a critical examination of Wilber's positions. This pairing is also featured because I have had the benefit of personal encounters with both Wilber and Derrida. Though I was able to spend considerably more time with Derrida than with Wilber, both of these encounters presented opportunities to ask questions relevant to the issues addressed in this essay. 

A few words should be said about how critical commentary may be seen to square with an integral approach to doing philosophy and spiritual inquiry. It would seem consistent with the logic of "integral" that an integral approach to inquiry focus on integrating different views by way of a process Wilber describes as "transcend and include." However, when an integral philosopher such as Wilber includes and appropriates the views of another thinker such as Derrida into the framework of his (Wilber's) orientation but does so on the basis of what appears to be an inadequate interpretation of those views, then critical commentary may be seen to be integrally beneficial in its effort to set the record straight. For, surely, integral theorists are not interested in building coherence out of misinterpretations of key philosophical works. And, if it should turn out to be the case that an illusory coherence were constructed on the basis of crucial misunderstandings of a philosophical position which, if adequately understood, challenged the metaphysical core of Wilber's spiritual vision, then it would be consistent with the integral desire for rigor and adequacy to throw open the door to this kind of critical commentary. 

In the spirit of full disclosure I confess I am divided in my loyalties on points where integral and postmodern philosophies may be seen to have fundamental differences. On the one hand, I side with Wilber on the issue of grand narratives. One of the things I most admire about Wilber is his steadfast attempt to fashion a "theory of everything." In pursuit of this ambition the comprehensive interdisciplinary breadth of his reach into the archives of world knowledge and wisdom traditions has been remarkable and sets a standard few have been able to match. In my view, any philosophy claiming to be philosophy constitutes an attempt, explicit or otherwise, at grand narrative. Even when a philosophical position claims to be no more than, say, a philosophy of language or a philosophy of morality or a philosophy of whatever, it does not and cannot avoid including within itself default assumptions ushering in conclusions pertaining to metaphysics, conclusions about the nature of being which immediately trigger entanglement in a theory of everything. So, on the issue of metanarratives I do not side with Jean-François Lyotard insofar as postmodernism, as he defines it, avoids grand narratives. In my opinion, Derrida does not side with Lyotard on this issue either—a conclusion drawn from Derrida's statements that it is not possible to escape metaphysics. 

On the other hand, when it comes to the question of the nature of being, I side with Derrida's postmodernism rather than Wilber's integral philosophy. In principle, there can be no deeper level of critical analysis than the metaphysical level, the question of being. Therefore, a challenge at the level of being is one that affects every aspect of what rests above it. In challenging Wilber's metaphysics, then, no part of his approach to spirituality remains untouched, but only the primary aspects affected are discussed below. This postmodern deconstructive challenge to Wilber need not be seen as an attempt to demolish integral philosophy or spirituality. Instead, the reason for illuminating the contrasts between Derrida and Wilber will be to demonstrate that the deconstructive approach cannot be, as Wilber would have it, appropriated into the integral project as Wilber understands and practices it. As will be argued, an adequate understanding of Derrida's thinking about being and time precludes translating it into an orientation compatible at the deepest levels with integral post-metaphysics. Whether this incompatibility requires revisions of integral foundations to the point where the notion of "integral" no longer seems appropriate is a question remaining to be worked out in spiritual communities relevant to the question. 

Seeing Derrida and Wilber as opposed in their respective views of the nature of being requires a fundamental characterization of both thinkers with regard to metaphysical positioning. Any such characterization amounts to interpretation—and interpretations, as will be argued herein, may always be significantly skewed from the mark of adequate textual and contextual understanding.
Read the whole essay.

The Mind Report - Tamar Szabo Gendler (Yale University) and Andrew Solomon (Far from the Tree)

Andrew Solomon is author of one of the year's best psychology (on several Best 10 lists I have seen), Far From the Tree: Parents, Children and the Search for Identity. Here is the publisher blurb about the book:
From the National Book Award–winning author of The Noonday Demon: An Atlas of Depression comes a monumental new work, a decade in the writing, about family. In Far from the Tree, Andrew Solomon tells the stories of parents who not only learn to deal with their exceptional children but also find profound meaning in doing so.
Solomon’s startling proposition is that diversity is what unites us all. He writes about families coping with deafness, dwarfism, Down syndrome, autism, schizophrenia, multiple severe disabilities, with children who are prodigies, who are conceived in rape, who become criminals, who are transgender. While each of these characteristics is potentially isolating, the experience of difference within families is universal, as are the triumphs of love Solomon documents in every chapter.

All parenting turns on a crucial question: to what extent parents should accept their children for who they are, and to what extent they should help them become their best selves. Drawing on forty thousand pages of interview transcripts with more than three hundred families, Solomon mines the eloquence of ordinary people facing extreme challenges. Whether considering prenatal screening for genetic disorders, cochlear implants for the deaf, or gender reassignment surgery for transgender people, Solomon narrates a universal struggle toward compassion. Many families grow closer through caring for a challenging child; most discover supportive communities of others similarly affected; some are inspired to become advocates and activists, celebrating the very conditions they once feared. Woven into their courageous and affirming stories is Solomon’s journey to accepting his own identity, which culminated in his midlife decision, influenced by this research, to become a parent.

Elegantly reported by a spectacularly original thinker, Far from the Tree explores themes of generosity, acceptance, and tolerance—all rooted in the insight that love can transcend every prejudice. This crucial and revelatory book expands our definition of what it is to be human.
Solomon is interviewed by Tamar Szabo Gendler (of Yale University) in this fascinating discussion.

The Mind Report

Tamar Szabo Gendler (Yale University) and Andrew Solomon (Far from the Tree)

On The Mind Report, Tamar speaks to Andrew Solomon, author of the new book, Far from the Tree. Andrew explains how his eyes were opened to the rich linguistic culture of the deaf community. Tamar asks him if he thinks schizophrenia or anorexia should be valorized as identities. Next, Andrew tells the moving story of Clinton Brown, a dwarf who exceeded all expectations, and two stories about parents of transgender children in radically different communities. Finally, Andrew has some closing words on identity, illness, and parenting

Recorded: Dec 31 |  Posted: Dec 2, 2012
Download:   wmv | mp4 | mp3 | fast mp3  

Friday, December 07, 2012

Barry Schwartz - Move Over Economists: We Need a Council of Psychological Advisers

I agree.

Move Over Economists: We Need a Council of Psychological Advisers

By Barry Schwartz
Nov 12 2012

Much of governing involves predicting behavior or getting people to change it. Lawyers and economists need some help with both.

Engraving from Vesalius, De humani corporis fabrica (Wikimedia Commons)
Though President Obama won reelection decisively, he won't have much time to celebrate. Many of the nation's problems -- stimulating employment, reducing the deficit, controlling health-care costs, and improving the quality of education -- are very serious, and some of them must be addressed with great urgency. And none of these problems can be addressed simply by waving a magic government wand. To a significant degree, they all involve understanding what motivates current practices -- of business-people, financiers, doctors, patients, teachers, students -- and what levers we may be able to use to change those practices.

Historically, when the need has arisen to change behavior, political leaders have turned to economists. That's one reason why presidents have a Council of Economic Advisers. When economists speak, presidents listen. And when economists have the president's ear, all their whispers are predicated on a set of assumptions about human behavior. Whether it's increasing GDP, reducing unemployment, sustaining Social Security, making sure people are financially prepared for retirement, or stabilizing the financial sector, economists commonly hold certain beliefs. They will for example argue that people are motivated by self-interest and are rational calculators of their interests, and that the most effective way to get people to change the way they behave is by creating the right material incentives.
Now, people are sometimes rational calculators, but often they are not. And self-interest and incentives certainly matter, but they aren't all that matters. The perspective of economists is importantly incomplete, sometimes even misguided.

That's why we need psychologists whispering in the president's other ear -- about the economy, but also about education, health care, and more. The United States needs a Council of Psychological Advisers -- a new body that would parallel and complement the Council of Economic Advisers -- to bring actual experts on human behavior into the most senior levels of conversation about how to change it.


Let's start by looking at the economy. Where did our financial institutions go wrong? And why did things get so out of hand? Why was there a housing "bubble"?

Somehow, "irrational exuberance" (as described by Robert Schiller) or "animal spirits" (as John Maynard Keynes dubbed them) overwhelmed rational calculations of risk and reward. These terms give the impression that a wild card or a joker -- something completely unpredictable and capricious -- thrusts itself into an otherwise perfectly rational system, and all hell breaks loose. Well, "irrational exuberance" and "animal spirits" are just sexy phrases for psychology, and psychologists have a good deal to say about both the causes and the consequences of these forces.

Economists offer little that helps us understand why bubbles occur or how they might be prevented. They also have little to tell us about how to prevent a "downward spiral of negative expectations" that makes fear of an economic downturn self-fulfilling.

Economists largely make assumptions about the rationality of human decision-making and proceed from there. Witness former Fed chairman Alan Greenspan's admission that he was mistaken during his time at the Fed in assuming that markets operate rationally and efficiently. The recent financial crisis and its persistent aftermath make it clear that ignoring the real psychology of "irrational" enthusiasm (or pessimism) can be perilous.

A Council of Psychological Advisers could help. This is not to say that macroeconomic variables don't matter and that the behavior of the economy is completely driven by the psychology of participants. Of course macroeconomic variables matter. But they are not, and never have been all that matters.


And aside from the acute economic crisis of the last few years, what about the looming crisis that millions of Baby Boomers are entering retirement age with no pensions and accumulated savings (including 401ks) of less than $50,000? A rational decision maker would have been saving for retirement from day one, knowing that Social Security would never provide enough, even if it remains solvent. But for someone with knowledge of the psychological impediments to making near-term sacrifices in the service of future benefits, the inadequacy of American savings is hardly a surprise.
In creating a Council of Psychological Advisers, the U.S. would be following an enlightened trail already blazed by Britain and France 
We can do more than smirk and finger-wag at our short-sighted peers. Thanks to research by several people -- Shlomo Benartzi, Richard Thaler, David Laibson, and Brigitte Madrian among them -- we now know how to increase dramatically the amount of money people save for their retirement. These researchers are all economists, by the way, but they are economists who appreciate the importance of psychology.

And what do you do when you want to get people to spend rather than save, as both former president Bush and President Obama did when they struggled to stimulate economic recovery with tax rebates? The rebates by themselves would put more money in people's pockets, but that wouldn't help unless they spent it. When people got rebates under President Bush, they got them in lump-sum checks, and estimates are that about 50 percent of that money was spent. When people got the Obama rebates, they came as small additions to each paycheck. A substantially higher proportion of the money was spent, making for a more effective stimulus, even as (or perhaps because) people were less aware they were getting more money back.

Again, knowledge of the psychology of economic decision-making leads you to expect just such an effect. Indeed, the Obama rebates were delivered in the way they were for just this reason; he had people with psychological sophistication whispering in his ear.

When it comes to public policy, economics sits atop the social sciences. Since virtually any policy you can think of involves spending money, the advice of economists is always solicited. But if they don't do an adequate job advising about the economy itself, you can be sure that they fall short advising on other matters.


There has been much justified hand wringing about the state of American education. We have clearly lost our privileged position in the world. Improving education will require recruiting and retaining excellent teachers and finding ways to motivate students. How can this worthy goal be achieved? At the moment, we're pointing in the direction of school choice and competition to produce better schools, higher pay to produce better teachers, big tests to monitor student performance, and financial incentives to motivate students. A bunch of carrots and sticks.

Will these kinds of measures be enough? A recent National Research Council review of efforts throughout the U.S. to incentivize school performance concluded that the effects have been small or non-existent, even when the incentives were substantial. And when big-test accountability does produce improvement in test scores, it is often as a result of teaching to the test or outright cheating. Research in psychology suggests that more important than pay (as long as it is adequate) are working conditions that allow teachers to be flexible, autonomous, and creative in their work with students, that provide them with mentoring, and that give teachers a sense that they are working in a community that has a common purpose.

From this perspective, the regimentation of instruction ushered in by big-test accountability is actually counter-productive. There is also growing evidence, some of it provided by psychologists Carol Dweck and Angela Duckworth, that the focus on beefing up the cognitive components of education that has dominated reform for the last 30 years may be misplaced. More important may be efforts to cultivate motivation and character (Paul Tough's remarkable new book, How Children Succeed, provides a vivid summary of this work). The importance of character and motivation suggests that the drill-and-test model of education that has become so common may actually be not just ineffective, but counterproductive.

A Council of Psychological Advisers could help inform the design of environments that will encourage students and teachers alike.


Everyone should have health insurance. This is a necessary, but not sufficient, goal for the maintenance of the health of the nation. But the cost of health care must also come down, lest it bankrupt the country. Computerized medical records that produce coordination of care will help bring down costs, but we also need to help patients (and their doctors) understand how to think about the efficacy and the risks involved in various medical procedures. There is plentiful evidence that patients make serious mistakes in thinking about risks and efficacy, and that their doctors make the very same mistakes, leading to costly but unnecessary procedures. Moreover, most medical care in a developed country like the U.S. involves management of chronic conditions (hypertension, heart disease, diabetes, asthma) rather than cure of acute diseases.

Managing these conditions effectively demands that patients be partners; they need to make lifestyle changes (e.g., diet, smoking, and exercise) that are often difficult to adhere to. A Council of Psychological Advisers can help in designing formats for presenting evidence about the efficacy and risks of various treatments that will reduce misunderstanding and thus reduce unnecessary procedures. And it can help develop interventions that will make patients health-care partners more effectively.

In a New Yorker article a few years ago, physician/author Atul Gawande described several programs in inner city clinics that dramatically reduced hospital admissions and improved patient health by employing life coaches who got to know patients and found ways to nudge their life styles in a healthier direction.


Traditional economic incentives like investment tax credits, energy taxes, and pollution credits might help us reduce our environmental footprint, but focusing exclusively on these neglects the extraordinary opportunity to call on citizens to do the right thing because it's the right thing. Indeed, there is even evidence that incentives can undermine people's desire to do the right thing. In a Swiss study of citizen willingness to have a nuclear waste dump located in their communities, researchers found that whereas 50 percent of citizens agreed (reluctantly) when no incentives were involved, only 25 percent agreed when substantial incentives were involved.

Each of us can take responsibility as citizens to contribute in small ways to solving the big environmental problems we face. As some citizens take responsibility, it makes others more likely to join in. Eventually a new social norm is created. And social norms can be more powerful than tax credits and penalties. Psychologist Robert Cialdani has provided several lovely demonstrations of techniques that encourage citizens to step up. A Council of Psychological Advisers can help in crafting appeals to citizens to do their duty.


Finally, let us ask the most fundamental question: what is public policy for? We aim to increase collective welfare, but just what does welfare consist in? For the most part, under the sway of economic thinking, our aim has been to make the country more prosperous -- to increase per capita GDP. The appeal of this goal is two-fold. First, we assume that if people are richer, they will be freer as individuals to choose the objects and activities that serve their welfare. We (the state and its technocrats) don't have to choose for them. So wealth serves as a proxy for everything else. And second, GDP can be measured. But it doesn't help much to pursue what you can measure if what you're measuring is the wrong thing. It doesn't help to get better at achieving goals if you're achieving the wrong goals. Fed Chairman Ben Bernanke said as much in a speech at a conference of economic researchers in Cambridge, Mass., on August 6: "The ultimate purpose of economics, of course, is to understand and promote the enhancement of well-being. Economic measurement accordingly must encompass measures of well-being and its determinants."

Much research in the psychology of well-being suggests that some wealth-enhancing policies improve welfare, but others do not. Indeed, some of what it takes to get more prosperous may be counterproductive when it comes to well-being. A Council of Psychological Advisers can help here too, in the design of a system of national "psychological accounts" that does a better job of measuring well-being than per capita GDP ever could.

I wish I could say that the U.S. would be leading the way if a Council of Psychological Advisers were created, but in fact, it would be following an enlightened trail already being blazed by others. The multinational Organization for Economic Cooperation and Development has been measuring quality of life for several years now. The French government, under former president Nicholas Sarkozy, issued a 300-page report three years ago on the limits of GDP as a measure of social welfare along with suggestions for how welfare measures can be improved. And in Great Britain, Prime Minister David Cameron has established a Behavioural Insights Team charged with formulating policy recommendations, based largely on psychological research, to help people make wiser decisions and live happier, healthier, more productive lives. And even these nations have been somewhat late to the game. Bhutan has been focused on measuring "gross national happiness" for 40 years, and has often chosen policies that promote well-being in preference to policies that would enhance GDP.

Many of us were cheered when President Obama was elected in 2008 that the Obama administration seemed marked by a renewed respect for knowledge and expertise. Whatever the politics of various policies might be, details of implementation were left not to political cronies, or to ideologues, but to people who actually have respect for evidence. I hope this respect for evidence and expertise will continue. But it needs to be the right evidence and expertise. A Council of Psychological Advisers is long overdue. This would be an excellent time to create one.

Shrink Rap Radio #325 – Reflections on The Animus Mundi with Jungian Analyst Monika Wikman PhD

This podcast from Dr, David Van Nuys features Monica Wikman, Ph.D., a Jungian Analyst and author of Pregnant Darkness: Alchemy and the Rebirth of Consciousness. Nice discussion.

Shrink Rap Radio #325 – Reflections on The Animus Mundi with Jungian Analyst Monika Wikman PhD

Monica Wikman, Ph.D. is a Jungian Analyst and author of Pregnant Darkness: Alchemy and the Rebirth of Consciousness (2005) and various articles in Jungian psychology journals. Monika obtained her BA from UC San Diego and her doctorate from the California School of Professional Psychology in San Diego, where her research took her deep into the study of dreams of people with terminal cancer. After teaching graduate students at California State University, Los Angeles, she graduated as a diplomat from the Jung-Von Franz Center for Depth Psychology in Zurich. She lectures internationally on mythology and symbolism, dreams and wellness, alchemy and creativity. In private practice as a Jungian Analyst and astrologer, she lives along a creek and under starry skies in Tesuque, New Mexico with horses, dogs, and friends. 
Check out the following Psychology CE Courses based on listening to Shrink Rap Radio interviews:
A psychology podcast by David Van Nuys, Ph.D.
copyright 2012: David Van Nuys, Ph.D.

Henrik Juel - Social Media and the Dialectic of Enlightenment

This intriguing article comes from Triple C (cognition, communication, co-operation), an open access journal for a global sustainable information society - Vol 10, No 2 (2012).

Henrik Juel 


My reflections in this paper concern revitalizing the critical potential of certain core concepts of Max Horkheimer and Theodor W. Adorno's Dialectic of Enlightenment (first published 1944) and bringing it to bear on the digital era in general and in particular on the phenomenon of modern social media. I find that the central philosophical critique of Dialectic of Enlightenment runs deeper than just a critique of contemporary (and perhaps now out-dated) media technique and cultural habits. It is a critical view of the process of civilization, economy and enlightenment as such, a critical view of the seemingly self-evident notion of pure reason, science and technology. What Horkheimer and Adorno are trying to capture and reflect is the very process of rationality backlashing into irrationality. We seem to have reached the era of mathematics and exact calculation, but this leaves us with no sense of control or meaningfulness, and in the face of crisis and systemic contradictions in the now global society we tend to regress and rely on older, more primitive forms of sense-making and coping: magic, mythology and metaphysics - even ritual behaviour. But these philosophical reflections, can they help us evaluate the role of today's social media?

Full Text: PDF

Here is a brief excerpt from the article:
For me as a young student of philosophy even that strange notion of dialectic began to make some sense, once I got well into the book and the worst of the Hegelian fog lifted. Thus while it was invigorating and enlightening, I also felt the dialectic of it and I found its account of history, civilization, and rationality to be both quite captivating and disturbing. And certainly it was a very, very critical philosophy. So what would happen if I tried to let the critical theory of that book meet with the phenomenon of modern social media?

On the face of it that did not seem likely to turn out as a peaceful encounter. It is well known that The Dialectic of Enlightenment features a very pessimistic and condemning section devoted to "The Culture Industry". Horkheimer and Adorno wrote the book during the Second World War while they were refugees in America (the first version appeared in 1944), and they seem to have been rather disappointed or even shocked in meeting there the pop-culture and mass media of the day. To them the magazines, the cinema, the radio shows, the emerging TV-shows, and even the jazz music, seemed to be in the poorest of taste; stupefying in its effect; a prolongation of the production rhythm of the industry; and certainly not enlightenment. Some have objected that on the other hand they were simply displaying their elitist taste, favouring high art, the avant-garde and the obscure notion of authenticity. But as I see it, simplifying this to be a question of taste or of different modes of reception within different consumer groups would be to seriously reduce the scope of the problems they were trying to address.

Thursday, December 06, 2012

The Challenges Of Treating Personality Disorders

From NPR's Talk of the Nation, this is an interesting discussion on personality disorders in psychotherapy. A lot of professionals would just as soon see the Axis II designation (personality disorders) dropped from the DSM - for a variety of reasons, not least of which is their origin in psychoanalytic theory.

One of the callers, near the end of the show, Dr. Deborah Rose (a psychiatrist in Palo Alto, CA) made a crucial and often neglected point in discussing various personality disorders -- if we can treat the underlying trauma, most personality disorders are curable, which runs counter to the accepted "wisdom," of the field.

One of the defining characteristics of a personality disorder (Axis II) versus a neurosis (Axis I) is that the Axis II person is fully ego syntonic, which means they think they are just fine and it's everyone else who is nuts. But an Axis I person is ego dystonic, meaning they know something is wrong, this is not who they see themselves as or who they have been up until that point.

Clearly the Axis II person will be more challenging, since they think there is nothing dysfunctional about their behavior. But rather than seeing them as "un-analyzable," as did Freud, we should simply understand that working with them will take time, and it will require more somatic techniques because their wounding is in the earliest development which is affective and somatic, but not verbal.

For a good introduction to and definition of personality disorders, check this link (a lot of what follows comes from this site and its very useful sections on personality disorders).

In general, there are three "types" of personality disorders (DSM-IV-TR): Cluster A (the "odd, eccentric" cluster), Cluster B (the "dramatic, emotional, erratic" cluster), and Cluster C (the "anxious, fearful" cluster).
  • Cluster A includes Paranoid Personality Disorder, Schizoid Personality Disorder, and Schizotypal Personality Disorders. These are defined by social awkwardness and social withdrawal.
  • Cluster B includes Borderline Personality Disorder, Narcissistic Personality Disorder, Histrionic Personality Disorder, and Antisocial Personality Disorder. These are related to affect regulation and impulse control (i.e., faulty attachment).
  • Cluster C includes the Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders. All of these are anxiety based.
These are the four primary features that are thought to distinguish personality disorders from other mental illnesses:
1. Extreme and distorted thinking patterns
2. Problematic emotional response patterns
3. Impulse control problems
4. Significant interpersonal problems
I would add to the list, 5. Ego Syntonic, as mentioned above.

This is from Wikipedia on the changes expected in the DSM-5 regarding personality disorders:
Major changes have been proposed in the assessment and diagnosis of personality disorders.[30] These include a revamped definition of personality disorder and a dimensional rather than a categorical approach based on the severity of dysfunctional personality trait domains (negative emotionality, introversion, antagonism, disinhibition, compulsivity, and schizotypy). In addition, patients would be assessed on how much they match each of six prototypic personality disorder types: antisocial/psychopathic, avoidant, borderline, narcissistic, obsessive-compulsive, and schizotypal with their criteria being derived directly from the dimensional personality trait domains. Some former personality disorders, like histrionic personality disorder, will be submerged under facets of various personality type domains (in this case, the narcissism and histrionism facets of antagonism).
So now we have 6 personality disorders instead of 10. The ones that have been dropped are dependent, histrionic, paranoid, and schizoid.


Benedict Carey, science reporter, The New York Times
Mark Lenzenweger, psychology professor, Binghamton University
December 4, 2012
Personality disorders represent some of the most challenging and mysterious problems in the field of mental health. People suffering from antisocial personality disorder or obsessive compulsive personality disorder are often misdiagnosed. The effects on the sufferers and their families can be wrenching.


This is TALK OF THE NATION. I'm Neal Conan, in Washington. Personality disorders come in many forms - avoidant, antisocial, narcissistic to name just a few. They make up a list of conditions difficult to characterize, difficult to treat. A team of psychiatric experts just wrapped up five years of work aimed at simplifying the diagnostic guidelines. Over the weekend the American Psychiatric Association rejected the proposed changes.

Mental health professionals, we want to hear from you this hour. How does the difficulty in defining personality disorder affect you and your patients? Give us a call, 800-989-8255. Email us, You can also join the conversation on our website. That's at Click on TALK OF THE NATION.

Benedict Carey is a science reporter for the The New York Times. He wrote a piece called "Thinking Clearly about Personality Disorders" that ran on November 26 and joins us now from our bureau in New York. Good to have you back on the program.


CONAN: And there's a lot we still don't know about personality disorders, but it is not because they are new.

CAREY: That's right. I mean they've been around forever. I mean personality is the most central and most memorable thing about any person, and of course we've seen all sorts of historical figures with clearly strange, grandiose personalities. You know, the Bible is full of interesting, charismatic characters that seem to represent sort of the extremes of personality.

And the personality disorders that we talk about now, or psychiatrists do, go back to the beginning of the 20th century, most of them do, and come out - mostly out of Freudian analysis, you know, therapists describing very interesting characters that come in to see them that don't fit into any category, an easy category.

CONAN: And how - we're defining terminology here, but how do these differ from things like psychosis or panic attacks, things like that?

CAREY: Right, those are symptoms. Those are things that come and go. Psychosis comes and goes, and so do panic attacks, and for that matter depression and other anxiety pangs. And they were for years in the manual of diagnosis separate, in an entirely separate category from personality, personality being, you know, something more long-standing that's rooted in who the person is, you know, who they - sort of how they grew up and how they deal with others and their emotional responses and much more sort of considered to be intrinsic to the individual than a passing symptom.

CONAN: And that makes it difficult for these people to understand there's something wrong.

CAREY: Right, I mean we all think we're kind of normal, right, more or less.

CONAN: Most days, anyway.

CAREY: That's right. And I don't think, you know, psychiatrists or clinical psychiatrists would say that always, that people are always blind to these things. I mean over time, you know, some of us, our blind spots become visible. But often that's the case. They are not so aware of the patterns, especially, you know, the disabling patterns and how they sort of fit together into kind of one archetype.

And so psychiatrists try to, you know, describe that and make it more understandable and so they can be treated.

CONAN: Yet all of this seems to have struck some rocky shoals. You wrote in your piece, and this is a damning thing to say, but many critics, you say, charge that psychiatry is failing patients. No other field of medicine can help.

CAREY: That's right, and I think a lot of psychiatrists agree with that, that these things, these personality disorders are difficult to identify. I think you need some training beyond, you know, beyond sort of the usual training. And also the treatments are very difficult too. They tend to be talk therapies, not always, but - and again, they're persistent, long-standing, long-standing problems.

It's really an extra load to be able to go and carefully identify something like this and treat it well. And so I think a lot of psychiatrists would agree that it's getting short shrift and that a lot of people, you know, could be helped by getting this directly addressed and aren't.

CONAN: And another problem that you point up in your story is that there are other symptoms that can accompany this - depression, anxiety. Those tend to get treated rather than the underlying condition.

CAREY: Yeah, that's right. It doesn't sound surprising. You know, if you have somebody who's, you know, sort of extremely narcissistic or paranoid or dependent, one of these personality disorder names, and all those things are evocative, and we know they can lead to, you know, severe emotional problems, not to mention, you know, it just - it doesn't help your relationships with other people.
So, you know, the - right now you can get drugs certainly for some of these things that may relieve the symptoms, but without addressing more core problems, you really - it's all temporary.

CONAN: We're talking with Benedict Carey, a science reporter for the The New York Times about personality disorders, and we want to hear from those of you in the mental health profession. How does the difficulty in defining, categorizing, diagnosing, treating these conditions, how does that affect you and your patients? 800-989-8255. Email us, Let's start with Christina(ph), Christina with us from Indianapolis.

CHRISTINA: Hi there.


CHRISTINA: Thank you for taking my call. My experience, I worked as a psychiatric technician in an inpatient hospital after I got my Bachelor's degree, and during that time - of course I had taken an abnormal psych class when I was in college and learned a little bit about these disorders - I got most of my training about how to identify various disorders alongside other clinicians.

And that - in that informal setting, there's a kind of a you-know-it-if-you-see-it mentality. And there's a lot of problems with that because what I would see when people would be admitted to the hospital, maybe this is that person's first encounter with this particular clinician, that patient and clinician are just getting to know each other.

And if that patient had a past (technical difficulties) disorder, but particularly (unintelligible) personality disorder, it would seem to bias the view on the clinical staff's part towards that person, whereas if the diagnosis was major depressive disorder or an anxiety disorder or even a psychotic disorder, that didn't seem to happen, the stigma didn't seem to be as strong.

I went on to get my doctoral degree, and now I teach at a campus where I get to teach the abnormal psych class. And so I try to have my students just think critically about this whole category of diagnosis and the many difficulties that are carried in the stigma and in the inconsistency across clinicians and applying the diagnostic categories.

I don't want to say that the APA has it completely wrong to retain it in the DSM, but going from DSM IV to DSM V, there's a lot of significant changes, and so I just think there are many, many worries about this whole category that leave us with more questions than answers.

CONAN: And just to clarify, the DSM sort of the bible of psychiatry. They're just coming out with a new edition, from IV to V, and that's where this difficulty of categorization sort of came to a point, Benedict Carey.

CAREY: Right, they spent years trying to update the manual. They do it every, whatever, 12 to 15 years. It's - it can be an arcane process. It is, mostly. But it's an influential book, and some of the - you know, some of the disorders are very interesting and very common. And so small changes or debates that are, you know, feel scholarly or mundane, often have, you know, have consequences, particularly in this book, the DSM V, or the Diagnostic and Statistical Manual, as it's called.

CONAN: And as you - you know, as you listen to our caller talking about this, you know, bias, it seemed to me that there was a bias, throwing your hands up in the air, personality disorders, but we don't know which one it is.

CAREY: Right, that certainly happens. I think the bias is understandable, because, you know, depression seems like something that happens to you, you know, the same thing with schizophrenia and bipolar and so on, whereas personality disorder, that feels like that's you. You know, that's on you. That's sort of how you sort of expressed yourself and managed your way through the world, and so you can see where there would be more stigma, I think.

Yeah, part of the problem, and one of the reasons they debated this, was that there are 10 personality disorders and that - and that we've mentioned some of them already. Narcissistic is one, antisocial, avoidant, borderline. So people are familiar with some of these labels. But a lot of patients who came in were getting more than one. So that doesn't make a lot of sense.

Or they're being put into a category, which is kind of a catch-all category, general personality disorder, which meant only that, you know, they had some very strange or extreme kind of behaviors and traits, but the, you know, the therapist couldn't figure out what diagnosis to give them.

CONAN: Let's see if we can get another caller in. This is Pat, and Pat's on the line with us from Durham.

PAT: Yes, hello, I'm Dr. Pat Webster. I'm a clinical psychologist. And I co-authored a book called "Winning at Love: The Alpha Male's Guide to Relationship Success." And in my practice, I think one of the difficulties with narcissistic personality disorder is that it's endemic. I think that it's - we're a culture of narcissists, and I think that often the bigger-than-life belief and symptoms that go on with narcissism are rewarded in our culture.

I think the mortgage debacle was engineered in - by people that we would diagnose as narcissistic personality disorders. And in their personal life, usually this doesn't really hit them until, say, the 40s or something like that, when they're lonely, they've had - they've gone through many, many relationships, and then the depression begins.

But it's hard because often we reward the outcome of narcissistic personality disorders in our culture.
CONAN: Do we reward narcissism, Benedict Carey?

CAREY: I mean I don't know the answer to that. I think it's - it's certainly an American type. You know, we grow them here. And I think that, you know, you can be a very successful and also extremely narcissistic person, and yes, be rewarded. I mean, I'm not saying that, you know, this is the predominant personality disorder in the U.S. I doubt it. I think that this is just one of the most annoying ones.


CAREY: And so they tend to be more of a headache than some of the other ones.

CONAN: Pat, thanks very much for the call.

PAT: You're very welcome.

CONAN: We're talking about personality disorders. If you work in mental health, how does the difficulty in defining these disorders affect you and your patients? 800-989-8255. Email us, Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

CONAN: This is TALK OF THE NATION, from NPR News. I'm Neal Conan. There are 10 commonly accepted syndromes - including paranoid, borderline and dependent - that qualify as personality disorders. They're often divided into three clusters: those characterized by odd, eccentric behavior or emotional and dramatic behavior or anxious, fearful behavior.

Beyond those broad outlines, though, they're incredibly hard to define. We've been talking with the New York Times' Benedict Carey about the difficulty with personality disorders, which he's called some of the most serious and striking syndromes in medicine. We'd like to hear from mental health professionals, too. How does the difficulty in defining personality disorders affect you and your patients?

Give us a call: 800-989-8255. Email is You can also join the conversation on our website. That's at Click on TALK OF THE NATION.

Joining us now to shed some light on how the psychiatric community is dealing with these disorders is Mike - Mark, excuse me, Lenzenweger. He is the psychology professor at Binghamton University and professor of psychiatry at the Personality Disorders Institute at the Weill Cornell Medical College, and he's with us by phone from his home in New York.

Good to have you with us today.

MARK LENZENWEGER: Pleasure to be here.

CONAN: Just so we get some sense of scope, how many people suffer from personality disorders, do you think?

LENZENWEGER: Well, the current estimate of prevalence of personality disorders in the United States is roughly 10 percent. So one in 10 Americans probably suffers from a diagnosable personality disorder.

CONAN: And there's a spectrum, though. It's not full-blown, immediately.

LENZENWEGER: Well, that's an interesting question, Neal. There is a discussion about how much of a spectrum there can be. But the 10 percent figure is based on people who actually meet the criteria for a diagnosis. So, for example, if it requires five out of nine criteria to meet a diagnosis, what do you say about a person who meets four out of nine? Are they - they're nearing the threshold, but they're not quite there.

But using strict thresholds - where you really expect people to meet the diagnostic criteria in the manual - it's one in 10.

CONAN: And, for example, a lot of us think we know something about some of these, but borderline personality disorder, for one, is not halfway there. It's a separate thing.

LENZENWEGER: Yes. Borderline personality disorder suffers from a bit of a misnomer as a name. It was initially coined as a name to describe a fairly serious, debilitating condition that early commissions - say, working in the 1930s, 1940s - thought somehow was on the border of psychosis, particularly schizophrenia.

So the term was coined to sort of describe that near-neighbor status, but we know now that's not true. But the name has been used for so long that psychiatry and clinical psychology prefer to stick with it.

CONAN: And we've talked about some of the difficulties that various people have in diagnosis. How does that manifest itself in the patients you see?

LENZENWEGER: The most tricky thing in terms of diagnosis is not so much in the definition of the disorders. That becomes something of a scholarly debate, and can go on for quite a while. The real trick in diagnosis is the actual diagnostic process, meaning sifting through the complicated life story that a person has and looking at the features they bring to life in terms of work, school functioning, social functioning, family functioning, and making sure that the dysfunction that you're calling personality disorder has been longstanding, that it's been there for the better part of the last five years, and then teasing it apart from issues such as depression anxiety, more transitory things that come and go, to be really sure that what you're looking at is what you intend to be calling personality disorder.

CONAN: And that, I suspect, takes a great deal of time.

LENZENWEGER: It can. It can. And that's one of the drawbacks of diagnosing the disorders, is that many people, frontline clinicians, simply often don't have that kind of time. You know, the researchers who spend hours and hours working on these problems in the laboratories, you might spend two to six hours conducting a diagnostic interview with the person that you're considering, you know, being in a personality disorders research study. Most clinicians simply don't have that time.
CONAN: And most of those interviews are about 45, 50 minutes, and then a lot of patients expect to walk out with a prescription.

LENZENWEGER: If you find a psychiatric interview that lasts that long these days, that's a little bit unusual in contemporary psychiatry, because people are hard-pressed and don't have the time, and many initial diagnostic impressions are gleaned very quickly.

With personality disorders, it's difficult to imagine even being close to having a full picture after 45 minutes, and the interesting thing is that there isn't going to be a prescription that will help the disorder at its core.

CONAN: Because it's - we don't know, or because it's not biological?

LENZENWEGER: Oh, it's probably biological in part, Neal. The research evidence really suggests that genetic factors do play a role in both normal personality and personality disorders, and neuroimaging research - some of which we've done at Cornell Medical - shows that there are, for example, in borderline personality disorder, very identifiable neural circuit abnormalities.

It's biological, but the medications we have don't necessarily make all of that right or fix it in the way that you'll see in, say, depression or anxiety, where you can treat the symptoms, at least, and bring a person to a lower level of distress.

CONAN: Let's get some more callers in on the conversation. 800-989-8255. Email: Richie's on the line with us from Atlanta.

RICHIE: Hello.


RICHIE: Hi. I have two comments. Number one, the DSM was written as a standardized, diagnostic manual. In my experience, it doesn't work out that way in everyday practice because, you know, your client can go to the first clinician and be diagnosed with one thing, and they'll go to another clinician, and it becomes subjective from clinician to clinician.

My second comment is that I currently work in substance abuse, and the clients that I see that have an Axis II diagnosis. When they know about it, my experience has been that it makes it much more difficult to work with them. And I was wondering what your guests would have to say about that.

CONAN: I wonder. Why don't we start with you, Dr. Lenzenweger?

LENZENWEGER: Well, in terms of reliability, the caller is wondering about how reliable are these systems. And in the hands of people that are trained and they're using an instrument - and this is important, that they're using what's called a structured clinical interview - reliability is actually quite good, meaning the same person could be interviewed by four or five different clinicians, and you would come up with broadly the same diagnosis.

So the reliability issue is not as challenging as some might think. The presence of a personality disorder diagnosis and how it affects a person is an interesting question. Some people find it very helpful and liberating, almost, in the sense that they finally have heard what is going on with them and how it can be treated.

Other people - and this partly depends on how it's delivered - see it as yet another strike against them.
CONAN: Yet - let me bring Benedict Carey back into the conversation - you say in your piece that more and more, people don't get that specific, though, a diagnosis. They're told they have personality disorder, not otherwise specified.

CAREY: Right, that's the category I mentioned, which is a more generalized one, which is I think where you see some of the features, but you're not sure that they - they don't seem to line up in any one - under one particular label or name. And so that can be - I think, you know, talk to Dr. Lenzenweger about this, but I think that - I don't know how helpful that is.

I mean, it's - I don't know that there's any specific therapy for that. I don't know if it's helpful for the patient. And basically, you've just been told you're messed up, and they can't tell you anything more about it. I mean, so I think that was one of the motivations, and I think that's one of the most common - maybe the most common - of the diagnoses here, and one of the motivations for trying to change or streamline it so it becomes more specific.

CONAN: Dr. Lenzenweger?

LENZENWEGER: Well, yes. I think Ben's right in the sense that the most common diagnosis out there for personality disorders is this so-called personality disorder not otherwise specified. And what that means is you have any number of personality disorder criteria met in your clinical picture, but you don't have enough to satisfy the threshold for any one particular disorder.

So it is something of a general catchall. What it tells the clinician, though, is that there is something that's clinically important that should be treated and should be the focus of treatment. And what you have to understand about personality disorder treatment is that it isn't always specifically directed at the features that make up the descriptions of the disorders.

You might spend a lot of time in therapy working on improving a person's interpersonal relations - you know, how they get along with their family members, their spouse, their partner, their boss, how they regulate their emotions, especially rage and anger and fear. So even though you don't fall into a particular basket with a very specific DSM-IV or DSM-5 name, what you're struggling with still gets treated.

CONAN: Richie, thanks for the call.

RICHIE: Thank you.

CONAN: Here's an email from Christie(ph) in Green Bay: As a psych nurse, I recognize that I do have a bias against some patients with personality disorders, especially those with borderline personality disorders. I work hard to keep my bias from affecting my patient care, but the very nature of BPD can make those patients demanding, manipulative and unpleasant. We all prefer to be around pleasant people, and clinicians are no exception. I have a suspicion that patients with personality disorder get less intensive medical care for just the same reason: lack of likeability with primary care providers.

I wonder, Dr. Lenzenweger, these personalities - likeability, manipulation and - does that factor into their treatment?

LENZENWEGER: Well, it shouldn't in terms of a professional, you know, posture with respect to your patients. If you're treating a personality disordered individual and you're working as a psychologist or a psychiatrist or a social worker, you know what to expect, and you know that someone is presenting a clinical picture. You know, their way of being may be disagreeable. It may be challenging, it may be trying, but your job is to get in there and try to help them.

And the person that commented on having a negative reaction, that's not unusual, especially for people who are interacting with someone with borderline, whether it's on the job, in school or in a nursing situation. But their job there is not necessarily to supply the treatment. When you're doing the treatment, that reaction to the person shouldn't drive the process.

CONAN: Benedict Carey, another question for you. You wrote your piece before news came out about the DSM-5 and the inability to reach some sort of decisions about categorization. Is this, as far as you know, going to continue? Are there going to be more efforts, or is this just hands up in the air and let's wait till next time?

CAREY: I don't know the answer to that. I think that they - you know, it's such a big project that it needs some time to put together. Also, by the way, you know, in research areas, people like Mark know that, you know, that different people have different theories about this. You know, what should it look like? What should we call them? How do we diagnose them?

There's 20 different theories about that, and part of the problem they had this time around was reconciling those or choosing one. There was argument all the way through. So in order to do it entirely again, they're going to need some time. The plan is, I think, for this manual to be updated more frequently - let's say every year or something like that - and to give it a little different numbers, 5.1 and .2.

But something as tricky as personality disorder, I think, is going to take some time, and I think that they will try again. My prediction would be it's going to, you know, be another 15 years.

CONAN: Our guests are Benedict Carey, a science reporter for The New York Times, and Mark Lenzenweger, a professor of psychology at Binghamton University, professor of psychiatry at the Personality Disorders Institute at the Weill Cornell Medical College. We're talking about personality disorders, and you're listening to TALK OF THE NATION, from NPR News.

And let's get Deborah on the line, Deborah with us from Palo Alto.

DEBORAH: Hi. This is Dr. Deborah Rose. I'm a psychiatrist in Palo Alto, and I've been treating post-traumatic stress disorder for 40 years. And I'm concerned that one major factor that leads to personality disorders, as they're called, is being omitted from this discussion and basically from a great deal of American psychiatry, and that is the role of complex post-traumatic stress disorder or early childhood post-traumatic stress disorder.

Post-traumatic stress disorder - whether it occurs acutely in adults or early on and, in many ways, in children - leads to a kind of hypertrophy and distortion of the normal, otherwise developing personality. It hypertrophies the...

CONAN: Excuse me. I don't understand the word hypertrophy. Forgive me.

DEBORAH: I'm sorry. It - I'm sorry to be using it. It leads to an exaggerated growth of certain parts of a person's personality, which are the ways that a person would habitually try to protect themselves emotionally from inner - inside and outside emotional dangers and threats and also get kind of distorted. It's like a burrow on a tree that is infected with something. And so you get distortions of personality, which lead then to often being diagnosed as personality disorders.

When I treat somebody for their early childhood post-traumatic stress disorder or their adult onset acute PTSD, what you find is that as you free them from the PTSD, the personality remains, who they were really meant to be, biologically and then with environmental factors of family and the added environment. So the personality disorder goes away, and you get a normal personality, and this is tremendously overlooked and failed to be diagnosed by the vast majority of mental health professionals in this country.

CONAN: Dr. Lenzenweger?

LENZENWEGER: Well, I appreciate the view about personality disorder and trauma, and, in fact, that is actually a very large focus of contemporary clinical psychiatry and clinical psychology. We know, for example, that a large proportion of individuals diagnosed with borderline personality disorder have been exposed, horrific as it sounds, to early childhood sexual abuse and physical abuse and/or maltreatment. And that's well-recognized and viewed as an important environmental component adding to, you know, that mix of things that could give rise to a personality disorder.

And not everyone who is traumatized goes on to have a personality disorder, and not everyone who has a personality disorder has had trauma in their life. But I think it's important to point out that there are many people doing a lot of research and treatment on the role and sort of effects of trauma in and of themselves as well as in connection to personality disorder. So it's a big focus.

CONAN: Deborah, thank you very much for the call. And I'm sure you could go on from there, but I'm afraid we're out of time.

DEBORAH: Thank you ever so much. Best wishes to you.

CONAN: We appreciate it. And, Dr. Lenzenweger, thank you very much for your time today.

LENZENWEGER: Well, thank you. It's been a pleasure.

CONAN: Mark Lenzenweger, professor of psychology at Binghamton University, professor of psychiatry at the Personality Disorders Institute at the Weill Cornell Medical College, with us by phone from his home in New York. And, Benedict Carey, nice to have you back on the program, and we'll have you back in 15 years once they've sorted this out.

CAREY: That sounds good. It's a date.

CONAN: OK. Benedict Carey, science reporter for The New York Times, joined us from our bureau in New York. Up next, a truly incredible story. It's illegal to leave North Korea, but some small number of North Koreans get out with help from an underground railroad through Asia. Melanie Kirkpatrick, author of "Escape from North Korea," joins us in just a moment. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.

Kafka’s Nightmare Tale, ‘A Country Doctor,’ Animated

From Open Culture, this is a creepy Japanimation of Franz Kafka's eerie and dark short story, "A Country Doctor." Enjoy all 21-minutes of this strangeness!

Franz Kafka was born in Prague, Czechoslovakia, in 1883, and died in 1924. He is known for the intense visionary character of his novels, stories, parables, and sketches, all written in German. Less than one-quarter of his writing consists of completed works. The most famous of his works are the unfinished novels The Trial, The Castle, and Amerika, and the short stories collected under the title The Penal Colony, from which this story is taken.

Kafka’s Nightmare Tale, ‘A Country Doctor,’ Told in Award-Winning Japanese Animation

December 5th, 2012

Here’s a good story for a cold December night: Franz Kafka’s cryptic, hallucinatory tale of “A Country Doctor.”
Written in Prague during the icy winter of 1916-1917, Kafka’s story unfolds in one long paragraph like a fevered nightmare. “I was in great perplexity,” says the narrator, an old doctor, as he sets out in a blizzard at night on an urgent but vague mission. But he can’t go anywhere. His horse, worn out by the winter, has just died and his servant girl is going door to door pleading for help. A surreal sequence of events follow.
“A Country Doctor” is permeated with the qualities that John Updike found so compelling in Kafka: “a sensation of anxiety and shame whose center cannot be located and therefore cannot be placated; a sense of an infinite difficulty within things, impeding every step; a sensitivity acute beyond usefulness, as if the nervous system, flayed of its old hide of social usage and religious belief, must record every touch as pain.”
In 2007 the award-winning Japanese animator Koji Yamamura made a 21-minute film (see above) which captures some of the strangeness and beauty of Kafka’s story. It seems somehow appropriate that the dreamlike narrative has been transmuted into a form and language unknown to Kafka. And if you aren’t familiar with the original, you can read a translation of “A Country Doctor” by Willa and Edwin Muir. You can also find Kafka’s stories in our collection of Free Audio Books and Free eBooks.
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