7T Seminar Series: The Rapidly Changing Brain – Of Taxi Driving Mice and Maze Running Men
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Offering multiple perspectives from many fields of human inquiry that may move all of us toward a more integrated understanding of who we are as conscious beings.
7T Seminar Series: The Rapidly Changing Brain – Of Taxi Driving Mice and Maze Running Men
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ABSTRACT
Mindfulness meditation, one type of meditation technique, has been shown to enhance emotional awareness and psychological flexibility as well as induce well-being and emotional balance. Scientists have also begun to examine how meditation may influence brain functions. This talk will examine the effect of mindfulness meditation practice on the brain systems in which psychological functions such as attention, emotional reactivity, emotion regulation, and self-view are instantiated. We will also discuss how different forms of meditation practices are being studied using neuroscientific technologies and are being integrated into clinical practice to address symptoms of anxiety, depression, and stress.
Speaker: Philippe Goldin
Philippe is a research scientist and heads the Clinically Applied Affective Neuroscience group in the Department of Psychology at Stanford University.
He spent 6 years in India and Nepal studying various languages, Buddhist philosophy and debate at Namgyal Monastery and the Dialectic Monastic Institute, and serving as an interpreter for various Tibetan Buddhist lamas. He then returned to the U.S. to complete a Ph.D. in Clinical Psychology at Rutgers University.
His NIH-funded clinical research focuses on (a) functional neuroimaging investigations of cognitive-affective mechanisms in adults with anxiety disorders, (b) comparing the effects of mindfulness meditation and cognitive-behavioral therapy on brain-behavior correlates of emotional reactivity and regulation, and (c) training children in family and elementary school settings in mindfulness skills to reduce anxiety and enhance compassion, self-esteem and quality of family interactions.
Seriously?The Future of Love
Contributors: Marc Gafni and Ken Wilber
Who doesn’t want to transform their love lives with husbands, wives, partners, family members, and friends? In this dialogue Ken and Mark explore "The Future of Love”, noting the many ways our hearts change and evolve with each stage of our evolution.
Americanizing the global mind?
Andrew Rasmussen, Ph.D, March 15, 2010Are we doing more harm than good by exporting our diagnoses and remedies for mental illnesses? A new book – Crazy Like Us: The Globalization of the American Psyche – sets the agenda for a vital public discussion.
The last few years in American mental health have been marked by a brutal public flogging. Revelations in 2008 and 2009 that drug research at Harvard and the University of Texas was tainted by millions of dollars in drug company undisclosed payments to the researchers (which were subsequently condemned on the floor of Congress by Senator Chuck Grassley) was followed by high profile media coverage of problems with the practice of psychotherapy.
In October 2009, findings from an article in the journal Psychological Science in the Public Interest, which chronicled how psychotherapists are notoriously ignorant of clinical advances in their field, were reported by Newsweek’s Sharon Begley in a stinging criticism of the profession. In January of this year, a review in the Journal of the American Medical Association (JAMA) of the research on depression medication argued that studies suggesting that drugs are not effective result from unnecessary prescription. In other words, for the minority who are clinically depressed, medication is a godsend, but for the majority who receive it – people who are just sad – it doesn’t do much.
Citing this and other research, Judith Warner called the entire field into question in the New York Times:
“This is the big picture of mental health care in America: not perfectly healthy people popping pills for no reason, but people with real illnesses lacking access to care; facing barriers like ignorance, stigma and high prices; or findings care that is ineffective.”
Now, this criticism has gone global with Crazy Like Us: The Globalization of the American Psyche, by journalist Ethan Watters, a book that takes aim at “the grand project of Americanizing the world’s understanding of the human mind.”
This is not Watters’ first foray into mental health critique, as he is the co-author of two books with UC Berkeley social psychologist Richard Ofshe, Making Monsters (1996), an indictment of the repressed memory phenomenon of the 1980s and ‘90s, and, perhaps more relevant to his current book, Therapy’s Delusions (1999), a scathing assessment of the psychoanalytic (i.e., Freudian) school of psychotherapy. Both books were somewhat successful, received mixed reviews (the former more praise than the latter), and were largely ignored by the academic world.
But those of us who work in the small corner of mental health research that examines the differences in diagnoses and symptoms between cultures are somewhat surprised by Crazy Like Us; our field, generally, remains well hidden in the crease between psychology and anthropology. That our first popular treatment should be a highly critical survey of this field of mental health is doubly shocking.
Watters’ central thesis goes something like this: by expanding their realm through the forces of globalization, American mental health professionals are harming other societies by introducing Western symptoms into the way people in other cultures express their distress and replacing the local explanations for mental health problems with Western scientific models. He begins by introducing readers to a fact that many of us who study mental health globally know well: the expression of and explanation for mental illness depend in part upon the culture in which the individuals afflicted reside. In the language of the field, they are “culturally-mediated.”
Watters provides several good examples of this in Crazy Like Us , but the clearest articulation comes from McGill Unversity Professor, and Editor of Transcultural Psychiatry, Laurence Kirmayer who is interviewed at length. Kirmayer explains that most cultures have an experience of isolation and decreased motivation that we, in the United States, typically, would call depression. In India this might be characterized by a feeling that the heart is physically descending in the body, in Nigeria by reports of a peppery feeling in the head, and in Korea by “‘fire illness’… a burning in the gut.”
Readers interested in hearing a compendium of foreign mental illnesses will not be disappointed. Most of these have analogs in the West (as with depression), but others do not. The most infamous of these is koro of Southeast Asia, or the sudden feeling that one’s penis is decreasing in size or disappearing altogether. If this sounds amusingly off-beat, an outbreak of a similar condition in the 1990s in a number of West African countries resulted in mobs beating and killing several women suspected of witchcraft. These psychological phenomena are real in that they have real behavioral consequences.
These “indigenous” disorders are being displaced by Western concepts primarily, Watters claims, by unwitting journalists in the developing world who defer to Western experts and by adventurous Western mental health professionals out to do good. Westerners introduce ideas of how mental health problems should be expressed – or, more accurately, how they are expressed in Western culture – and sufferers hear about these and mimic them.
Watters credits his hypothesis to the psychiatric historian Edward Shorter, who argued that how mental disorders are expressed changes throughout history as the theories proposed to explain them are popularized. Hysteria in Freud’s day, for example, involved psychogenic paralysis because some young woman in the late 1800s developed the symptom which was then reported by a doctor as a sign of distress, and pretty soon most of the Viennese female upper crust had an arm or leg vüllig paralysiert. Such paralysis is not much of a problem among Viennese womanhood anymore because it fell out of the “symptom pool” after enough people discovered it wasn’t “real” in an organic sense. Watters takes this historical analysis and applies it cross-culturally.
Each chapter of Crazy Like Us is built around a central researcher in cross-cultural mental health, one of “psychology’s version of botanists in the rainforest, desperate to document the diversity while staying only a few steps ahead of the bulldozers.” These guides are joined in the narrative by mainstream American practitioners trying to justify their actions, and real people suffering from the disorders in question. The stories of the afflicted and their families are often moving, and thankfully devoid of the kind of patronizing “victim narratives” so prevalent in discussion of the communities subject to American cultural hegemony. The disorders afflicted upon non-Western cultures are anorexia in Hong Kong, posttraumatic stress disorder in post-tsunami Sri Lanka, schizophrenia in Zanzibar, and depression in Japan.
Watters is a skilled storyteller: A Zanzibari family’s tender care for two schizophrenic members is used to make a powerful argument that seeing the disorder in spiritual terms and not biomedical terms creates a more humane environment for care. Although this is beautifully told, it is the chronicle of “the largest international psychological intervention of all time” in post-tsunami Sri Lanka that gets my money. I should disclose that I know and like the researcher at the heart of this story, Dr. Gaithri Fernando.
In “The Wave That Brought PTSD to Sri Lanka,” the buffoonish acts of Western psychologists as told by Watters are both hilarious and infuriating: Thousands of volunteer therapists arrive in the immediate aftermath of the disaster to stay for two weeks to provide “psychosocial programming,” which turns out to consist of drawing pictures with children and leading week-long trainings that are supposed to produce a legion of skilled trauma counselors. These Western volunteers have virtually no knowledge whatsoever of the Sri Lankan cultures they encounter, let alone the local concepts of mental health and suffering.
They arrive with the certainty that Sri Lankans will suffer a PTSD epidemic, and they get to work doing, well, something. But something is not always better than nothing, particularly when such health tourists are involved. When asked by Watters about the value of coming for such a short period of time, one of these volunteers responds with, “So much of it is showing up.” Having witnessed psychosocial programming in disaster settings first hand, I can confirm that such efforts are often poorly planned and executed, and that this attitude is common. But surrounded by devastation, one wishes mental health practitioners would “show up” with something more obviously useful—a hammer and some nails, perhaps. In the weeks following the January 12, 2010 earthquake in Haiti, I received multiple emails in my inbox about proposals to provide disaster therapy to survivors. There will undoubtedly be Haitians who will need psychological help in the next year or so, but let’s get them into houses before we put them on the couch.
Watters also recounts a more insidious imposition of American mental health than bumbling Westerners who really just want to help. In 1990’s Japan, GlaxoSmithKline worked to create the idea of a subclinical depression in order to market antidepressants. It is well documented (e.g., in corporate memos from Eli Lilly) that prior to the 1990’s, Western pharmaceutical companies felt that Japanese conceptions of depression were too severe to warrant mass-marketing campaigns. The Japanese concept of depression (utsubyô) did not include normal sadness arising from long hours and abuse by bosses, but was limited to that small proportion of the population that were chemically imbalanced and needed inpatient care. Watters makes a persuasive argument that GlaxoSmithKline used notions from cross-cultural psychology to create a marketing strategy for the idea that being sad was a real mental problem – and thus warranted medication. This in turn expanded Japanese notions of depression.
In making his case Watters interviews Osamu Tajima and Junko Kitanaka, Japanese experts in depression, as well as Kitanaka’s mentor, the aforementioned Laurence Kirmayer. Tajima and Kirmayer were contracted by GlaxoSmithKline to educate them on cross-cultural perspectives. In Crazy Like Us, both are frank that they were duped by their former sponsors in this undertaking. Kirmayer remains a vocal opponent of the practices of international pharmaceutical companies.
While well sourced and engaging, Crazy Like Us, surprisingly, does not always provide a clear social critique. In his acknowledgements, Watters thanks those who helped him with “finding my way out of the conceptual labyrinths that these long chapters sometimes created” but I don’t think Watters ever really finds his way out.
Throughout the book Watters confuses the clash between American and indigenous conceptions of mental health with the importation of bad American mental health practices of the sort exposed in the last couple of years. Although Watters clearly wants to make the case for the first of these two problems, his evidence really points to the second. To argue against the counseling efforts of therapists in the Sri Lanka, he cites the now well-known literature on Critical Incident Stress Debriefing that shows that asking people to “process” a traumatic event shortly after the event may actually increase the likelihood that they develop PTSD. With regards to GlaxoSmithKline’s conquest of the sadness of Japanese salarimen, Watters cites the “junk science” practices of industry-sponsored research and keeping null findings on antidepressants’ effectiveness out of the scientific literature. These are disorders that afflict American mental health on its own terms, and that we are exporting these bad practices is the real story of Crazy Like Us.
Despite Watters’ bleak conclusions, there has been some pushback to these forces. The nascent global mental health movement, led by such luminaries as Dr. Vikram Patel, aims to do for mental health what HIV/AIDS activists did for sufferers of that affliction through advocating for local, low cost solutions to addressing depression and anxiety. Global mental health integrates cross-cultural psychology, public health, and human rights, and is based on the promise that mental disorders have underlying universal neurological structures but their symptoms and explanations vary in important ways across cultures. Patel argues that the way to ensure that symptoms and explanatory models are not bulldozered by globalization – and more importantly that effective indigenous models of treatment are not dismantled – is to relocate mental health research and care to local communities.
The job of Western mental health professionals can thus be seen as a sort of technology transfer of the tools of research and service development to local health systems. Patel has shown that this is feasible using community health workers in Goa, India, and his model has been taken up around the world.
After 250 pages of at times brutal critique, Watters is oddly ambivalent as to whether or not American psychiatry’s conquest of the world will necessarily result in replacing something valuable with something less valuable. In the conclusion, he mentions that his wife, a psychiatrist, is concerned that his book might unfairly disparage mental health workers. He responds (rather tepidly) that his “point is not that [other cultures] necessarily have it right—only that they have it different.”
Perhaps Watters has reasons other than his wife’s career to be ambivalent about his stance. Although the examples he provides us uniformly support the central thesis that useful traditions are being lost, he may well be aware of several places in the world where the traditional treatments for individuals suffering from psychotic episodes include chaining them to poles in the ground and, for some, severe beatings. Leaving these practices untouched avoids a central dilemma in global mental health: How do we integrate a respect for the human rights of the mentally disordered with a respect for indigenous solutions that may conflict with those rights?
So what are we to make of American mental health’s “flattening of the landscape of the human psyche itself?” Crazy Like Us is primarily descriptive, leaving us with little to do with Watters’ thesis but stay home. Perhaps this is the right idea, perhaps not. At the very least we have Watters’ cautionary tales to show what can happen when we take our particular forms of insanity on the road.
Andrew Rasmussen, PhD is an Assistant Professor at New York University’s School of Medicine and the Research Director at the Bellevue/NYU Program for Survivors of Torture. http://andyrasmussen.wordpress.com/
Illuminating the Edges of Self
19. Mar, 2010 by Alden Gannon
Silent retreat participants often speak of what I call the re-entry problem. During the course of the retreat, the noise of the mind loses some of its grip on us. We often gain access to the silence that forms the ground of all things. What has seemed frustratingly elusive in our busy lives becomes apparent and easily accessed.
But then we go home to traffic jams, clients, bosses, families and friends. The clarity and calm gets lost somewhere in the shuffle, and within a week it seems we’re right back in the mind states that led us to seek retreat in the first place. And when I examined this closely in myself, I discovered that most of the old painful patterns and thought streams that re-emerged after retreat were triggered through close relationships with family and coworkers. And without access to these relationships on retreat, I had escaped those conditions that caused these mind states to arise.
Relationships reveal the edges of ourselves. When friction arises with others, it can expose places within us that remained hidden in the retreat environment. And in the process of awakening, we become conscious of processes and phenomena that were not in our awareness. Friction at the edge of our selves can be a powerful agent for exposing unconscious patterns and beliefs that need to be examined under meditative awareness.
What exactly is this interpersonal conflict that is so common to the human experience? It might be as simple as annoyance at a cell phone user in a restaurant or as complex as the roots of wars or hatred. What does this experience reveal about us? How do we bring meditative awareness into the difficult emotions of our close relationships?
I facilitate a group of meditation practitioners who are exploring these questions. We gather together and practice mindful speaking and listening in a space of meditative awareness. Someone offers a problem they are struggling with, typically within a close relationship. The group practices listening mindfully to both the speaker and their own reactions to the story presented.
The speaker invites an inquiry into the conditions beneath the story. For example, the speaker might tell us about a recurring conflict she has with her partner over housework. Gradually, we move from the narrative into progressively deeper meanings the speaker takes from the events related to us. Little by little, we honor then release the outer levels of the story, seeking their more fundamental forms.
For instance, our example story might start with statements like “he always forgets to take out the trash” or “I hate having to nag.” These emphasize the boundaries between partners and spans the conflict over time (“always forgets”). The speaker is granted complete safety and held within a non-judgmental space to allow the unedited thought stream to emerge. Expressing the story completely begins to release its hold.
But we don’t stop there. We seek the root causes and conditions of the narrative. Beneath the narrative lives fundamental beliefs about ourselves that are at the same time deeply personal and profoundly transpersonal. A more fundamental version of the same story might be “he doesn’t love me.” To the speaker, that is the meaning behind the story and much closer to the actual source of suffering. An even deeper observation might be that the speaker feels undeserving of love. As the inquiry proceeds, it moves towards revealing unseen aspects of the self and away from the events of the narrative. It becomes more personal and directly revealing.
But at the same time, it moves towards the transpersonal. As we gradually release the drama of the story to reveal its roots, we also move closer to the universal human experience and away from our unique experience. We see that all human beings have felt unloved or unheard. Often our group falls into a space of deeper connection where we are no longer sharing personal stories, but the universal experience of the human condition. The truth of suffering and its release through non-attachment is revealed in the moment of seeing through our personal narrative into the experience of all sentient beings.
Behind our group is the deeply shared intuition that the spiritual journey must travel through the personal, not around it. The core of our personal pain needs to be examined and unpacked. The challenge is to hold our stories without either enforcing our belief in them or dismissing them outright. They must be allowed to release themselves, in their own time, under the light of meditative awareness. Outside of the retreat environment where friction and old patterns inevitably arise, we can focus our attention on our own root narratives with the same loving care and persistence we practiced on the breath in the meditation center. And unsurprisingly, reveal the same truths.
Bio
- Summary
- What does it mean to be human and alive?
The thousands of different cultures and languages on Earth have compellingly different answers to that question. "We are a wildly imaginative and creative species," declares Wade Davis, and then proves it with his accounts and photographs of humanity plumbing the soul of culture, of psyche, and of landscape.
The threat to cultures is often ideological, Davis notes, such as when Mao whispered in the ear of the Dalai Lama that "all religion is poison," set about destroying Tibetan culture.
The genius of culture is the ability to survive in impossible conditions, Davis concludes. We cannot afford to lose any of that variety of skills, because we are not only impoverished without it, we are vulnerable without it.
Stewart Brand is a co-founder and managing director of Global Business Network, founded and runs the GBN Book Club, and is the president of The Long Now Foundation.
Brand is well known for founding, editing and publishing the Whole Earth Catalog (01968-85), which received a National Book Award for the 01972 issue. In 01984, he founded The WELL (Whole Earth 'Lectronic Link), a computer teleconference system for the San Francisco Bay Area. It now has 11,000 active users worldwide and is considered a bellwether of the genre.
Brand has been a member of the Board of Trustees of the Santa Fe Institute, an interdisciplinary center studying the sciences of complexity, since 1989. He received the Golden Gadfly Lifetime Achievement Award from the Media Alliance, San Francisco in the same year.
He was a founding member of the Board of Directors of the Electronic Frontier Foundation, an organization which supports civil rights and responsibilities in electronic media, and is an acting adviser to Ecotrust, Portland-based preservers of temperate rain forest from Alaska to San Francisco.
Brand is the author of many pioneering books including The Clock Of The Long Now (1999), How Buildings Learn: What Happens After They're Built (1994), The Media Lab: Inventing the Future at MIT (1987), and Two Cybernetic Frontiers on Gregory Bateson and cutting-edge computer science in 1974. It had the first use of the term "personal computer" in print and was the first book to report on computer hackers.
Edmund Wade Davis (born December 14, 1953) is a noted Canadian anthropologist, ethnobotanist, author and photographer whose work has focused on worldwide indigenous cultures, especially in North and South America and particularly involving the traditional uses and beliefs associated with psychoactive plants. Davis came to prominence with his 1985 best-selling book The Serpent and the Rainbow about the zombies of Haiti.
Davis has published popular articles in Outside, National Geographic, Fortune and Conde Nast Traveler.Buy
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Psychosocial and Neural Correlates of Resilience
February 22, 2010Adriana Feder, MD
Assistant Professor of Psychiatry, Mount Sinai School of Medicine
First published in Psychiatry Weekly, Volume 5, Issue 4, on February 22, 2010.This interview was conducted on January 19, 2010 by Lonnie Stoltzfoos
Introduction
The complex neurobiological mechanisms underlying resilience to stress have garnered greater attention over the past few years. Recent research on the biology of resilience spans a range of disciplines, including genetic, epigenetic, developmental, neuroendocrine and neural circuitry studies. Researchers are attempting to understand the relationships between these layers of inquiry, as well as interactions with environmental influences.
Definition of Resilience
There are many different definitions of resilience in the literature, according to Dr. Adriana Feder, but most definitions refer to “the capacity of an individual to adapt successfully in the face of trauma, or significant acute or chronic stressors.”
“In psychiatry we tend to define resilience as the capacity to adapt well psychologically upon exposure to significant stressors, without developing mental illness or a psychiatric disorder,” continues Dr. Feder. “But other researchers have also looked at general functioning and social relationships, and at how individuals perform at school or in their work environment.”
Resilience research first began in the 1970s with studies of children who adapted well despite significant adversity. This work identified the importance of relationships with a caring adult, social competence, and the capacity for self-regulation, among several other factors. Later research turned to identifying factors associated with resilience in adulthood. Recent technological advances have made it possible to focus on the underlying biological processes associated with resilient phenotypes.
The Psychobiology of Resilience
In a 2009 Nature Reviews Neuroscience review, Dr. Feder and colleagues highlighted several psychological attributes associated with resilience: facing fears; dispositional optimism, associated with the ability to seek and maintain social support; the capacity to reframe negative circumstances in a more positive light; and a strong moral framework, sometimes reinforced by religious beliefs.
“Ultimately, it is important to understand the biological underpinnings of these psychological attributes,” she says. And, referring to psychological characteristics identified in studies of resilient children, Dr. Feder says, “Positive emotions in children, and the capacity for self-regulation, are shaped by genetic makeup in interaction with life experiences. Understanding these different layers can help identify psychological and biological strategies that enhance resilience.”
The best-known gene-environment interaction involves a polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR). The short allele of 5-HTTLPR has been associated with decreased serotonin transporter availability, resulting in lower reuptake of serotonin. In several studies, individuals carrying this short allele have shown greater risk for depression in the face of adverse life events, including childhood maltreatment, although recent meta-analyses have questioned these findings.
According to Dr. Feder, “Additional studies have identified a range of polymorphisms of relevance to resilience, including hypothalamic-pituitary-adrenal (HPA) axis genes, as well as genes coding for a range of neurotransmitters and neuropeptides.” For example, a recent study by de Kloet and associates found that polymorphisms in the gene coding for the corticotropin-releasing hormone (CRH) type 1 receptor moderate the influence of child abuse on depressive symptoms in adulthood. It is well known that sustained high levels of CRH associated with early life trauma have detrimental effects on CNS function and general health. Some forms of this gene, however, appear to have a protective effect in the face of early trauma exposure.
Animal studies have introduced the study of epigenetic mechanisms in resilience. Epigenetics refers to long-term changes in gene expression not otherwise associated with changes in the DNA sequence. In experiments by Meaney and colleagues, the offspring of female rats displaying more nurturing behavior (high licking and grooming compared to low licking and grooming) had less methylation of the glucocorticoid receptor (GR) gene in the hippocampus, resulting in higher GR expression, lower anxiety-related behavior and better HPA axis regulation. In addition, research by Nestler and colleagues has delineated molecular mechanisms underlying resilience to a social defeat stress paradigm in rodents, including the induction of gene expression changes only seen in resilient mice.
Neural Circuitries of Reward and Fear
Functional brain imaging studies in humans have demonstrated differential function of circuits involved in emotion regulation in several stress-related disorders, including major depression and posttraumatic stress disorder, compared to healthy controls. The fear and reward systems are two key and interrelated circuits of relevance to resilience. Yet, very little research on these circuits has been conducted in resilient individuals who have survived trauma exposure with relatively intact functioning.
“Well-functioning fear circuitry in resilient individuals, for example, might prevent over-generalization of fear responses to different contexts,” explains Dr. Feder. “This will only be clarified by studying individuals who have themselves survived an assault or a serious motor vehicle accident with few sustained symptoms.”
Another example involves reward circuit function. We now know from Fredrickson’s studies of positive emotion that the capacity to experience positive emotions in stressful contexts contributes to decreased autonomic reactivity.
“Positive emotions have also been linked to reward system function,” states Dr. Feder, “and brain imaging studies of reward circuitry function in resilient individuals are the next step.”
Conclusion
“Some of our understanding of resilience can be extrapolated from studies of individuals with depression and PTSD,” continues Dr. Feder, “but resilience is not just the opposite of vulnerability. In order to understand the unique mechanisms associated with resilience, we need more studies in people who have survived trauma and have adapted well. There is much to discover about the neurobiology underlying psychological traits characteristic of resilient individuals, with potential applications to prevention and treatment of stress-related psychiatric disorders.”
Disclosure: Dr. Feder has received grant support from the Department of Defense, GlaxoSmithKline, and the National Institutes of Health.
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Buddhist Geeks 164: Now That’s Zen
22. Mar, 2010 by AdyashantiEpisode Description:
We’re joined by spiritual teacher Adyashanti to discuss his 15 years of training with Zen teacher Arvis Joen Justi. He shares details from his initial awakening at 25–where he realized that he was what he was seeking–to the end of the search several years later at 31. It’s at that point that Arvis asked Adyashanti to begin teaching, and as he shares with us, his teaching evolved and changed fairly quickly. He shares how it changed, and how he saw it as a natural evolution of his Zen training, rather than an entirely new form.
This is part 1 of a two-part series. Listen to part 2 (airing next week).
Episode Links:
Transcript
About this talk
Questions of good and evil, right and wrong are commonly thought unanswerable by science. But Sam Harris argues that science can -- and should -- be an authority on moral issues, shaping human values and setting out what constitutes a good life.
About Sam Harris
Adored by secularists, feared by the pious, Sam Harris' best-selling books argue that religion is ruinous and, worse, stupid -- and that questioning religious faith might just save civilization. Full bio and more links
Check out the IFS Growth Programs Blog for more information on parts work, including an introductory evening.Filed Under (Inner Critic) by Jay Earley on 03-01-2010In our continuing study of the Inner Critic, we have coined a new phrase and concept. Your Inner Mentor is the healthy version of the Critic. It performs a necessary function in your psyche that the Critic does in a destructive way. It looks at any shortcomings you might have, mistakes you’ve made, or ways that you need to grow. However, it does this with complete self-acceptance, without any harshness or self-judgment. It is kind and caring toward you in seeing where you need self-improvement. It is open to any criticisms from others but doesn’t automatically believe them. It encourages you to look at yourself with humility to see the ways that you need to change how you operate in the world, and it helps you to make these changes in a supportive, encouraging way, just like a kindly mentor. When you have worked on one of your Inner Critic parts and it is transformed, it becomes an Inner Mentor for you.
Let’s see how this might work externally by looking at an example of dealing with a child. Suppose you are a parent, and your child doesn’t clean up his room the way you asked him to. If you act like an Inner Critic, you might say in a harsh, loud voice, “You lazy slob. You’re no good. Can’t you do anything right!” However, if you instead act like an Inner Mentor, you might say in a kindly supportive voice, “Oh, honey, that’s not quite what I was looking for. Let me show you how to clean up a room. Would you like me to do it with you?”
The Inner Mentor and the Inner Champion (see previous blogs) are integrated with each other, not polarized. They naturally support each other. The Inner Champion helps you to feel confident and valuable, and the Inner Mentor helps you to improve while still feeling good about yourself.
Today the medical mafia struck another devastating blow to the health and freedom of all Americans. With the support of an inarguably corrupt Congress that has simply abandoned the real needs of the American people, the sick-care industry has locked in a high-profit scheme of disease and monopoly-priced pharmaceuticals in a nation that can ill afford either one.Read the rest.
And this Pharma-funded betrayal, it turns out, was led by the Democrats. Passed on a 219-212 vote that was only accomplished thanks to closed-door, last-minute secret meetings among the last holdouts, this new legislation puts America under the stranglehold of the medical mafia while doing absolutely nothing to address real health care reform. There is no mention in the bill, for example, of vitamin D for preventing cancer, or orthomolecular medicine for preventing degenerative disease. There's not even a word about protecting health freedom or ending the century of oppression that has been waged against naturopathic practitioners by the AMA, FDA and FTC.
The new legislation does, however, lock in billions of dollars in monopoly profits for the pharmaceutical companies -- the same companies who spent millions of dollars pushing for its passage and who depend on the continuation of sickness and disease for their future profits.
There's only one problem with this health care reform bill: It doesn't reform health care. It has almost nothing to do with health care at all, in fact: It's really more of an effort to expand a broken sick-care system. When faced with the problem that our sick-care system doesn't work, Congress somehow decided that fixing the problem merely involved expanding the failures to include everyone!
And you don't even get a choice in the matter, either. All Americans are now required to pay into a sick-care system of monopolized, pharmaceutical medicine even if they reject that failed system of medicine. So the healthy people who actually take responsibility for their health are financially penalized and forced to subsidize profits for drug companies!
5 Overblown Fears About Healthcare Reform:Here's a cursory look at what's in the legislation that the House of Representatives passed last night—and what didn't make the final cut. See a slide show of the 10 things that are (and aren't) in the healthcare bill.
1. Insurance for millions
Under the legislation, 32 million more people will have health insurance in 2019 than without the bill. That means that about 94 percent of all U.S. citizens will have insurance by the end of the decade. That still falls short of "universal coverage," but it's a significant increase from the 83 percent of American citizens who are covered today.
2. Coverage for people with pre-existing conditions
Right now, insurance companies can deny coverage to people with "pre-existing conditions," like cancer and heart disease, to name just two of many. The healthcare bill would ban this practice.
3. Help buying insurance
Lower-income Americans who can't afford to buy insurance will get help in one of two ways. The bill expands Medicaid, the free government plan for the poor and disabled, to anyone making up to about $15,000 a year. (About 16 million new people are expected to go into Medicaid or the Children's Health Insurance Program because of the bill.) Second, it would provide subsidies to people who aren't poor enough to qualify for Medicare but still struggle to afford insurance. Individuals making up to about $44,000 would qualify for some kind of subsidy. And for people who don't get insurance from their employers, they'd be able to shop for plans on new insurance exchanges.
4. Help for prescription drugs
Right off the bat, the bill will give seniors a $250 rebate to help pay for prescription drugs. Over the next decade, it also will get rid of the so-called doughnut hole (Medicare, thanks to quirks of past laws, helps cover seniors who spend either less than $2,700 or more than about $6,150 on prescription drugs, but nothing in the middle). To put it simply, seniors will get much more help paying for drugs.
5. Penalties for people who don't buy insurance and companies that don't offer it
The bill has what's called an "individual mandate," which means that most Americans, starting in 2014, must have insurance or face a penalty. The penalty would be $95 or 1 percent of income (whichever is greater) in 2014 and go up to $695 or 2.5 percent of income in 2016. The bill also includes an "employer mandate," which means that most businesses that don't offer insurance to their employees will face a penalty, too. Companies with fewer than 50 workers would be exempt.
6. No "public option"
Much of the debate in the past year was consumed by talk about the "public option," which was pushed by liberal Democrats who wanted the government to provide an alternative to private insurance plans. The House included it in its bill last fall, but the Senate, in order to get to 60 votes, did not. The final bill doesn't have the public option, either.
7. No traditional Medicare cuts
Seniors won't see cuts to their regular Medicare benefits. Those who have Medicare Advantage, however, may see some changes. Medicare Advantage plans, which are paid for by the government but administered by private companies, offer extra benefits like eye care and dental visits. These plans, on average, cost the government about 15 percent more per person than regular Medicare. In an effort to cut spending, the bill gradually cuts the amount the government will give private insurers to offer Medicare Advantage, which may lead to insurers dropping benefits or dropping out altogether.
8. Higher taxes for the wealthy
To help pay its $940 billion price, the bill raises certain taxes on individuals making more than $200,000 a year and couples making over $250,000. For example, the Medicare payroll tax would rise (for these individuals), as would taxes on some investments.
9. Cutting the deficit
Even though Republicans say the bill is too expensive and spends wastefully, the Congressional Budget Office says that it will actually help cut the deficit, by more than $130 billion in its first 10 years and more than a trillion in the second 10 years. That said, the CBO admits that there's considerable uncertainty in its estimates.
10. Making healthcare cheaper
The cost of healthcare for Americans (and the amount the government spends on healthcare) has been rising for more than a while now. The bill has several ideas for "controlling costs," including experiments to pay hospitals and doctors a lump sum for treating a particular patient, rather than paying them for every single test and procedure they provide. There are also programs in the bill to bring medicine into the digital age. Experts say these ideas could be game-changing, but it's too early to tell if they'll actually work.
Here are a few of the most overblown concerns:Read the whole article.The government will take over one sixth of the economy. That would be alarming if it were true. But government involvement in healthcare will increase gradually over time and remain modest, especially since there's no "public option" in the current plan that would set up a government-run insurer. If you have doubts, consider the attitude of professional investors, who would stand to lose a lot if the government took over healthcare. They don't exactly seem worried. Shares of health insurers like Aetna, UnitedHealth, Wellpoint, and Cigna—subject to the strongest new rules under reform—have outperformed the stock market over the past year. The pharmaceutical and hospital industries also are considered winners because there will be millions of new customers who suddenly have insurance that can pay for treatment. That led the entire stock market higher the day after reform passed. In fact, it's hard to identify any part of the private-sector healthcare industry that stands to lose under reform.
The federal debt will explode. It might, but not because of healthcare reform. The Congressional Budget Office—which is probably the most reliable, nonpartisan number-crunching outfit in Washington—says the reforms will reduce government deficits by $143 billion through 2019, thanks to new taxes and fees and cost savings in government healthcare programs like Medicare. But opponents of the bill and powerful lobbying groups like the U.S. Chamber of Commerce say otherwise, and they seem to have had a stronger influence on public opinion than CBO's methodical analysis. A recent poll by the Kaiser Family Foundation, for example, found that 55 percent of Americans mistakenly believe the CBO has said the healthcare legislation will add to the deficit. Only 15 percent know that CBO has said the opposite.
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Doctors will revolt. Doctors don't like the current system, in which insurance companies call the shots. But instead of sweeping reform and more government involvement, they prefer gradual reform that puts more control in the hands of … doctors. In one recent survey, nearly one third of physicians said they'd consider leaving medicine if reform passes, which it now has. Doctors worry that the new rules will cut into their incomes—which may happen, eventually. But it's implausible that thousand of doctors who have dedicated years to a complex profession will simply quit. What will they do? Become accountants? Open a Subway franchise? Besides, with millions of new patients seeking care, the demand for doctors will actually rise, not decline. And if cost controls discourage the docs who are in it to get rich, maybe that will help bring costs down for everybody else. Meanwhile, the American Medical Association and dozens of other physicians' lobbying groups will continue to look out for doctors' interests in Washington.
Businesses will suffer. The new rules will impose fees on businesses with more than 50 employees if their workers receive government subsidies to buy insurance in lieu of employer-provided coverage. Business groups complain that this could stunt economic growth and slow hiring. But businesses are more resourceful than that. It's true that many companies will have to absorb additional costs, which they do every year anyway when health insurance premiums go up. But well-run companies excel at solving problems. That's what makes them successful. Smart entrepreneurs salivate at the chance to outcompete bigger firms that can't manage challenges like this. And companies already pass on the rising costs of healthcare to their employees; there's no reason to expect that will change if they can't manage costs some other way. There's also an outside chance that the new insurance exchanges will make life easier for small businesses, as intended, by giving their workers a way to buy coverage at rates comparable to what big companies are able to negotiate.
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Socalized medicine is on the way. In the Kaiser poll, 41 percent of respondents said they believe the new law would require people who already get insurance through their employer to change their coverage. But most people who already have health coverage won't have to change anything, unless they want to. The new rules will have the most direct impact on people who don't have coverage, or who don't get it through an employer. Those who fear the advent of "socialized medicine" mainly seem to worry that the current set of reforms is just Phase 1, to be followed by bigger changes that will replace doctors with bureaucrats and render individual patients even more powerless than they are now. This is supposed to happen despite the likelihood that the Democrats who supported reform will lose seats in the November elections, while Republicans who opposed reform will gain seats. It seems much more likely that after surviving the battles of the last year, the current for-profit healthcare industry will be with us for the foreseeable future.
Posted: March 22, 2010
Coming to chain restaurants nationwide, courtesy of Congress (or at least 219 House Democrats): calorie counts on menus and menu boards. Health reform legislation passed yesterday includes provisions to require restaurants with more than 20 outlets to post calorie information for all of their regular menu items.
Whether the move, which some cities have already instituted, will actually work to change purchases or reduce waistlines is still a matter of debate. A working paper released in January by the Stanford Graduate School of Business looked at Starbucks. It found that the calorie posting mandated in New York City was linked with a 6 percent reduction in calories per transaction—though beverage purchases weren't affected. A study conducted by the New York City Department of Health and Mental Hygiene also found an impact; it said that people who saw the posted calories and used the information in their purchasing decisions "consumed 152 fewer calories at hamburger chains and 73 fewer calories at sandwich shops compared with everyone else," wrote USA Today. (It's worth noting that it was the city government that mandated the calorie postings in New York.)
Read the whole article.
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From Reason, I'll Tax the Insurance That You Lack:
As I've mentioned before, one of the main factors that soured the insurance companies on President Obama’s health care plan was the mismatch between the cost of medical coverage and the size of the penalties for failing to buy it. If the government cannot conscript enough young, healthy policyholders to subsidize care for people with pre-existing conditions, rates will shoot up, encouraging more of the healthier customers to drop coverage, which will cause rates to rise further still, and so on. As Peter Suderman put it in January, "Go through a couple iterations of this, and fairly quickly you have a very small, very sick, and very, very expensive insurance pool." Washington Post columnist Charles Lane, a supporter of ObamaCare, is worried about just such an "adverse selection" spiral, and it’s not hard to see why.
Under the bill Obama is about to sign, the penalty for failing to buy medical insurance is initially $95 or up to 1 percent of income, whichever is greater; it rises to $695 or 2.5 percent of income by 2016. In 2009, according to an industry-sponsored survey (PDF), coverage for a single person in the individual market cost an average of about $3,000. For a young, healthy person making $30,000 a year, paying the penalty ($750) will be much cheaper than buying insurance he already has decided he does not want. In fact, the gap between the penalty and the cost of insurance will be larger than these numbers indicate because premiums will be pushed up by new minimum coverage standards and by regulations requiring insurers to accept people with pre-existing conditions and charge them the same rates as everyone else. Furthermore, because those new rules mean that people can safely wait until they get sick to buy coverage, the young and healthy may be even less inclined to comply with the individual mandate.
Read more.
In lobbying for the health care reform bill, Barack Obama liked to say, “Don’t let the perfect be the enemy of the good.” But what he really meant was, “Don’t let the perfect be the enemy of the mediocre.”
Because the passage of the health reform bill is not nearly as good as it should be.
There’s no public option.
There’s no federal rate commission on insurance industry pay hikes.
There’s no removal of the anti-trust exemption for health insurers.And most of the benefits don’t kick in until 2014, which is bad morals and bad politics. It leaves people to suffer needlessly, and it gives the Republicans an opportunity to rollback health care reform before most people have had an opportunity to enjoy its full fruits.
For instance, insurance companies can still discriminate against adults with preexisting conditions until the year 2014. If you’re sick now, and you’re over 21, you’re going to have try to hang on for three years and three quarters.
I don’t call that compassion—or reform.
Another example: The bill will expand Medicaid coverage to single poor adults for the first time—a really good thing--but that won’t happen until 2014, either. (And the ceiling is 133% of the poverty line, not 150%, as in the original House bill.)
So if you’re single and poor, you’ve got to hang on, too.
There are some other really nasty parts to this bill, as Physicians for a National Health Program have outlined.
“Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform,” the group says.
Meanwhile, the consumer may still get socked. “ Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill,” the group says. “Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.”
And hospitals with a lot of public patients will face steep cuts. “The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions.”
Then, of course, is the assault on abortion rights in the bill, which Obama will make even worse with an Executive Order he is writing on the subject to try to mollify the pro-life crowd.
At bottom, the bill was needless complicated. A much simpler approach would have been to offer Medicare for all who want it, a position that 65 percent of the American people favored. But no, Obama left the private insurance industry with a corner on the market.
The sadness is, Obama and the Democrats had the power to push through a much better bill. And the rhetoric and the muscle he summoned toward the end could have been used just as effectively for such a bill, rather than the final inferior product.
Despite all the attacks about socialism coming from the right, Obama’s health care reform bill wasn’t socialistic enough. Hell, it wasn’t even New Deal enough.
“Don't believe anyone who says Obama's health care legislation marks a swing of the pendulum back toward the Great Society and the New Deal,” Robert Reich notes. “Obama's health bill is a very conservative piece of legislation, building on a Republican rather than a New Deal foundation.” (To be fair, Reich believes passage of the bill is a “very big deal” in political terms, though, since it advances the argument for a positive role for government.)
Yes, Barack Obama deserves some credit.
Yes, he finally woke up to the fact that bipartisanship is a myth.
And yes, he pushed hard for this bill at the end, though it took Nancy Pelosi to stiffen his spine.
But he should have woken up earlier. And he should have pushed harder for a better bill.
Not a perfect one. But not a mediocre one, either.
Read the rest.The good news: The combined package would reduce the deficit by slightly more over the next ten years ($143 billion) than previously estimated ($138 billion). And nothing has changed about the projected increase in insurance coverage. CBO still expects that the legislation would increase the number of people with health coverage by 32 million in 2019.
The interesting news: A few months ago, CBO invented a particularly useful measure of the federal government’s commitment to health care. This measure combines federal spending on health care and federal tax subsidies for health care. If you view many tax subsidies as close equivalents to spending (as I do), this is a very important metric. It would indicate, for example, that if you increase health spending, but decrease tax subsidies by the same amount, that the federal commitment to health care is not increasing, even though both spending and taxes would be rising. I think that’s a useful way to look at things.
So how does the legislative package line up on this measure?
CBO estimated that H.R. 3590, as passed by the Senate, would increase the federal budgetary commitment to health care over the 2010–2019 period; the net increase in that commitment would be about $210 billion over that 10-year period. The combined effect of enacting H.R. 3590 and the reconciliation proposal would be to increase that commitment by about $390 billion over 10 years. Thus, the incremental effect of the reconciliation proposal (if H.R. 3590 had been enacted) would be to increase the federal budgetary commitment to health care by about $180 billion over the 2010–2019 period.
In subsequent years, the effects of the provisions of the two bills combined that would tend to decrease the federal budgetary commitment to health care would grow faster than the effects of the provisions that would increase it. As a result, CBO expects that enacting both proposals would generate a reduction in the federal budgetary commitment to health care during the decade following the 10-year budget window—which is the same conclusion that CBO reached about H.R. 3590, as passed by the Senate.
In short, the reconciliation package increases the federal commitment to health care over the next decade (e.g., by rolling back the excise tax on expensive insurance plans that’s in the Senate bill) but then brings it down in the future (e.g., by ramping up the excise tax beyond the ten year window).
From a budget point of view, the basic structure of the legislative package is thus: Expand the commitment to health care in the next decade, pay for that expansion using other revenue sources, and then reduce the overall health commitment in later years.
Step one of health care reform has passed. Republicans vow to campaign on repealing it, which means that from now until the election they will use all of their communication channels to tell the public about all the problems with the health care bill. This is an opportunity. We have to tell the public that the answer to the problems the Republicans describe is not repeal; it is Medicare Buy-In, leading to Medicare-For-All.
Like the Iraq War there are facts and there are Republican lies. Over time facts catch up with lies. In spite of what the Republicans had most of the country believing, over time the public came to understand that Iraq did not attack us on 9/11. Over time the public came to understand that Iraq was not preparing to attack us with nukes.
And just as with Iraq, over time the public will come to understand that Republicans have lied to them about health care. There are no "death panels." There is no "government takeover." Etc. Over time the public will become comfortable with the reform that has passed and it will become unthinkable to go back.
The coming Republican campaign to turn the public against items in the legislation should be answered by saying this is why we now need to add a Medicare Buy-In before it takes effect. As Republicans proceed with their campaign to knock down the legislation we must make the solution a choice between going back to the bad old ways, and adding Medicare Buy-In.