Learning to act right (13)… Promiscuous paranoids

Learning to act right (13)… Promiscuous paranoids
Torrey Orton
October 27, 2010


Among some men in the 20 to 40 age range there's an unexpected result of being in the binge drinking / drugs and sex scene. It only arises when they part the scene for a more constant form of relationship…sometimes their first real love. They appear on my therapeutic doorstep with obsessive fantasies that their new girlfriend is having it off with any guy they say hello to or, more particularly, any guy they were once close to. This is aggravated if the girlfriend has a history somewhat like their own – one of apparently disinterested sex in one of the principle social forms recognised as 'normal': one nighters and friends with privileges, or its more honest moniker - fuckbuddies.


Their presenting "mental health problem" is hyper-vigilant jealousy with anger punctuations which threaten relationship health, or their partner's. In other words, they are on the verge of Obsessive Compulsive Disorder in their minds. The driver, as usual with OCD, is an apparently inescapable dilemma or conflict which attacks the individual's self-concept.


The binge sex dilemma looks roughly like this: the guy develops obsessive imagery / thoughts about the partner's probability of being seduced (or re-seduced!) by another guy; this is accompanied sometimes by acute self-denigration about being unlikely to be able to compete with the imagined seducer's attractions; the guy also imagines that his partner is in fact positively disposed to seduction if given the slightest encouragement by the irresistible seducer.


Treatment is simple except for the hidden dilemma within the picture above. Exposure and CBT work fine, but do not touch the dilemma which is lodged in the male self-image. The guy knows that all guys are roughly like him, at least in his general social network (pubs, clubs, etc., on weekend nights). Anyone female is fair game and may consider him to be fair game in turn. But the male self-image says the women are sluts and guys are players, or hotties, or choose your self-approbation of preference and enter here.


This valuing system means that any girlfriends who come out of the binge social system are players, too, which leaves the guys at best on an equal moral footing with the gals. But that's not what they really think, despite sexual equity in the binge play space. This part of the treatment requires confronting at least the present equality of indulgence across genders*. It's a hard burnishing of a tarnished esteem. Not a few clients have choked on the way, though all have come through so far.


If the girlfriend does not originate in the scene, then she may find herself treated like a prospective player because that is boyfriend's default position on women (underneath the sexual equity cover). Girlfriend, meanwhile, cannot easily be told boyfriend is/was a player with a dance card the length of a wishfully extendable appendage.


I guess that various aspects of this valuing and behavioural world contribute to the rampant uncertainty and diffidence about relationships which pass before me daily in therapy. This is expressed through conflicting needs: one, for certainty that a relationship will be inviolable and one for certainty that escape is always possible with minimum damage (itself usually expressed as financial – the only certain entity in the relationship universe because it is totally abstract and so can harbour any meaning allocated to it!). Listening to would-be and actual couples struggle to denominate their contributions to the joint exercise of a shared future is often pathetic. When did finance ever reduce paranoia?


I think this works similarly for gay as straight men, with appropriate gender distinctions in their partners. See this post for an example.


*none of this means that equity and equality in sex are achieved without various infractions of good taste, respect, or activities in the violence domain, since being players does not grant a free pass to civility. To an extent it prohibits real civility, and respect is out of the question, for both self and others.

“Mentally competent” and “asking for death” – can I rationally choose death?

"Mentally competent" and "asking for death" – can I rationally choose death?
Torrey Orton
October 20, 2010


Decisionmaking and death – irritated reflections on Ahmed, Gray and others.


"balance-sheet" suicide and "rational" suicide – way stations in the argument about how a choice to die can be justifiable. This argument hangs partly on an undiscussed dispute about what a 'rational' decision is. It swings back and forth because rational thinking is persistently misunderstood as affect free thinking. The standard model is reflected in Ahmed's (TheAGE, Oct 7, '10) discussion, which leaves him stuck and indecisive.


Stuck
I've been stuck for two weeks in this misunderstanding, too, which from my present perspective is no problem because I cannot influence it. I am clear myself where I stand on my own access to effective self-destruction. The details matter some. Nigel Gray's in THE AUSTRALIAN, Oct 6, 2010 alternatives, for example, are quite attractive to my needs to pre-empt an unfortunate death. But a well refined approach to what a good argument for my euthanasia should be will not increase my access to it. That portal is blocked now by a few others' (lifer kooks and gutless pollies) beliefs that I should not have it. By the way, by their default to inaction, the gutless pollies of course cast themselves as supporters of the kook believers. The pollies are a very special class of banal believers – swaying in the intemperate breezes of the various kooks (individual and institutional) for fear of losing something. That fear costs them their integrity and legitimacy, and the rest of us our representation.


Two rationalist fantasies
There are two rationalist fantasies employed in the euthanasia debate: both to the detriment of my rights.

1- that we can and should be able to make rational decisions about our deaths, unclouded by irrational affect; and,

2-that we can only make irrational decisions about euthanasia, because all reason on matters of death is always clouded by 'mental problems' about being close to death – feeling down about being ill, fearing our decline and tormenting ourselves with our pathetic state(s); that is, we are mentally ill if dying, and so unable to decide.

The emotional factors are not understood within the range of normal human emotions. So, the depression, sadness, etc., felt by the dying and the-in-danger-of-dying are treated as pathological rather than normal responses to perceived (and objectively real) dangers. Ahmed acknowledges this implicitly by referring to dialysis research where personal control emerged as a key determinant of patient depression and connecting it to related Oregon findings about euthanasia choosers and oncologists' observations of cancer patients. He then confuses his discussion by calling this mix of feelings and needs "personality factors". While his personal position on patient decision-making is never made explicit, it is suggested by his use of the term "saved" in discussing suicide by aged, near terminal patients.


Rational decisions = ?
What do we know about decision-making by everyday humans (not rats or undergraduates, please)? Simply, that rational or logical decisions mainly exist in digital systems like ICT, positivist economics and its social science affiliates, and the foundations of classical physics and chemistry. The latter have been withdrawing from the fantasy that a number is a discrete item, that data are clearly discernible from each other, since Einstein. And data clear or foggy do not, it is generally agreed, have feelings or thoughts except perhaps in some delicate metaphysics (electrons feel their neighbours and scurry off to a safe place at a nano-distance; planetary attraction is a species of elective affinity?).


Behavioural economics is the belated acknowledgement that Adam Smith was right about economy – it's not the numbers that matter, except to bankers and even not to them when they consider their "quality time". There's a place in human development where an increase in quantities of livelihood produce no gain in quality of living. Many of us are there now.


Judgment = intuition
Decision-making is making judgments. These are integrating intuitions, summarising whole experiences into actions. They do not follow iterative, additive pathways except in expostfacto reconstructions of the sort used in "evidence-based" medicine and its allied affiliates. Try mapping the decision steps in a serious life issue on a decision mapping system like this: http://www.austhinkconsulting.com/ . You will still end up with a judgment which cannot be rationally explained except by reference to supposedly non-rational, emotive factors. Judgments express values in relation to important facts. Important facts are the valued ones.


Individual rights only available fully to a group
If our rights were pure universal truths they would just be. When they are contested, as with euthanasia, abortion and just war, for example, their limited claims are made apparent in the act of their dispute. If they were pure and universal they would be substrate, assumptions, of our life processes. The pointy end of the rights stick these days is individual rights. The upshot of the contest in matters socio-economic, so far, is that a few get to monster the many in the name of the many's right to choices they cannot make.


Nigel Gray argues for euthanasia from a personal choice perspective. He stretches his case just as egregiously as he claims the pro-lifers do theirs, but maybe not for the same effect. He proposes a pure right of individual choice on the basis that "..this is one's own business, no one else's." He certainly has a right to think this, but that does not constitute a right to die with no consideration for the effects on others. It's an irritated right with which I sympathise but cannot honour as any more rational than those who say I do not have it (because it belongs to God for instance.)


Putting my hand up for certainty
A string of ways of dying from self inflicted euthanasia to physician assisted euthanasias – the actually occurring choice-based deaths - sit inside the over-arching fact that (so far) we will all die if we live. Euthanasia already exists de facto in physician assisted deaths, either by legally mandated turning off life-support or providing assured decline into death with family-agreed terminal palliations (morphine comas). This is where the individual choice wheels meet the highway of life – namely, with a hand-up if you want it, and sometimes if you do not. I could do with a bit more certainty in my hands.

Appreciation (29) … Ant flurries, or termites?

Appreciation (29) … Ant flurries, or termites?
Torrey Orton
Oct 5, 2010


We were walking the local hills on the first real day of spring. That is, the first day two plus layers were not required on top by the effects of wind-chill at 15 degrees C or less (which is what we've had at sea level for three months straight). An hour and a half into the ramble, we were on the home stretch of a circle route around what passes for a water course with falls here. It had two virtues: it was 50 minutes from home and there was audible and visible water in it. And, we had not been there for 10 years or so, having given ourselves over to more highly invested (in time and distance) wanders to find ramble-worthy spots. Particularly lately, there are quite a few with major water and falls*.

 
As we were coming down a modest decline I noticed to the left of the path a small flurry of fluttering things which on first look I thought were spring seeds in dispersal flight. They were rising on a slight breeze – not enough to sustain the visible activity. But the numbers were constant and dense enough to seem, in some long unexercised memory of things past, a snowlike event.

 
A silly perception in fact since the temperature was 23C. Less silly in their mimicking the wandering rise and fall of big-flake snow in quiet winter air. The storm effect was intensified be a mid afternoon sun highlighting the individuals in its 45 degree rays.

 
So, I looked more around than up and spotted 10 meters off the track a termite-looking mound on which the storm seemed to centre. Only getting closer did I see the newly winged ones walking up the brownish, one meter mound from its base. They were slowly unlimbering their wings as they climbed, ending with a preparatory flap or two before jumping off on their one-way ticket wedding flights. It was one of those wonders of nature so far from my understanding that I'm still not sure who they were - ants or termites – partly because I did not know to look for the distinguishing differences!


* A week earlier we had visited one of the rivers burned out by the 2009 Black Saturday bushfires. Many of these once camping and walking areas are still closed to public use, though one can now drive down the access roads. Along one such we saw one of our favourite cascades on the Murrindindi River running in full flow from the recent rains. But it was unveiled. Where for a couple decades of regular walking in near rainforest conditions along that part of the river yielded varying intensities of rushing waters over tumbled rock surfaces, we now found bare rocks and remnant trunks, everything open to the eye made prying by fire. A new falls, with a waiting period of 20-30 years to get back to 'normal' is probably beyond our allocated time….so we will learn to like the unveiled.

6 Views of death (3) – ‘Normal’ ends of life: the self-extermination challenge.

6 Views of death (3) – 'Normal' ends of life: the self-extermination challenge.


Torrey Orton


Oct.1, 2010

My life / death view: I am sure I have a right to live and die in as much as I can choose to do so. I did not choose to be born, but choose everyday to stay alive. I'm aware that I may not get to choose when to die, but I certainly will die. The same cannot be said for my birth; it was not certain. Like my birth, my death will be in the hands of others in some respects, the least of which, from my point of view, will be cleaning up afterwards, just as it was for my birth.

I deal three days a week with younger people (20's to 40's) who think /feel their lives are not worth living for various amounts of time, with regular recurrences and typical shared origins in excruciatingly inescapable traumas. Also typically, they have self-administered palliative problems (addictions) and often have irregular employments, housing and similar signs of fragmented lives. Quite a few sustain professional presences of great sophistication and substantial achievement. I have no trouble believing it's too soon for them to go. How successful I am in conveying that conviction into self-affirmation is a session by session challenge.


…unlucky not to die well.

 As for myself, on the other hand, I am quite sure I want to have the choice of dying when I see fit. That means dying before my natural time, possibly. That I may die as I write will do fine as my time, should it be so. It's a ponderous decline into multiple incapacities, worst of all a mental decline, which I will choose to avoid if I can. Given diagnoses of certain kinds, I would initiate a process of self-extermination, I hope. That 'hope' expresses my awareness that I may not be strong enough, which I may get a chance to test, if I'm unlucky not to die well. Next to a lingering death, a failed effort at pre-empting it is my greatest fear. I'd like some certainty in my own hands. Either this will be legal – e.g. running a car into an immovable object – or, at the moment, illegal by amassing a sufficient quantity of appropriate medications.


I do not have the time to read much of what's written in the so-called 'debate' about euthanasia. I don't really care about much of the detail, or to make arguments in detail which I am intellectually competent to do. I have patients to care for and other things to think. Not to write at all on this is dangerous and part of me knows that the fools in the religions and the politics of late capitalism and post-modernity are likely to lock away pre-emptive opportunities I am as certain I deserve as they are I do not. That's the making of rages, and even the fools I just mentioned must know these are growing day by day, just maybe not in the minds of people like me.


Natural right to choose…

 I know I have a natural right to self-extermination, but not a legal one here in Australia. There are those who would say I have no natural right, either, but they do not check their assumptions about the sources of right, being stuck in a system of presumptive answers which is historical, not 'natural'. This system is the Abrahamic religions of the Book. I really do not mind their believing what comes with allegiance to The Book, including endless to-the-death struggles about whose version is correct, true or The Word. I am amazed that a profoundly clear truth, like that the religions propose, should produce so much distress for believers, but not amazed enough to want to help them out by adding myself to one of their ranks. How could I choose?

"But our right to choose is important and is too often deliberately forgotten or conveniently ignored by those who evangelise around "the right to life"...." .Geoff Gallop, in The AGE 28092010.

The Australian politics of life-death are this: a few (about 20 %) of the electorate in Australia are prepared to fight (to the death?) to preserve the right of every conception to come to term and every adult to be constrained from dying on their own terms, assisted or not. The latest pro-euthanasia figures are 76% in favour. The 20%ers get a larger electoral influence because the field of voters is finely poised between the major parties and small factors shift small margins in the most finely poised electorates. Electorally correct and ethically unfair


Fundamentalist convictions

 So what part of the anti-euthanasia arguments are just tactics to cover fundamentalist convictions? Such tactics might be expressions of moral outrage, pseudo-scientific or "evidence-based" facts and ad hominem assaults demonstrating other non-believers' attitudes descend from character faults or notional immoralities.… Where such tactics do not work there are only implacable demands or refusals on offer.


An example of apparent evidence-based arguments is Dr. Ruth Gawler in TheAGE, Letters 29/9/2010. In a self-described backflip on euthanasia, she notes that cancer patients "initially … are often confused in their thinking." She doesn't say anything about what happens to the initially confused after some work. Competent cancer treatment like the Gawlers provide must help clarity, among other things. Viz- people who start confused do not have to remain that way.


She adds to her evidence against euthanasia that population issues make getting clear about good reasons for dying unlikely. This is an argument carried by her professional status, not any clarity of fact or causal connection.


Because we can do it…

 Underlying the pro-life argument is a scientistic lie – that unnatural efforts must be made to preserve lives – at the beginning or the end of the life span, and in some cases before it (IVF) because we can do it scientifically. I don't think this is what the gods recommended in their times. Once again there was a sad letter pleading for families to let their elders die when ready and to do the legal homework to minimize useless resuscitations. (TheAGE 29/9/10).


This reflection yields another: that there may be a need to achieve something for my life in / thru my death, a clarifying of the moral ground…which invites a recollection of possible causes for choosing to end life, eg.: (1) to save the life of another; (2) to prevent a useless decline into a terminal outcome; (3) as a weapon of struggle (martyrdom); (4) to save precious resources for others (cousin of #1, but with no specific other(s) in mind or view).


Two self-destructions

 Finally, let's notice a matter of origins. There are two self-destructions: the Greek one and the Roman one. Euthanasia, the good death, is Greek; suicide, the bad death, is Latin, as are its familiars matricide, fratricide and patricide. But a death by one's own hand is self (sui) killing (cide), whatever the labeling. Some deaths we choose to label nicely and others not. The choice is a discrimination between those with an acceptable rationale and those without one (in the eyes of some others). I don't know that the Greeks and Romans differed that much on matters of life and death. The choice is moral, not factual of course, leaving aside the problem of determining if a death is by accident or intent.


A song comes along with this thought – "Suicide is painless.." and reminds me of the absurdity of life and death, except when we can give meaning to it. Generally the meaning achieved by making our own choices exceeds that by following others' choices for us. Perhaps the worst situation is that where making meaning seems impossible but action is required which only produces absurdity. There's a literature around this dilemma. Yossarian, where are you? Slaughter House 5, Catch 22, Mash...