cars and other symbols

To continue on my current holier-than-thou theme I am now going to slag off the entire medical profession, so apologise in advance to anyone medical who owns a luxury car who might be reading this (especially if you know me personally)

My weekly act of smugness is to drive my 12 year old Honda Civic into the private medical centre carpark, and park it between a couple of brand new BMW’s. I usually rejoice quietly to myself about my lack of enslavement to the silly materialist trappings of everyone around me – and I have been known to take photos.

Mostly I run into friends with high-paying professions who have accumulated all the right status symbols and I smile indulgently at their stressful existence. I think “thank God I don’t have to work my b**t off to aquire an expensive piece of metal and then pay ridiculous amounts of insurance to watch the thing depreciate at an alarming rate”. The same goes for mortgages or ridiculously overpriced renovations in expensive suburbs, or highly inflated school fees.

I also feel that it is somehow my mission in life to have a positive influence on people and remind them that the world doesn’t fall apart if we don’t live in the “top” suburb of the most expensive city or have the right designer clothes. I cheerily discuss my latest ebay purchases or the delights of Vinnies shopping to perplexed and slightly alarmed colleagues.

This all gives me a bit of fun, really. But every once in a while I will have to admit a moment of uncertainty. I might run into someone I haven’t seen for a few years who is just purchasing a huge home in the expensive suburb. I realise that we probably couldn’t do that if we tried, having been out of the high earning stakes for a few years. They have a new degree or are enrolling their kids in something I have not thought was necessary. And I wonder – what have I been doing all this time?

These moments don’t last long. Being on a spiritual path and rejecting the material has glorious abundant rewards which are truly unspeakable, and every day I am joyful and thankful. But these rewards are intangible and cannot easily be trotted out for inspection. Materialistic success produces recognisable outcomes, solid physical objects of possession that can be pulled out and flaunted at a dinner party to boost self-esteem and compare favourably.

This is not to say that I don’t have a lot of materialistic resources. I have been blessed excessively in that area, and don’t know how lucky I am. But within the culture of the medical profession the standards are impossibly high and frankly silly. People blindly accept the need for these kinds of acquisitions, I virtually know no specialist who drives an ordinary car or lives in an average suburb. I wonder why they can’t see through the capitalist system. Haven’t they read “Affluenza” or Status Anxiety? And as for psychiatrists, don’t they know the happiness research? Hasn’t it been fairly much proved (see Seligman) that money past a certain level really has no connection with happiness.

It’s an automatic rite of passage as a consultant that you buy a luxury (European) car, start dressing to appropriate standard and the status home and the status schools are unquestioned. People who don’t do these things are regarded with suspicion, almost as irresponsible or perhaps they just have not grown up yet. It’s about being recognised as superior to others and having achieved well.

This is simply the all-pervasive consumer capitalism of this age infiltrating the ethical values of medicos, but to me this is sad. People do work hard, but not for the benefit of anyone else, and make their own existence miserable in the process. They are people who otherwise might be comfortable financially but relaxed, and free to make decisions on the basis of some other values besides money. A doctor who chose to have a less expensive life might be free to spend time with their families and pursue creative hobbies or research, and offer inexpensive services to patients who really need it.

There is much more to be said about this topic. I seem to remember in the history of medicine it hasn’t always been this way.

happiness wins science book prize

This looks like an interesting book, haven’t read it myself. There is a lot going around about happiness and positive psychology these days.

linkto story

technologies of faith

OK here’s another PhD idea for when I’m 40. Examine the “technologies” of the major religious faiths ie prayer and meditation, psychology from the Bible and the Buddha. Compare to psychological therapies.

Invent a form of cognitive therapy based on Jesus’ teachings.

thanatophobia

Here at the white elephant, we are not afraid to tackle the big issues… It’s almost my bedtime here and I am just scraping in with a post on the second day of NaBloPoMo.

So what is thanatophobia? It’s defined as a fear of one’s own death and is apparently very common. Why is it interesting? Because there are so many layers to it.

Firstly, thanatophobia is a form of anxiety. It’s a phobia, which is classed as anxiety. It comes with physical anxiety symptoms such as shortness of breath, increased heart rate, muscle tension, nausea, dizziness etc etc. It can be associated with panic attacks. It’s a fear of something which is at once inevitable but also quite unlikely at any given moment in time. The person is afraid of something which they know is definitely going to happen, but they have no way of knowing when.

Thanatophobia also has an existential, even theological component. If someone is afraid of death, what do they fear? The actual fear must relate to the person’s beliefs about death. What do they think is going to happen to them when they die and why is it so frightening.

Here’s a range of possible beliefs about death:
- nothing happens, you cease to exist (materialist view)
- you may go to heaven or hell, depending on some kind of judgment of your actions in this life (Judeo-Christian view)
- reincarnation (Hindu, Buddhist)
- some people believe in ghosts, or spirits of the dead who somehow just float around the earthly plane making a nuisance of themselves

For those who believe the first option, a fear of death is not very rational. After all if you don’t exist, what does it matter? You won’t be suffering. For Christians, and similar viewpoints, a fear of death could be related to some kind of guilt. You feel you have done wrong and you are going to hell. In that case all that is required is to repent and you’ll be forgiven – easy.

Those who believe in reincarnation may be afraid of their own karma. They may have done wrong and fear a horrible next life. It’s understandable. It’s also understandable for those who believe in spirits or ghosts to feel afraid. Who would want to be floating around forever, feeling cold and scaring people?

I get the feeling that most people with this fear haven’t quite worked out their own beliefs yet. They may be searching, and the fear could be a healthy sign that they are moving towards some kind of spiritual growth.

Some writers (like Elisabeth Kubler-Ross, Victor Frankl and also in the Tibetan Book of Living and Dying) emphasise the need to confront one’s own mortality in order to grow or really be able to live well. Death is a necessary step on the road to rebirth in a number of ways, some of which are symbolic. There’s a cycle.

Fear of death could also be related to other problems. It could be due to narcissism (fear of one’s own nonexistence) or fear of the unknown. It could also be related to a death-wish as sometimes we fear what we really desire.

I don’t have thanatophobia and I’m frankly quite unconcerned about the whole thing. I don’t fear death and I don’t pretend to know what is going to happen to me there. I have some kind of faith that tells me it will be OK. But I find the whole thing very interesting.

pathology pyramid

In psychiatry or psychology, what are the presenting symptoms and what lies underneath? This could be an interesting study, re personality issues. Common presenting problems are usually depression, anxiety, substance abuse (these are extremely prevalent as we know). Later on, we discover other features over time. Could there be a pyramid effect?

Articles (psychiatry)

The good news: suicide rates have fallen significantly in Australia from 1997 to 2004. The bad news: suicides continue to rise in indigenous populations, particularly the Top End. (MJA)

Neonatal exposure to SSRIs is showing some undesirable outcomes including lower birth weights, respiratory distress and jaundice. These outcomes are worse than those in offspring of depressed mothers.

And finally, more grim news. paternal age is a risk factor for autism, seeming to be most pronounced after a paternal age of 40. However the risk has jumped from 9 to 32 per 100 000 – not a huge number.

Evolutionary psychiatry

Great summary of evo-psychiatry here. Thanks again to Brain Ethics. I would read all of this if I had the time or mental ability ; )

sleep and happiness

I have no doubt that sleep causes happiness. I only have to look at my children in the morning after a bad night’s sleep, and then again after a decent nap. I only have to look at myself at 10pm after being up since 4am that morning, and then again the next day after a decent night’s sleep.

There is a complex relationship between sleep and depression – basically it’s an inverse relationship and it’s a circular one. Sleep deprivation often leads to depression and the more depressed you are, the worse the sleep gets. Sleep deprive me for long enough and I develop an intense dislike for a lot of people – luckily it’s short lived.