captaincliff

I believe James Holmes, the shooter in the Batman/Aurora Colorado theater tragedy will be found to be suffering from a severe mental illness with a violent homicidal psychosis. Specifically, I think he will be diagnosed as having Paranoid Schizophrenia with an underlying Schizotypal (S) or Antisocial personality disorder (APD). While rare, this combination of conditions (see Jared Lee Loughner, the man accused of the Tucson shooting spree crime and the cluster of symptoms displayed by Robert DeNiro’s quirky character Travis Bickle in the movie Taxi Driver) can result in an identifiable spiral into “violent psychosis” or controlled (as opposed to impulsive) homicidal behavior when ideas of reference transition over time and under stress into “delusions of reference” (see below) as it did for John Hinkley in his delusional obsession with the actress Jodie Foster in the movie Taxi Driver, by coincidence. In fact Hinckley watched the movie 15 times in a row…….creepy much?

Taxi Driver clip:   http://www.youtube.com/watch?v=lQkpes3dgzg

I suspect that it will be revealed that James Holmes, while quite bright intellectually , was struggling to keep up academically in his Ph.D. program in Neuroscience at the University of Colorado. As a result of growing cognitive problems, ongoing sleep difficulties, and increasing symptoms of severe mental illness (psychosis including ideas of reference) he was either asked or pressured (or voluntarily elected) to withdraw from his academic program which then became a trigger to his worsening psychiatric condition and disturbed behavior. Lacking self esteem and security in his self perceived academic/intellectual identity (against a consistent background of prior high achievement) he was also about to be forced out/evicted from his graduate student-only housing. I believe these multiple stressors and perceived rejections precipitated his rapid descent into madness/violence. On a reality level there was “no going back” in his life (and current predicament) which ironically was a philosophical and scientific subject of interest he explored earlier in his life at science camp in San Diego (see video) where he studied “Temporal Illusions” or as he said it, “I’ve been working with a temporal illusion. It’s an illusion that allows you to change the past.”

I believe like the movie character Travis Bickle, James Holmes instead began to construct an “alternate reality” and pseudo identity for himself as “The Joker” to cope with his growing psychiatric problems, feelings of alienation and pre-existing social anxiety. Based on his relatively isolated loner type personality, he needed to see himself both as a coherent and powerful character (such as the Joker in Batman, see description below) as well as someone who could “successfully” act out his violent delusional fantasies. In his case (again quite rare) the boundary line between video game killing, movie violence, and gaming/computer generated alter-egos/actual violence became progressively blurred. Such a personality is then capable of focusing themselves into highly organized and well orchestrated plans to commit mass violence. Such a plan included the construction of home-made bombs in his residence purchased from materials bought off the internet for a period of many months. Whether or not James Holmes had a history of being bullied in school or harassed for being different or “weird” earlier in life will turn out to be less relevant than his progressive loss of reality testing and developing psychotic obsessions/violent fantasies/delusions. Whether such a diagnosis will ultimately reflect on or impacted his ability to tell “right from wrong”, a necessary feature of an “insanity” defense, is not debated here. It will, without a doubt, be debated in court.  Such a defense, while difficult at best can be used properly but unsuccessfully as well as improperly but successfully (see John Hinckley and/or the Unibomber case and Ted Kaczynski).  This behavioral profile and diagnosis is made based on early and rather spotty news reports, videos, and biographical information as well as logical deduction utilizing basic forensic principles and crime analysis.

Additional Notes:  Notice the irony of the violent ad shown before the video of James Holmes at science camp:    http://www.heavy.com/news/2012/07/18-year-old-james-holmes-talks-temporal-illusions-in-video/

The Joker:  Throughout his comic book appearances, the Joker is portrayed as a master criminal whose characterization has varied. The original and currently dominant image is of a highly intelligent psychopath with a warped, sadistic sense of humor, while other writers have portrayed him as an eccentric prankster. He has been repeatedly analyzed by critics as the perfect adversary for Batman; their long, dynamic relationship often parallels the concept of yin and yang. As one of the most iconic and recognized villains in popular media, The Joker was ranked #1 on Wizard’s list of the 100 Greatest Villains of All Time.[3]   James Holmes was the kind of person who wanted to be “the best”, so he picked the very “best” villain to be. His focus on high achievement thus carried over to his psychotic delusions.

Ideas of reference and delusions of reference:

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This article is about a mental illness.
Ideas of reference and delusions of reference involve people having a belief or perception that irrelevant, unrelated phenomena in the world refer to them directly or have special personal significance: ‘the notion that everything one perceives in the world relates to one’s own personal destiny’.[1]

In psychiatry, delusions of reference form part of the diagnostic criteria for psychotic illnesses such as schizophrenia,[2] delusional disorder, or bipolar disorder during the elevated stages of mania. To a lesser extent, it can be a hallmark of paranoid personality disorder. Such symptoms can also be caused by intoxication, especially with hallucinogens or stimulants like methamphetamine.

[edit] Delusions of reference:

‘Ideas of reference must be distinguished from delusions of reference which may be similar in content but are held with greater conviction’.[11] With the former, but not the latter, the person holding them may have ‘the feeling that strangers are talking about him/her, but if challenged, acknowledges that the people may be talking about something else’.[12]

At the same time, there may be ‘transitions…to delusions’ from ideas of reference: whereas ‘abortive ideas of reference, in the beginning of their development or, in Schizotypal personalities, continuously, may remain subject to the patient’s criticism…under adverse circumstances, by minimal economic shifts, however, reality testing may be lost and daydreams of this kind turn into delusions’.[13]

It has been noted that the character ‘rigidly controlled by his superego…readily forms sensitive ideas of reference. A key experience may occur in his life circumstances and quite suddenly these ideas become structured as delusions of reference’.[14] Within the ‘focus of paranoia…that man crossing his legs, that woman wearing that blouse – it can’t just be accidental. It has a particular meaning, is intended to convey something’.[15]

Persons with ideas of reference may experience:

Believing that ‘somehow everyone on a passing city bus is talking about them, yet they may be able to acknowledge this is unlikely’.[16]
A feeling that people on television or radio are talking about or talking directly to them
Believing that headlines or stories in newspapers are written especially for them
Believing that events (even world events) have been deliberately contrived for them, or have special personal significance for them
Believing that the lyrics of a song are specifically about them
Seeing objects or events as being set up deliberately to convey a special or particular meaning to themselves
Thinking ‘that the slightest careless movement on the part of another person had great personal meaning…increased significance’.[17]

Robert DeNiro/Travis Bickle emerging symptoms of Violent Schizophrenia and Schizotypal  Personality Disorder in the movie Taxi Driver: A Psychiatric Cinematic Analysis (see below) 

Movie Scene
Taxi Driver :Content Description and Various Symptoms

Introduction

Schizophrenia spectrum; Negative and cognitive symptoms; Prevalence; Odd cluster; Introduction of  Schizctypal Personality Disorder to DSM

Scene 1: Start

Scene 2: Travis Bickle

Vocational issues; Peculiar ideas; Schizotypal Personality Disorder and the military; Useful psychological testing; Vague descriptions; Childhood symptoms; Biosocial formulation; Functional impairment; Psychiatric rehabilitation; Tangential digression; DSM-IV-TR diagnostic criterion A(4) for Schizctypal Personality Disorder: Verbal deficits and speech; The challenge of interpersonal relationships
Scene 3: Tom & Betsy

Stalking; Dangerousness; Frontal confrontation
Scene 4: Wizard’s Court

DSM-IV-TR diagnostic criterion A(6) for Schizctypal Personality Disorder: Affective style; DSM-IV-TR diagnostic criterion A(5) for Schizctypal Personality Disorder: Suspiciousness and paranoid ideation; Cognitive-behavioral formulation; DSM-IV-TR diagnostic criterion A(1) for Schizctypal Personality Disorder: Ideas of reference

Scene 5: A New Volunteer    Unusual language; Idiosyncratic phrasing and construction; Impaired reality testing; DSM-IV-TR diagnostic criterion A(2) forSchizctypal Personality Disorder: Telepathic, paranormal and superstitious communication; Bizarre fantasies; DSM-IV-TR diagnostic criterion A(7) for Schizctypal Personality Disorder: Odd behavior and appearance; Ruminative cognitive style; Another look at speech patterns
Scene 6: Charles Palantine

Bizarre thinking, behavior and speech; Empathetic and understanding interviewing
Scene 7: Aborted Fare

Ideas of reference
Scene 8: A Date with Betsy

DSM-IV-TR diagnostic criterion A for Schizctypal Personality Disorder; Social and interpersonal deficits; inattentiveness to social conventions; DSM-IV-TR diagnostic criterion A(3) for Schizctypal Personality Disorder: Impaired reality testing; Transient psychotic episodes
Scene 9: Confrontation

Unkempt appearance; A trigger: Close interpersonal relationships; Obsession…enmity; Therapeutic relationships; Internal/external rage; On being an object of an obsession; Unusual words or concepts; Psychodynamic formulation of Schizctypal Personality Disorder

Scene 10:Curbside Cuckold

Dangerous absence of insight; Ideas or reference
Scene 11: A Word with Wizard    DSM-IV-TR diagnostic criterion A(8) for Schizctypal Personality Disorder: Lack of close personal relationships; Inability to reach out to mental health professionals
Scene 12: Running into Iris

A psychologically variant theme; Diminished desire for intimate contact; Biosocial formulation; Impaired reality testing
Scene 13: Easy Andy

Psychdynamics of a stalker

Scene 14: Henry Krinkle

Sinking lower into derangement; Odd appearance; Social skills deficits; Cumulative effect of ideas of reference

Scene 15: You Talking To Me?

Out of his mind
Scene 16: Market Robbery

Metaphors become different characters; Permission for violence

Scene 17: Late for the Sky

Last bit of reality

Scene 18: Dear Father and Mother

Those most vulnerable to stalking; Idiosyncratic phrasing; and construction; Impaied reality testing; Familially of Schizctypal Personality Disorder – psychodynamic, biosocial, interpersonal

Scene 19: TV Critic

Intensity of the stalker’s emotions

Scene 20: Looking for Action

Affective style of a person with Schizctypal Personality Disorder;  Inattentiveness to social conventions

Scene 21: A $10 Room

Diminished desire for intimate contacts; Inability to deal with sexuality
Scene 22: Breakfast with Iris

Impaired reality testing; Ideas of reference; Fearful and dismissing attachment style; Verbal episodic memory deficits
Scene 23: Dancing with Sport

Imagining his rival with Iris; Danger when reality conflicts with distortions

Scene 24: The Palantine Rally

Odd, eccentric and peculiar appearance; Pharmacology for Schizctypal Personality Disorder

Scene 25: Suck on This

Schizctypal Personality Disorder: Stability vs. psychosis

Scene 26: Shooting Gallery

Psychotic violence

Scene 27: Bang, Bang, Bang

Schizotypal Personality Disorder: Most are not dangerous

Scene 28: Dear Mr. Bickle

Madman vs. sane man; Normalcy does not last; Insight-oriented psychotherapy; Supportive psychotherapy; Cognitive-behavioral therapy; Family and group therapies; Introducing medication

Diagnostic Note

Travis demonstrates DSM-IV-TR diagnostic criteria for Schizctypal Personality Disorder

References

Excerpt from Scene 2: Travis Bickle
The main character, Travis Bickle, is introduced as he walks into the office of a New York City taxi cab company and inquires about a job as a driver.
It is not surprising that Travis is applying for this type of job because people with Schizctypal Personality Disorder gravitate toward jobs that demand little interaction with others (Sperry, 2003, p. 242).

He tells the interviewer that he wants to drive a cab because he cannot sleep nights and that going to all night porno movies has not been a helpful alternative. When the interviewer asks Travis what he does now, while most people would offer a response about their employment or vocational activities, Travis follows the conversation thread he had begun and responds:

Now? Ride around nights mostly. Subways, buses. [I] figure, you know, [if] I’m gonna do that, I might as well get paid for it.

Interviewing people with Schizctypal Personality Disorder usually elicits surprising statements and peculiar ideas (Sperry, 2003, p. 249).

Travis is a 26 year old US Marine veteran of the Vietnam War. He seems to identify with that role as he wears a Marine jacket with a patch from his King Kong Company and displays a Vietnamese flag in his impoverished, messy apartment. Travis’ success at becoming a Marine leads to speculation that Travis was able to meet high standards. However, other than the fact that he was a Marine no real information about Travis’ military career is revealed to support such speculation.

In addition to observation, the Minnesota Multiphase Personality Inventory (MMPI-2), the Million Clinical Multiaxial Inventory (MCMI-III), and the Rorschach Psychodiagnostic Test can be useful in diagnosing Schizctypal Personality Disorder. On the MMPI-2 a 2-7-8 (depression-psychasthenia-schizophrenia) code is likely. Scales F (frequency) and O (social introversion) are also likely to be elevated. On the MCMI-III, elevations on S (schizotypal), 2 (avoidant), 7 (obsessive-compulsive), and 8A (passive-aggressive) can be expected. On the Rorschach, these individuals have records that are more similar to schizophrenics and borderline personality-disorded individuals than to schizoid individuals (Sperry, 2003, p. 250). The Multidimentional Personality Questionnaire (MPQ) has been found to be a powerful measure of personality that has been used in research. It is a paper-and-pencil true/false test that has used to identify personality correlates of violence and crime across cultures, countries race and gender (Nestor, 2002, p. 1977).

In contrast to the impressive record inferred by having been a Marine, Travis offered a very unimpressive response to the question about his education:

Travis: Some, Here, there, you know.

People with Schizctypal Personality Disorder are prone to vague descriptions. Perhaps, also related to this response is the fact that the symptoms of Schizctypal Personality Disorder may begin in childhood or adolescence showing as a tendency toward solitary pursuit of activities, poor peer relationships, pronounced social anxiety, and underachievement in school. Other symptoms that may be present during the developmental years are hypersensitivity to criticism or correction, unusual use of language, odd thoughts, or bizarre fantasies. Children with these tendencies appear socially out-of-step with peers and often become the object of malicious teasing by their peers, which increases the feelings of isolation and social ineptness they feel (Gilles, 2003).

Travis leads a dark, lonely and isolated life where he seems to be confined to his depressing apartment, the dreary taxi cab he drives or a shady movie house showing pornographic films.
This is consistent with the biosocial formulation reported by Sperry (2003, p. 246) which is that Schizctypal Personality Disorder is self-perpetuated by social isolation, overprotection and self-insulation. While social isolation has immediate benefits, in the long run they are counterproductive as they deprive these individuals of opportunities to develop social skills and they foster dependency. Furthermore, the individual’s tendency toward self-insulation further perpetuates the spiral of cognitive and social deterioration that typifies Schizctypal Personality Disorder.

Travis fills his body with junk food, drugs and alcohol, the latter two which he carries with him when he is out of his apartment. He lacks the interpersonal skills to make acceptable conversation as exemplified in the work environment with the boss and in the social environment of the movie house where he tries to make social conversation with the woman working at the snack counter. In both examples he forces the other person to threaten him in some way in order to get him to stop.
This exemplifies the initial results from the Collaborative Longitudinal Personality Disorders Study, one of the first studies to document and quantify the extent of functional impairment in patients with an Axis II disorder in contrast to patients having an impairing Axis I disorder. Patients with Schizctypal Personality Disorder were found to have significantly more impairment at work, in social relations, and in leisure activities than patients with Axis I obsessive-compulsive or major depressive disorder…These results not only underscore the misconceptions that clinicians have been known to have of the extent of psychiatric morbidity attendant to Axis II disorders but also suggest the importance of utilizing integrative treatment interventions that emphasize psychosocial rehabilitation to mitigate the pernicious effects of personality disorders on functioning (Sperry, 2003, pp. 18-19).

Another important note here is that the comment that agitated the boss, the comment about Travis’ conscience being clear, was a tangential digression, another symptom to which people with  are prone (Gilles, 2003).

Travis’ only uneventful verbal communication occurs in his living environment where he is alone and writes in his diary.

When Travis is asked if the taxi driver job would be “moonlighting” for him, Travis does not know what the term “moonlighting” means.

This may be due to verbal episodic memory deficits, a well-established feature of the schizophrenia spectrum that has been found in individuals with Schizctypal Personality Disorder. In an NIMH Grant supported study comparing individuals with Schizctypal Personality Disorder to individuals with other personality disorders and a group of healthy volunteers those with Schizctypal Personality Disorder learned verbal and visual-spatial information at a reduced rate and recalled fewer words and objects after a long delay (McClure, et. al., 2006). Another explanation may be that people with Schizctypal Personality Disorder may have speech patterns that appear strange in their structure and phrasing…and some may verbalize their responses by being overly concrete. Thus, Travis may use such a term to mean “lighting the moon” (Gilles, 2003).
Travis, however, does get the job. One may speculate that it was not because of his interview behavior but, rather, because the interviewer appears to feel some comradery with a fellow marine and because Travis is willing to do what the interviewer needs, i.e., someone who is willing to drive on Jewish holidays and to drive nights and work uptown, South Bronx and Harlem.
Travis sees the world as dirty and “venal”:

Thank God for the rain, which has washed away the garbage and the trash off the sidewalks…All the animals come out at night. Whores, skunk-pussies, buggers, queens, fairies, dopers, junkies. Sick, venal. Someday a real rain’ll come and wash all this scum off the streets…
The DSM-IV-TR criterion A(4) for Schizctypal Personality Disorder, which is placed on Axis II (see next paragraph), asserts that metaphorical speech is often found in people with Schizctypal Personality Disorder. Other speech patterns that may emerge include overelaborate, circumstantial, stereotyped, and as mentioned earlier, vague (APA, 2000, p. 701; Sperry, 2003, p. 244).

As a Westerner, how do I begin to describe a Shanghai Xiaolongbao dumpling that one does not just gulp down (or drown in chili oil and shoyu) but instead allows to dance on ones palate before it explodes into distinct flavors of pork, chicken and rich savory broth? How can I explain the difference between a run-of-the-mill Hong Kong style noodle house or dim sum palace, whether in SF’s Chinatown or along Atlanta’s Buford Highway and the holy shrine to dumplings known as Din Tai Fung? This is a place where practically every dish arrives looking simple, even coy, but then when eaten proceeds to transform into the dim sum equivalent of a prima ballerina at the Bolshoi ?

There is a matter-of-factness about the smiling servers and seating hostesses that borders on almost cavalier, right up until the actual food arrives. The moment you bite into a mound of steaming fresh garlic green beans or shrimp topped pork shu mai there is a palpable culinary awakening. I nearly dropped my chopsticks on the floor and was tempted to bow down in reverence while facing the large glass enclosed prep kitchen. Inside, a dozen identically masked and aproned chefs work deftly to cut, roll, shape and stuff the sacred XLB dumplings. Like Santa’s helpers in December they can barely keep up with consumer demand. I kid you not. The juicy pork dumplings are that good. Also good is the chicken fried rice with fresh green onion and dry fried pork chop over rice. Multiple orders of everything is the norm here rather then the exception. A Zagat rating of 26 amid literal miles of competing Chinese, Vietnamese, and Korean restaurants in the celebrity-obsessed cultural wasteland known as metropolitan Los Angeles does not lie.  It’s also obvious by the wait for seating that diners are more then willing to drive, fly, surf and parasail to Din Tai Fung for the privilege of eating there. I would bet it’s the same deal in their other location in Seattle and the single outpost in Sydney Australia where I am told foodies brave jellyfish and shark infested waters to eat Shanghai dumplings. Again, it is the simplicity of the dishes which belie their ineffable richness and fullness of flavor. THAT is what made me surrender to Din Tai Fung’s charm, and now, alas, I am hooked like a forlorn suitor with a serious dumpling addiction. Only the peanut oil deep fried egg rolls from Chan’s Tea House in Highland Park, Illinois (a now distant culinary memory of my childhood) comes even close. As I fly home to Atlanta I can only close my misty eyes, savor the experience, and hope we shall meet….and eat again.

Now that Sandusky is in jail and Romney is “retroactively retired”, I’m not sure which HuffPost article to read first. I used to watch the Sunday Evening News with Walter Cronkite. Then, if time allowed …The Wonderful World of Disney. These two programs seemed to describe two very different worlds and views of reality. I suspected somebody was either lying or exaggerating the truth. All the main players I just mentioned are gone, except for Romney, who I kind of wish WAS gone because he is still talking made-up in the moment shit on every TV channel (not counting the reality TV shows).  Plus, nowadays everyone gets their news online. I dont know, what sounds more interesting, “10 Things Not To Say to Someone with Fibromyalgia” or “Woman Attacked By Raccoons”?  I also see that a White Buffalo was born on a farm in Connecticut which is a very sacred and life changing event to Native Americans, but maybe not as big a deal in Hartford. I just hope they keep the baby bison calf safe from poachers, thieves….and raccoons. Those suckers can be nasty. I learned that from watching “Turtle Man”. Live Action!!

While the tabloids continue to promote public speculation and outrage over Robert Kennedy Jr’s decision to exhume the dead body of his wife, Mary Kennedy and move her burial spot to a different and more remote section of the cemetery, other details fail to arouse suspicion, but they should. Her coroners report and toxicology results found no evidence of recent alcohol use, her reported primary “drug” of choice. However, the following info was noted:

The medical examiner’s autopsy report from last week also revealed that there was no alcohol found in Mary Kennedy’s body, but she had taken three antidepressants — trazadone, venlafaxine and desmethylvenlafaxine.

Trazadone, Effexor, and Pristiq, which is a synthetic form of Effexor the dual receptor SSRI anti-depressant. Anyone who knows anything about Effexor knows that it (and any of its close chemical cousins, like Pristiq) has a horrible side effect profile and discontinuation syndrome.  In other words, if you try to go even a DAY without taking the medication you feel absolutely awful and suffer from side effects almost as bad as the depression you were attempting to treat…and she was taking both…at the same time. Trazadone or Deseryl is a sedating antidepressant. It makes most people drowsy and is sometimes used as a sleep aid or to help treat anxiety and panic symptoms. Of course, if Mary Kennedy happened to have a mood disorder, bipolar illness or Borderline Personality Disorder (BPD), as reported, none of the medications in her would be advisable because they could individually or together trigger mania, insomnia, irritability, confusion and suicidal thinking. Kinda makes you wonder what genius psychiatrist she was seeing, or if she was seeing someone who specialized in these areas at all.

Unfortunately a lot of doctors, even good ones fall into the trap of over-prescribing and under-diagnosing. They dont take enough time and dont ask enough detailed questions. They have their prescription pads out before you even finish telling them what you feel is wrong or what is not quite right. The sad part is that the person who first found Mary Kennedy hanging from a rafter in her barn was not the housekeeper as first reported. It was her AA sponsor coming over to check up on her. The sponsor found her body with Mary’s hands on her neck, under the ropes……as if she had “second thoughts” about the whole thing. Maybe thats more common then we think when ones whole life, ones children, and everything we have to live for flashes before our eyes. Or maybe the medications were lousy choices that were not treating the main psychological or psychiatric problem and caused certain side-effects that just made things worse, like impulsive behavior and suicidal ideation. I feel bad for her, but not for her psychiatrist or private physician, whoever that might be. Maybe somebody should look into it.
http://newyork.newsday.com/news/nation/aa-sponsor-recalls-finding-mary-kennedy-s-body-1.3834474

The Owl

Posted on July 11, 2012 by Cliff Mazer, Ph.D. aka CaptCliff

I believe one of the first books I read as a small boy was Robinson Crusoe. It was about a guy who was shipwrecked on a tropical island for many years and went half mad in his isolation and attempt to survive alone. Sort of like Tom Hanks in Cast Away but without Wilson the volleyball or the Fed Ex boxes. I dont really know what the appeal of the book was for me so long ago and at such a young age (maybe 8 or 9 or 10 years old). Soon after (if not at the same time) I developed a related interest in Pirates and pirate ships which has remained with me until this very day. I’m sure Walt Disney movies like Swiss Family Robinson had something to do with it too. Anyway, in Robinson Crusoe there is a distinct sense of a person going through a “crucible” of self-reflection and growth. He didn’t just survive, he matured and changed as a person. The isolation and loneliness forced him to rethink his prior life, earlier beliefs, and core values. I suppose that the time of life I am in currently, what I politely call “semi-retirement” is somewhat similar. Since no longer having my work days cram packed with neurotic clients needing me to listen to their problems and pontificate back to them from my “high horse” of knowledge and advanced education, I’ve chosen (or possibly been forced) to look into the psychological mirror more often then ever before. I have the time to think about what I did right and what I did miserably wrong up until now. Some of the things I realize about myself have been shocking and hard to swallow. Insight and self-awareness, while necessary for growth, often carries with it a certain amount of regret and remorse as well.

While privileged in many many ways, my life has not gone easy and my trajectory of so-called “success”, as defined by societal standards, has not been all upward and linear. At a deeper level there has always been an ongoing “push-pull” within me about God, faith, and spiritual purpose. One part of me is atheistic, rational, along the lines of a secular humanist (dont ask me to define what that is, I’m not really sure) and another part notices unmistakable “coincidences” and unlikely moments that seem purely designed for my recognition and/or personal realization. Things that seem totally random at the time also can reveal themselves to be important symbols or metaphors pointing toward needed growth. I almost used the word “enlightenment” there but that would be way too grandiose, even for me the self-confessed narcissist. Fortunately or unfortunately, I’m not deluded enough to believe I am anywhere near to my Siddhartha moment. If anything there is a bittersweet Robinson Crusoe feeling of unfinished silent sadness but with simultaneous beauty. Like him I can see and hear the timeless beach and the surf sounding with its ever present ebb and flow. I can smell the driftwood of his campfire and the saltiness in the air as he waits and watches and experiences the “wonder” of it all. He wants to be rescued but, at the same time, he knows that you cant go back to what “was”. The same thing happened to Tom Hanks when he was eventually rescued in Cast Away. The world had changed, people had gone on with their lives. We are all “universes” unto ourselves and more often then not, we orbit around our own self-centered psyches and self-concepts, no matter how many churches, synagogues, civic organizations and college fraternities we belong to. I was never a big “joiner”. Like a pirate captain I dreamed of having great authority and garnering others loyalty, respect and allegiance, but I also would likely be the first person in the group or “platoon” to question rules and authority and consider other alternatives to blind loyalty or taking big risks, ie., “What the fuck am I doing here in Iraq or Vietnam??” or ” Wait, what exactly is the purpose and cost/benefit of throwing myself on that live grenade? Perhaps I’ll let some other schmuck do that?” Maybe all of the above is what makes up the difference between emotional maturity, intelligence (critical thinking) and wisdom. Or maybe I’m just a chickenshit at heart. I just know being a dead hero for a lousy or muddled cause is personally unappealing and not worth the shiny medal.

An example of these seemingly random occurrences and personal symbols in life? Last night was a hellish rainstorm. It poured and poured like a biblical flood. It even hailed and threatened to snap the surrounding trees with gusts of wind blowing against my house, the still unfinished, jam packed, too-often renovated personal Ark in the comfy suburbs of Atlanta, Georgia. I lost electrical power, cable tv, and of course my beloved internet connection. I had just yesterday blogged about how utterly dependent we all are on this digital-electronic connection that makes us all even crazier and lonelier (disconnected) people than when we started BC= (Before Computers). Of course at first it was “cool” that I lost power, kind of like being a kid in a massive snowstorm in Chicago, around 1967. Within a couple hours however I was already worrying about not only my cherished tropical flavored Popsicles in the freezer and my home-made chicken salad in the refrigerator, but to be honest….what the hell was I going to DO with myself all night??

When the storm cleared (at first) it was twilight. I kept hearing a distinctive bird call sound from my backyard. Not a regular “tweet tweet” bird but a “hoo-hoo-hoo” sound, sort of like a stereotypical owl from Winnie the Pooh or maybe a National Geographic special.  I walked out to my back deck…..wait, I “peered nervously” off my back deck and saw the largest and most beautiful OWL sitting in a nearby tree staring right at me. Honestly I was fascinated and terrified. He/she looked at me, did another “hoo-hoo or two and then flew right over my house to the other side. It was MASSIVE with its wings extended and it’s body arched in flight. If I hadn’t seen it and heard it “hoo” me, I would have mistaken it for a bald eagle or a California Condor. Anyway, by this time I’m totally entranced in my wimpy over-civilized, under nurtured by Mother Nature way, and followed the bird to the other side of the house that luckily also has a deck that I could carefully creep out onto…. and therefore escape from (meaning scamper away screaming like a little girl) if necessary.  Normally, in lesser situations I am already armed with a large can of Raid or a single rubber flip flop raised ominously above my head in what modern humans do to signal their ability to defend themselves against other large indoor predators, like a spider.  Obviously this bird of prey and gorgeous symbol of something (fill in the blank) was not going to give two shits about me or my flimsy flip flops. Then I watched as ANOTHER giant Owl flew over and joined his/her partner. They sat there together like a pair of well trained animal actors or animatronic Ewoks in the forest scene from Star Wars, but actually far more reminiscent of the large exotic animals from the comedy Evan Almighty. I apologize for the lame movie references but i dont know how else to describe the dramatic impact and surreal visual effect of this particular in the moment experience. After a final “hoo-hoo” they BOTH took off together and flew DIRECTLY in front of me and disappeared. I shit you not. I exaggerate nothing. It was magical, beautiful and I dont expect anybody to really believe me.  It took another two hours for my electrical power to come back on and if it wasn’t for my big flashlight from Home Depot and my book, Outliers by Malcolm Gladwell, I might have gone into chemical withdrawal from not being able to surf the internet for needless useless information and something to do with my itchy twitchy social media addicted fingers. Now I have to figure out what I want to do with this unusual magical mystical experience, whether you believe me or not. Or maybe more apropos to Robinson Crusoe and his well-worn diary circa 1704, that just might be the first official blog on record I have to decide what it all means even if nobody ever reads this. Either way, the real challenge is to disconnect from the known social world and consensual reality and listen carefully to the Wise Owl, both the ones right out there and the one in here (pointing to my heart).

One of my new Facebook friends, a gifted writer and successful blogger herself posted a link to an alarming article about internet addiction. Scary stuff. Apparently being online all the time not only is turning our brains into mush but also causing us to develop serious mental illnesses. As per my last rant, I thought it was only petty narcissism. However scientific studies are confirming a link between internet activity and psychosis, OCD, ADD, anxiety, depression, and multiple personality disorders. Of course I have all of those problems as well but I assumed it was all the coffee I’ve been drinking thanks to my Fathers Day gift from my kids (one of those fancy Keurig one shot of anything coffee machines). It’s hard to resist having Starbucks, Dunkin Donuts, Caribou Coffee and Peets dark roast/Red Bull blend…all in one day. By the time I get into bed at night I am ready not just for my Ambien, but for a shot of Haldol and Thorazine as well. Maybe I can get a k-cup canister of those powerful medications that also fits into the handy dandy caffeine machine.

Anyway, this article which was so well written that I seethed with internet induced jealousy and envy, something I am quite used to. It really hit home. Of course after reading it fully and digesting its implications I felt compelled to stay online and do further research, just to see if the guy was making shit up. Of course he wasn’t and I could literally feel my frontal lobes turning into Jello while I searched WebMD and Wikipedia for further proof. I was highly annoyed at one point by my need to use the bathroom, so of course I shlepped both my cell phone and my laptop with me…..Omg, what am I doing? I’m turning into Cartman from South Park when he gets addicted to playing World of Warcraft! He had his mother bring him a plastic urinal bowl so he could continue to stay connected and play video games uninterrupted. I’m only a tad behind him since I was wondering if Verizon has water resistant cell phone covers so that I can take my phone into the shower with me, just in case. Just in case of what? That’s the central question. Is this what the Matrix and that uber-confusing Inception movie were trying to say? Is my life just a virtual dream and I’m really a quadriplegic dwarf with a head sensor and a blow tube directing a cursor on a screen somewhere and living a second life as a neurotic Jewish Psychologist? So many possibilities and so few answers. I think maybe I’ll just take a walk outside instead.
   http://www.thedailybeast.com/newsweek/2012/07/08/is-the-internet-making-us-crazy-what-the-new-research-says.html?fb_ref=article&fb_source=home_multiline

They say that Facebook appeals to both narcissists and voyeurs at heart. There is some research to support the first assertion in that narcissistically inclined people are more likely to update their statuses frequently, tag themselves in photos more often and generally have more Facebook friends. Phew, what a relief. I was pretty convinced of my own narcissism until I saw the stuff about the number of friends and the tagging of photos. I’m not even sure how to do that and I hate how i look on camera. I carefully avoid posting and taking pictures of myself, especially is I look shitty, which is often. I threaten to sue any of my children or their friends if they even THINK to include a  picture that has me in it, especially when I was in my fatter phases or a member of the bad Hair Club. When I see old pictures of myself wearing a hairpiece and trying vainly (literally) to not appear old or bald, I cringe. I look like a bloated mafia member after a big Italian meal in South Phily. I could have played a supporting role in Goodfellas or even the Sopranos.  I dont know what I was thinking. Trying to have hair is alot of work and it never worked. Plus, I’m ADD so I never got it right and obsessed about all the wrong things, like making sure I had a perfectly symmetrical but completely unnatural and age inappropriate part. I should have noticed instead that I was wearing two completely different colored socks and leaving the house (again) without my wallet or house keys. Under stress my self-care and attention to detail got worse. I’m pretty sure at my ex-wife’s funeral in 1999 I was wearing my hairpiece upside down and backwards. I was a mess. Shaving my head in the last couple years has been a huge relief. Now when it’s 106 degrees outside I can find a swimming pool and attempt to stay underwater without losing my wig or scaring small children, …ie, “Omg Mommy there’s a big rat in the pool!” Also, trying to keep hair in place, either glued or transplanted is a losing proposition, especially in windy places like Honolulu, Boulder Colorado and well, just about every place I’ve ever lived. My wife used to call it “hair surfing” and we both were big aficionados of this now obsolete extreme sporting event. We both were willing to walk an extra city block, whether in Manhattan or the Windy City itself to avoid an obvious hair disturbance.

Let’s face it, narcissism is best left to the young, and according to scientific studies the younger generations are doing a bang up job at being self-absorbed. I beg anybody who reads this to NOT add up all my photo albums, self-serving blogs, so called witty rejoinders and obnoxious self promoting  profile descriptions. I feel like enough of an asshole already and I would hate to add “self-deluded” to my already over the weight limit leaning narcissistic personality inventory. What me grandiose?
http://www.cnn.com/2012/03/21/tech/social-media/facebook-narcissistic-behaviors/index.html

Dear Young People of Planet Earth,

You know who you are. In fact, unfortunately, if you are reading this, you are probably NOT who I am talking about. I mean the young people who are perpetually busy on their laptops, iPhones, gaming systems, and listening to dubstep remixes and mashups when they are not working on their remarkable abs or doing yoga/pilates. Do you and your cohort of technophiles with oversized texting thumbs have ANY idea how difficult it is for older people to stay current with the rapid pace of technological change and innovation? It’s exhausting and humiliating. Cant we just take a break for a year or two? Could I just call a short “time out” until I catch up with all the mobile apps, urban dictionary terms, and acronyms for everything you hipsters and tech nerds take for granted?

If it wasn’t for South Park and my sons I wouldn’t know anything. It’s irritating waking up and seeing a new term online or major change in how coffee is made and cars turn on that AGAIN leaves me and my generation in the dust. You know that South African guy, the double amputee running in the London Olympics? Everyone is happy for him and feels proud of his accomplishment. So do I. Now imagine him without his blade runner prosthetic legs and feet. That’s how I feel technologically….except minus hands (and thumb dexterity) too. Metaphorically speaking I feel stuck at the starting line while everyone else breaks out of the blocks with tremendous speed, agility and endurance. I’m sitting there at the starting line on my technological stumps, a technological torso and/or tortoise in a 400 meter race to the future….of everything.

Ok, I admit it. I put a lot of you down over the years for being stupid about history, current events, literature, and DIY knowledge such as how to fix a broken toilet, about which you dont have a frickin’ clue. I was just trying to make myself feel better because I have no idea what an “open source” is, what quantum computing is about, or what these information data “clouds” are going to do for everybody. I just hope it doesn’t rain all weekend so that I can rake my yard. I know, you dont know what a rake is either. It’s the weird device that came before the blower that you also dont use because you are too busy taking over the world and sharing your files instantly…with everybody (like in the Verizon commercial). I have a file cabinet. I guess that’s different. PS What the hell is a “mashup”?

Today I introduce you to a new and highly effective form of cognitive therapy. Yes, that’s right. You, my 12 Facebook friends are the lucky first recipients of this cosmic knowledge. I know your attention spans are short and my penchant for rambling quite long, so let’s get right to it. Most people suffer from some form of low self-esteem. Dont let my colleagues in Clinical Psych and Psychiatry fool you. They have nothing to do all day except make up new diagnoses and personality disorders. Alot of time they are high on caffeinated Expresso drinks and their own medicine when they get in these moods and decide to create another syndrome to describe someone who:  cant match up their socks after taking them out of the dryer (symptom one) and/or  feels irritated/irked to find the toilet paper roll put on backwards (symptom two). Finding the toilet paper roll completely empty after your adult children and extended family have visited for another free dinner is apparently the confirmatory diagnostic marker. Of course that’s 78% of the total population, but hey, now we can add two more new pages to the DSM manual and these guys can adjourn the panel discussion and still make that 7:00 PM reservation at Morton’s Steak House.

The point is that the real problem, psychologically speaking, is low self-worth otherwise known as thinking one is a piece of poop in a society of high achieving, Audi sportcar driving software engineers and Kardashian wannabes with fake boobs and dental implants. Of course your Facebook friends with their relentless and obsessive postings of positive news and life coach inspired slogans, ie. “Today Be All You Can Be!”, etc., just reaffirms what a douche-bag you are by comparison.

So what’s the magic cure you are by now wanting to know from CaptCliff, the rogue-ish alter-ego of the more boring and less effusive therapist known as Dr. Cliff, a man who dwells with one foot in the conventional world of Clinical Psychology and the other foot firmly planted in a pile of dog crap acquired in his son’s backyard (they mow it only on important Jewish holidays)? The cure, plain and simple, is to compare yourself to fools and idiots and become better at discerning just how many people meet THAT particular diagnostic criteria. Just now I saw a cable tv show about venomous snakes in Florida. By the way (by my count) Florida is comprised of 86% fools and idiots. If you dont believe me just watch any of those TruTV programs or YouTubes on “Dumbest Anything and Everything”. Florida has the Dumbest of the Dumb and they truly capture the look and feel of stupidity when they talk, when they fight (see my son’s viral video below), when they attempt to elude the police drunk and when they are finally apprehended and are asked to do difficult tasks like walk straight. I know many of these Florida residents are high on home-made meth, crack, glue, and synthetic marijuana and that the absence of teeth in their mouths may be related to poor nutrition, the absence of dental hygiene and the daily ingestion of Oxycodone.

Still, nobody does a better job or gives a more dramatic illustration of “dumb as a door knob” as somebody from Florida. OK, I did that thing again where I ramble and digress….I was telling you about the dummy in South Florida and venomous snakes, so that you could feel like Albert Einstein in comparison. So this lady and her family are barbecuing in the backyard and the kids find a small snake. Normally there is a right thing to do and a wrong thing to do. The right thing to do is to find something long and sturdy like a shovel or a shotgun and either mercilessly beat it (the snake) to death and not stop until it looks like a rainbow roll at the local sushi bar or blow its head off and then use the shovel to do the aforementioned “Benihana teppanyaki chef on coke” routine on the slimy intruder. The wrong and obviously stupid thing to do is to assume the snake is small and non-venomous even tho you have never taken a single college course in anything, let alone Herpetology and put it in a cardboard shoebox as a temporary pet. Long story short: the lady opened the box to touch the snake and was bitten on the hand by a baby water moccasin. Of course she had to go to the hospital and get the whole anti-venom treatment with the prolonged dialogue with the doctor about whether they would have to amputate her arm or not. I personally didn’t need to see the ending, because I felt better about myself immediately, wouldn’t you?

Do you see the principle involved here? We can liberate ourselves together by purposely having Days of Stupidity. We can request that news channels and radio programs, even the few smart, educational ones like NPR have dedicated programming that focuses on the unwise, the unhealthy and especially the ungodly ridiculously stupid. However, here’s the rub. The cognitive rewiring of our brains, due to the miracle of neuroplasticity (dont ask) will NOT work unless we consciously are focusing and feeling ourselves to be much better by comparison. This, by the way, is one of the secrets of narcissism and people with Narcissistic Personality Disorder, like Donald Trump. Guys like Trump are able to proceed with foolish and illogical endeavors, like believing that President Obama is really a Muslim cleric born in the Congo and raised by Osama bin Ladin, while still maintaining a supremely high self-esteem. Trump even can look in the mirror and say he likes his absurd comb over hair!  He has trained himself through this same cognitive method, now revealed by me to you. I include an oldie but goodie video (previously discussed on my blog) of some scum bag Florida residents arguing with each other with extreme stupidity to help get your self-esteem therapy started. More to follow. Good luck to you.  Captcliff   PS  If you really care, it turned out they didn’t have to cut off the idiot lady’s arm, even tho I was tempted to meet her at the hospital with the shovel and do it for her, thus saving the taxpayers alot of money. The narcissistic politicians with high self-esteem all agree that we need to find creative ways to cut back on our nation’s health care costs.

Submitted for Publication in the Anxiety section of the NYTimes:

Any similarities to actual Psychologists or known Insomniacs is purely coincidental

Subject: Anxiety, Insomnia and Me

Who could possibly be more neurotic then a Clinical Psychologist with a pre-existing condition of anxiety? What about an anxious Jewish Clinical Psychologist with chronic insomnia and ADHD? If there was such a thing as a board game called “Scrabble : The DSM-5 special addition”, that diagnostic concept alone would be worth a shit-ton of points, not to mention off-shoot words that mean “angst”. Dont get me wrong, I’m perfectly fine with my therapy clients. They even help me feel better about myself and whatever might possibly be wrong with me by comparison. Can you spell “schadenfreude”, which literally means the enjoyment obtained from the troubles of others? That’s a pretty good scrabble word too. Of course it also helps that I’m pretty good at what I do. I’m also pretty sure nobody is all that surprised to hear that psychologists and psychotherapist can sit there cool, calm and collected all day long while doing their business and then once the work day is over revert into Woody Allen-like creatures who roam the night and their medicine cabinets seeking relief from their own panoply of problems including panic disorders, anxiety and insomnia.

Luckily, in my case I dont have acute anxiety or panic attacks. That would be too easy. Instead over the last few years I have gradually developed a problem with sleeping. I know what you armchair doctors are thinking. I tried it all. I did the “comprehensive” sleep study along with all the other overweight middle aged males shlepping to the outpatient facility/ faux hotel room with their favorite pillows. I’m really shocked that I couldn’t get much sleep that night with 57 different electrodes taped to my body and two stone faced sleep lab technicians staring at me through a glass window. Of course a world class neurotic person with generalized anxiety such as myself spent most of my “Sleepless in the Sleep Lab” time thinking about the guy on You Tube viral video who keeled over and died in the sleep lab… while technicians watched through the glass window. I guess they didn’t notice him sitting up, clutching his chest and falling off the bed.

Beyond the sleep lab testing I also have tried many of the tried and true methods for dealing with night time anxiety and insomnia. I kept a sleep diary, ie. Monday- no sleep, Tuesday-no sleep, Wednesday- delirious and possibly psychotic and no sleep, etc.  I used relaxation tapes. I engaged in progressive muscle relaxation and cognitive therapy, ie. “I am a wonderful, tired human being and my left leg is getting heavy and going numb. Wait, do I have MS??”  The basic problem with neurotic anxiety is that certain people think too much. While other people accept many things just as they are, I often keep questioning both out of habit as a therapist and from a constitutional predisposition toward morbid curiosity. But WHY am I aging more toward the top of my body and less toward the bottom? How is it possible to grow hair on my back and shoulders and ears but not on my head? These are just a few of the questions that preoccupy me while the rest of the world is sleeping soundly.

It’s not easy for a Ph.D. in Clinical Psychology to finally bite the bullet and call his colleague the M.D. psychiatrist and fess up to having anxiety and less sleep then my 15 year old male client with ADD who took his Ritalin at midnite thinking it was Ibuprofen. This is where I first learned about the wonders of prescription sleeping pills. By the way, have you ever taken Ambien (Zolpidem), the popular sleeping pill and gotten a relatively decent nights sleep only to wake up to garlic bread crumbs, a stop watch, an empty carton of orange sherbet and one of your neighbors you never met before in your bed?  Ok, I am exaggerating about the neighbor but the rest is the gods honest truth. The good news is that the magic little pill worked and worked fast. The bad news is that it may work too well for a while and then not enough after that..which sounds a little bit like heroin or cocaine. But I digress, let me explain more about this wonder drug.

Ambien (Zolpidem) is some good stuff for many of us who cant just do as Samuel L. Jackson eloquently puts it in his popular audio childrens book, “Go The Fuck To Sleep!” There are millions of reasons people cant fall asleep or stay asleep. As my friend the shrink explained it, the older you get the harder it seems to turn off the mental computer and go into “sleep mode”. I’m sure the 32 different electronic and digital devices in my room all simultaneously blinking and lighting up dont help either. Then there are the “bad sleep habits” including obsessional behavior, ie. “Wait, it’s 3:25 AM, I better check my Facebook status to see if anyone else liked my status update”or “hey, I wonder if anyone has linked to my web blog (otherwise known as my post-mortem memoirs) in the middle of the night unnoticed.”  Bottomline, the more you think, the less you sleep, and the less you sleep, the more anxious and neurotic you get.

Anyway, back to insomnia and Ambien. If you are one of the 23 million people who take it now (thats right, we are all in some kind of bizarre post- Prozac nation sleeping pill cult) it can have some unusual side effects for certain zombified individuals. Instead of eating peoples brains some of us just sleepwalk, often to the kitchen where we collect and consume an assortment of foodstuff and odd utensils. One morning I found a Ginsu knife and a plastic ice cream scoop in my room that I had no memory of. Maybe the scooper went with the orange sherbet left melting on the floor. I cant say. The point is that weird things happen once the Ambien Undead arise. Some people like my 25 year old son Eli have more obvious so-called “paradoxical” side effects like the absolute refusal to sleep and instead have long protracted conversations with select items in the refrigerator, including the fresh produce. I’m not kidding or exaggerating this. It really happened. Also, Eli happens to be a personal trainer with huge muscles. Abruptly intervening in his intimate exchange with the carrots and broccoli was not easy. He didnt get belligerent or anything. He just didn’t want to be rudely interrupted or awakened from whatever weird trip he was on. Apparently I dont either when I am under the biochemical effects of Ambien. The only funny part about it is my initial reaction of great surprise to the seemingly random things strewn around the next morning. I now have a predictable pre-set exclamation that I say aloud for full dramatic effect, “Hey, how did THAT get there??” Of course when “that” involves a neighbor’s cat hanging from a ceiling fan or three empty bags of Doritos (the big ones) on the floor next to the bed it’s a little hard to deny who was responsible. Later finding the car in the driveway with the motor still running takes the whole thing up a notch/nacho. If this gets any worse I’m either going to have to call my shrink back or at the very least start checking the car trunk each morning for groceries.

P.S.  Riiight, here’s what kept me up last nite writing this article. Is it more correct to say awoke, awaken, awoken, or ewok (out of frustration) in the fourth paragraph about Ambien? The online arguments on the subject are endless and wholly inconclusive. I gave up and said “wake up to”. Meanwhile, I then couldn’t go the fuck to sleep…..and wonder if this will ever get published…and if it does I wonder if that will be good, bad or indifferent for business…..Oy Vey.

Cliff Mazer Ph.D. is a Clinical Psychologist and humorist who lives and works in Sandy Springs, Georgia. He has a thing  for Pirates and other people with ADHD. He blogs fairly anonymously on Facebook and WordPress at https://captaincliff.wordpress.com/     Contact:  404-932-7193