July 19

A Capital Idea Part 79: Life Satisfaction, Income Inequality, and Quality of Life

Denmark makes a nice example, but true knowledge requires looking at the cumulative reality, not selective cherry picking of the best examples. I realized last time that I should look at these issues across the nations of the world. If I had access to statistics programs, I could run correlations between these variables, but in the absence of these programs, I spent most of the day yesterday comparing the highest and lowest 10 nations on these variables, an informal technique which yields very similar conclusions to that of a correlation coefficient. I also found one site which had a scatterplot of the relation between income and life satisfaction (http://www.gallup.com/poll/104608/worldwide-residents-richer-nations-more-satisfied.aspx), but it didn't give the correlation coefficient and income isn't quite the variable I most wanted to look at, preferring Quality of Life instead.

What I found was mostly as I had postulated. One comparison had very weak results, in the direction I expected, and another had even stronger results than expected, but in general, they showed that income inequality goes with low quality of life and low quality of life goes with poor life satisfaction. The link between income inequality and life satisfaction is the weak one, but I will present explanations for that.

The link between per capita national income and life satisfaction seems to belie the old saying that "Money can't buy happiness." However, the situation is not that simple. Actually, as national income goes up, the relation between the two variables becomes weaker. In other words, nations where most of the people are so poor that they are destitute and have trouble meeting basic needs such as finding enough to eat, truly have poor life satisfaction, with good reason. However, nations where people generally have enough income that they don't have to worry about starving or meeting basic needs, tend to have fairly good and similar life satisfaction, whether it is a particularly rich nation, or a modestly wealthy nation. Differences among these "better off" nations are probably much more due to other factors such as income inequality, cultural factors, social harmony, etc. Overall, looking at the scatter plot graph, it looks like a fairly strong correlation between per capita income and life satisfaction, perhaps around .60. The scale for correlations ranges from -1 (complete opposites) to +1 (complete correspondence).

Next, I looked at the GINI Index (http://en.wikipedia.org/wiki/List_of_countries_by_income_equality), which measures income inequality, focusing on the ten nations with the highest GINI Index, and the ten with the lowest. These nations were compared on both Quality of Life, and the Satisfaction with Life Index. The ten nations with the lowest GINI Indices, in alphabetical order, were Croatia, Denmark, Finland, Germany, Hungary, Japan, Norway, Slovakia, Slovenia, and the Ukraine. Of course, Denmark has the lowest GINI Index. These nations have relative income equality. The ten nations with the highest GINI Indices, in alphabetical order, were Bolivia, Botswana, Chile, Columbia, Guatemala, Haiti, Honduras, Panama, Paraguay, and South Africa. Actually, some nations were left out of these lists because they did not have data on the Satisfaction with Life Index and/or the Quality of Life Index, so these are the top and bottom 10 nations on the GINI Index which have data on all 3 variables. Also, there is not a specific year for the GINI Index, as the data year varies for different nations, but in every case, it is from the past several years.

There are 111 nations with Quality of Life data as of 2005 on Wikipedia (http://en.wikipedia.org/wiki/Quality-of-life_index). I took the Quality of Life rankings of the ten nations with the lowest GINI Indices, and found that they averaged 40.25. The Quality of Life rankings of the ten nations with the higest GINI Indices averaged 77.5. Thus, Quality of Life was far worse in nations with great income disparities than in nations with small income disparities. Next, I did the same type of comparison between the GINI Index and Satisfaction with Life, which lists 178 nations on this index as of 2006 (http://en.wikipedia.org/wiki/Satisfaction_with_Life_Index). In this case, I found that the ten nations with the lowest GINI Indices averaged a rank of 72.6 on Satisfaction with Life, while the ten nations with the highest GINI Indices have only a slightly higher average, 76.3 on the Satisfaction with Life Index (lower rankings being better). Of course, as many people have pointed out, Satisfaction with Life is essentially a subjective measure. The two largest biases in this measure which I can identify are the tendency to be self-deprecating as opposed to being narcissistically egotistical, and peoples' life expectations in terms of what it takes to make them feel "happy." For example, I noticed that Satisfaction with Life ratings for Asian nations tend to be low, which I think has to do with a relative tendency to be self-deprecating by citizens of Asian nations. There was only 1 Asian nation on either GINI Index list, Japan, but it ranked 90th in Satisfaction with Life even though it is 17th on Quality of Life and has one of the world's very lowest GINI Indices. In terms of peoples' expectations, I would expect these to be relatively low among poor people with relatively little hope of social progress. Poor peoples in nations with great income disparities, in other words, may be easier to please, assuming they accept their situation and feel that there is little they can do about it. (Otherwise, with the empowerment of the people, a revolution is in the offiing.) They are essentially comparing themselves to a lower standard than other peoples.

The final comparison I did was Satisfaction with Life, compared with Quality of Life. The reason I felt this comparison was needed is that I felt, as explained in the previous post, that Quality of Life is a better measure of a nation's wealth than is per capita income. Also, if I am correct, there should be an even stronger relation between Satisfaction with Life and Quality of Life than there is between Satisfaction with Life and per capita income, because Quality of Life takes into account variables such as access to good, cheap health care or education -- things which progressive societies do for their citizens -- which contribute to life satisfaction, which per capita income does not. It is important to note that there are no measures of life satisfaction included in the Quality of Life measure. The two measures are completely independent of each other. However, Wikipedia states that the Satisfaction with Life Index correlates strongly with health, wealth, and access to basic education. The results I found were striking. The ten nations with the highest Satisfaction with Life ratings which also had Quality of Life ratings were, in order of rank, Denmark, Switzerland, Austria, Iceland, Finland, Sweden, Canada, Ireland, Luxembourg, and Costa Rica. The ten nations with the lowest Satisfaction with Life ratings which also had Quality of Life ratings were Rwanda, Bulgaria, Pakistan, Russia, Georgia, Belarus, Turkmenistan, Armenia, Ukraine, Moldava, and Zimbabwe, with Zimbabwe having the lowest rank. The average Quality of Life rank for the top 10 nations on Satisfaction with Life is 10.9, which is not that far from being the top 10 nations overall in terms of Quality of Life. In contrast, the 10 basket cases at the bottom of the life satisfaction list, have an average ranking of 93.8 out of 111 on Quality of Life, not far from being as bad as it could be. In other words, it appears that there is an extremely high correlation between Satisfaction with Life, and Quality of Life -- higher than the correlation between Satisfaction with Life and per capita income, as I had postulated.

To put these findings in context, let me reiterate from the previous post, the variables found in the Quality of Life Index. These are health, family life, community life, material well-being, political stability and security, climate and geography, job security, political freedom, and gender equality. In other words, nations which have progressive policies such as empowerment of women, inexpensive and effective health care, trade union membership (found in the community life variable), high public sector employment (job security leading to low unemployment) and so forth, also tend to have higher Quality of Life ratings (and thus good resource use and national wealth), which correlates very highly with life satisfaction.

Of course, we have a "chicken or egg" problem with all of these correlations, or to be more technical, the issue that correlation does not imply causality. Whether life satisfaction leads to a better quality of life, vice versa, or some of both is not a settled issue, although it's probably some of both. Simlarly, whether relative income equality leads to a better quality of life, vice versa, or some of both cannot be determined by the fact that the two variables are related. If I could run a sophisticated causal modeling analysis including government policies, I suspect I would most likely find that progressive government policies (including the high tax rates that these necessitate) lead to a lower GINI Index, leading in turn to better quality of life, which finally leads to better life satisfaction. High life satisfaction also should have a feedback loop to quality of life (i.e., the economy) and even to government policies.

Such conclusions of course await futher research, unless somebody has already done it. We need to be aware of what works and what doesn't work in terms of government policy, in order to have a nation of informed and politically involved citizens and voters. Presumably, a nation of informed citizens will choose by and large, policies which work. The problem is when misinformed or uninformed citizens vote for politicians who advocate policies that do not work, when only a biased minority of the population even votes, or when politicians with their own agendas fail to carry out the will of an informed electorate. The importance of sharing information which can show us that progressive policies work well and conservative ones don't work so well, cannot be overstated.


Robindell's picture
Robindell 8 years 30 weeks ago

Semantics plays a role in this type of analysis. You could go a step further and say that satisfaction is not identical to what Maslow called self-actualization. People may have educational opportunties, jobs with stable, adequate income, and affordable, accessible health care. Those things would theoretically prevent the inception of an excessive amount of stress and worry, which would lower the satisfaction rating as well as the quality of life score. There are conditions necessary for quality of life, but knowing what degree of quality is needed for someone to feel as if satisfaction has been attained is no doubt quite subjective. There are both individual ideas as well as cultural standards of satisfaction that could affect such an evaluation. Mere satisfaction in and of itself is not necessarily the same as real happiness. Conveniences can become rather prosaic and not very enlivened.

Years ago, it was sometimes mentioned that Sweden, a country which seemed to have a fairly strong social safety net, had the highest suicide rate of any country. Some argued that all the tension and strife of survival found in other places had been reduced in Sweden to a point where life became, for some, depressing and without real purpose. Everything had been thought out in advance in a way that may have eliminated a sense of spontaneity or what philosophers sometimes call authenticity.

In a similar way, rich conservative people in America, with their desire to control and manipulate others, don't seem psychologically happy or fufilled. When you have an interest in destroying others through economic means, that does not suggest those in charge are satisfied with their own lives, even though they may believe that they are. Their misery almost seems Freudian, i.e., unconscious.

My job involves working with the public, and it primarily involves social psychological types of situations and behavior. Even when I am willing to help others by providing a service, some people insist on doing some of the task themselves. Some people seem to have difficulty with the idea of having a "servant", i.e., me, to help them. Perhaps they have had to do so much for themselves that they have difficulty comprehending the notion of having someone to assist them, even though it is my job and my responsibility to do so. Some people will say to us, somewhat facetiously, "I don't want to take your job away from you." They will then stand aside and let me do my work. With others, it seems as if their work ethic is so strong, and that is a characteristic of Americans, what Max Weber called the "Protestant Work Ethic," that they prefer to do work even when someone is available to do it for them. I sometimes imagine that one of people's greatest leisure activities in America is mowing their lawns. Partly it is the sense of property ownership that is involved with our individualistic culture, and partly the premium that Americans place on practical activities and of accomplishing something.

You would have to compare how work is structured in the American workplace compared to those in other countries and connect that to differing unemployment rates as well comparing wages for the same or similar jobs from one country to another to understand what goes into social inequality. I am not sure that this kind of cross-cultural analysis on as large of an international scale that you are talking about has ever been attempted. From what I can see from my limited vantage point, there is a certain connection in this country between the lack of fair distribution of income and health care benefits, and the lack of fair distribution and lack of availability of jobs. We don't have enough jobs to go around. That prompts free-market conservatives to say, lower the bottom on minimum wage. You could have consultants whose job it would be to figure out how to create more available slots rather than to reduce wages of low-income workers or downsize companies. I am not sure how you would go about changing the current beliefs which exist with these executives and managers to modify or rearrange the employment picture.

Another thing that goes with the job, in my case, is that some people are not responsive when I first encounter and then greet them. That seems a bit strange even to me, sometimes, taking into account that this is the midwest where it is assumed that friendliness goes hand-in-hand with the cows and the corn. The ambiguity of the situation and the inherent complexity of human communication makes it difficult for me to know if the person is just introverted by nature, is not feeling well for some reason on that particular day, or if he or she has been taught culturally to disregard an insignificant service worker who they have no real social connection with. A higher-status employee might be responsed to whereas I might be ignored. Yet, I do encounter people who are relatively friendly and talkactive, sometimes asking me how I am doing, or even making a joke of some kind, what cultural anthropologists would call joking behavor. If we lived in a society where most people are highly satisfied with the quality of their lives, the question I wonder about is, how would such a society look in terms of social behavior? Would there be clear signs of happiness, of well-adjusted people, or would individual differences in personality obscure this sense of satisfaction or happiness? People do have differing styles and preferences. In my subjective view, there are many people who are able to meet their needs and may be doing o.k. financially, but who are not satisified or fufilled with their lives, nonetheless.

One of the criticisms I have of both psychiatry and clinical psychology is that they define mental health in terms of an absence of symptoms. Someone is basically either normal or abnormal. The absence of symptoms of some abnormal psychological condition does not automatically mean that someone is satisfied with their life circumstances or with the culture in which they live. There isn't agreement on what comprises a high-functioning, well-adjusted, happy society.

I may not own an art collection, but that does not mean that I don't appreciate and enjoy looking at art. I could live without art and culture, but I probably would be the poorer for it.

In America, the basic necessities of life are lacking for many citizens, but at the same time, people who are well-taken care of, because of the nature of our culture, in many cases don't seem to appreciate life all that effectively. I think you would have to be more detailed in evaluating social values and social behavior to understand different levels of satisfaction among different societies.

I have observed that people in our culture are often in a hurry. Contrary to popular opinion, and this is something that sociologists or social psychologists may not have studied all that thoroughly, I don't think this sense of having to rush through life is caused by people being busy or having things to do. They are busy and do have things to do, but I don't think that completely accounts for their behavior in this regard. Most things can wait. Most people are not the CEO of some huge corporation or the president of a university. People rush both coming and going. At times, it really does seem to be a "rat race." When people rush, it sometimes works to their disadvantage as they tend to forget and leave things behind. This is where the psychological or medical diagnosis of ADD ends, and the culture of not attending to one's immediate business and feeling a constant impatience and the need to rush begins. Part of this, in my opinion, is that we have a high intolerance level toward others in our society. We have overcrowding and overpopulation, too many people and not enough space and not enough privacy. I think that people feel as if they are in competition with other individuals in our culture. Perhaps this translates into aggressive driving and behavior that often seems dehumanizing. The social circumstances of behavior are a kind of window into the emotional state of society.

Jean Paul Sartre through his existentialism believed that life is essentially pointless and meaningless. Herbert Marcuse, who was a social essayist and social critic and philosopher of sorts, answered Sartre by saying that life only seems meaningless because of the oppressive nature of society. I agree with Sartre's view, but Marcuse did have a good point that the oppression enhances the natural alienation which already is a part of existence.

Natural Lefty's picture
Natural Lefty 8 years 30 weeks ago

Robindell, you make a good point about self-actualization. In fact, some of my earlier Capital Ideas posts deal with the idea that the ideal economy would be structured to help people self-actualize. It is not the same as "happiness" which is usually conceived of as "having a good time." Self-actualization has more to do with well-being and being a productive person, to combine two of your comments. Psychopathology is usually defined in terms of the absence of symptoms, as opposed to self-actualization which is a measure of wellness defined in terms of what people do. If being psychologically well were synonymous with the absence of symptoms, dead people would be the wellest of the well. Also, people who are relatively inert and bland in their behavior would be more well than those who are proactive and intelligent -- people who dare to be different. Clearly, we need a measure of psychopathology which takes into account the active aspect of wellness. Of course, these measures of life satisfaction (although I haven't actually seen it and it was written by Adrian White, a Social Psychologist from England) of necessity are a bit superficial and don't capture the richness or deepness of true psychological wellness as captured in the term self-actualization. I have the same impression of rich people in that, although most of them are "happy," it is the sort of happiness that reflects having "fun" things to do and the phony satisfaction of being a "winner" in the grand competitive financial game they play. Most Americans are indeed in a hurry. I think this is being studied in a variety of ways, actually. The study of stress and Type A Personality comes to mind as one line of research which has been around for a long time. There is also some "positive psychology" research recently which I think is relevant to this topic.

The case of Sweden probably had more to do with Seasonal Affective Disorder than anything else, in which lack of sunlight results in a person having too little melatonin, leading to depression. Researchers have figured out that artificial sunlight cures SAD.

Do you know that there is something called Existential Psychology? It is considered a part of Humanistic Psychology, and it focuses on finding meaning in life. I don't know if that is where Sartre went with his philosophy, but that seems likely. On the other hand, sometimes life seems to lack inherent meaning, especially when we find the situation abusive. I believe there is greater meaning, in things like evolution, but it's kind of like seing the forest when we are in the midst of the trees.

I may be a little quiet with strangers but I would certainly greet the employee. I probably also would want to do the work myself if I could. My wife likes to do everything for herself, and usually, the hard way (sigh).

Robindell's picture
Robindell 8 years 30 weeks ago

To answer your question, yes, the name Rollo May comes to mind when you mention existential psychology. I don't know much about it, but I think it is different from Sartre and other existential philosphers and phenomonologists. Another psychologist who may be related to existential psychology is Victor Frankl who was a concentration camp survivor and based his approach on his search for meaning in that difficult and deadly setting, which he called, if I am not mistaken, Logotherapy. I once had to read Sartre's novel Nausea for a class. Our professor was trained at the University of Chicago and was demanding and knew his business, as is apt to be the case with U. of C. people. In fact, Senator Bernie Sanders is a U. of C. graduate.

(No comment is probably needed, but in case you didn't see it, see my reply and final comment at your previous post on Denmark.)

Natural Lefty's picture
Natural Lefty 8 years 30 weeks ago

Correct, Rollo May and Viktor Frankl are two of the best known existential psychologists. I think Frankl's therapy technique is called logotherapy. I guess they don't have much to do with Sartre, although most existential psychologists are also European.

I am a big Bernie fan, and wish he, or someone like him, were our President. I hope Elizabeth Warren runs for the Senate and wins. Maybe she could eventually be our first female President, and a true progressive.

nimblecivet 8 years 30 weeks ago

One name I have seen come up is K.D. Laing, who is usually characterized as "postmodern" but I wonder if it might not be more accurate to categorize him as existentialist. I don't know though because like I said I only know of him because he was mentioned by others, most recently by myself Deleuze and Guattari in Anti-Oedipus. The latter work could mesh with Nat. Lefty's work here because it touches upon the relationship of psychology and mass-psychology. It may be (I'm a layperson so I don't know) that mass-psychology and social-psychology overlap. Mass-psychology is not merely the study of the behavior of crowds or the means of propogandizing them (Bernays). Deleuze and Guattari take the discipline past Wilhelm Reich (The Mass Psychology of Fascism), and in doing so de-politicize it. Reich wanted to know why people accepted fascism and totalitarianism (in the U.S.S.R.). D&G somewhat succesfully disentagled psychology from the Oedipal formalism in their attempt to indicate in what direction society could develop the understanding of individual health and satisfaction in a social context. They conclude the work with the example of a schizophrenic who was cured by being given a job as a mechanic and ask what a society is worth if it does not proffer this cure, does not investigate intuitively to find such cures.

Natural Lefty's picture
Natural Lefty 8 years 30 weeks ago

Good comments, NC!

I hadn't heard of K.D. Laing the existentialist or postmodernist, so maybe you need to tell me more about him. When I read K.D. Laing I thought of a lesbian singer by that name; that's quite a coincidence, or maybe not.

Mass psychology is definitely a topic of study within social psychology. I think a social psychologist named Diener, among others, is well-known for studying that topic. For example, they look at deindividuation and how people in large groups may lose their inhibition (or alternatively, succumb to conformity pressure) and do things that they otherwise would not. This is definitely not a political approach to mass psychology, but it has political applications. I have not heard of Deleuze and Guattari, either. I might have heard of Wilhelm Reich, but if I did, it was a bad connotation. I remember a guy named Reich who thought that molestation was good for children. He had been molested as a child himself, so I used that as one of my examples of bias in personality theories coming from personal experience.

The example of the schizophrenic who became better when he became a mechanic reminds me of Harry Stack Sullivan's approach, which was based on relating personally to schizophrenics. He had pretty good success in treating schizophrenics in this way, before the days of antipsychotic drugs. My wife had a patient that she gave jobs around her mental hospital in Taiwan, which helped him keep his symptoms under control, although he was never really normal. He now runs his parents' grocery store, is married and has a child. However, he didn't tell his wife about his schizophrenia, which is not a good thing, and I think she had to figure it out on her own.

p.s. I followed through on the idea of comparing nations with high and low tax rates, and the results are super, although I haven't written it up yet. Nations with high tax rates are doing much better on the whole than nations with low tax rates, and of course, tax rates are something which are set by politicians. Nations with higher tax rates do tend to have higher per capita incomes too, so they would be expected to do better, but the difference in incomes isn't all that great between high and low tax rate nations. In fact, the nation with the highest per capita income has one of the world's lowest tax rates (Qatar, I think). And of course, nations with high tax rates may very well have higher per capita incomes over time because of the higher tax rate.

We are still very worried about my dad. He had a catheter inserted, but he didn't seem sure what the course of treatment would be. He has an enlarged prostate gland and bladder, and presumably it is the prostate which is causing the enlargment of the bladder. He might have to go to a convalescent home for a while, my mom said. That seems awful. I thought they would just give him drugs or do surgery, then send him home.

nimblecivet 8 years 30 weeks ago

Oops! I meant R.D. Laing. I just read his Wikipedia article which breaks down his views. He radically questioned psychology and psychiatry, and I suppose there will always be figures like that as a discipline first evolves. Deleuze and Guattari didn't discuss Laing in depth, but must have mentioned him and some of his ideas because they were congruent with their project of dislodging psychology from Freudian formalism, if I'm using that term correctly. I'm fairly certain the Reich's we're talking about are different; I'm not aware of any accusations against the author The Mass Psychology of Fascism. Also D&G wanted to contribute to a transformation of society that rendered the process of deindividuation of the type Reich described as impossible. They saw Reich and Laing as engaged in a similar effort but Freud as something to be left behind essentially, although they didn't quite go that far as to say as much.

That's terrible news about your father, I hope he finds a way to get back home quickly!

Keep up the good work.

Robindell's picture
Robindell 8 years 30 weeks ago

I think niblecivet is thinking of of R.D. Laing, who was a British or actually Scottish psychiatrist, a physician, who was involved with alternative treatment for schziophrenics, a little along the lines of Dr. Harry Stack Sullivan but somewhat more recent. Laing had certain philosophical influences on his theoretical approach. As I remember it, he was not considered to be an existentialist per se either philosophically or psychologically, but he was influenced by phenomonology, which is a philosophical perspective that is related to existentialism but is not the same, and may have had some existentialist influences. Laing was also influenced by a specific concept which is known as "ontological insecurity" which is probably sort of a theological idea, maybe related to Paul Tillich or Soren Kierkegaard. Laing's most famous book was The Politics of Experience. The one statement of his which I remember from a long time ago is that it would be difficult not to decend into madness given the existence of the nuclear bomb. When he was working, I think that was probably during the Cold War. Laing if I recall tried to see things through the eyes of the schizophrenic rather than as an external, cold clinician. He seemed to suggest that madness was a response to the difficulties of life and existence in the modern world.

I am glad Natural Lefty mentioned Harry Stack Sullivan. Dr. Sullivan, who was also a psychiatrist, was from the Washington, D.C./Maryland area. He sometimes saw patients at a private psychiatric hospital in Rockville, MD, which in case you are not familiar with it is near Bethesda and is also a Washington suburb. The hospital was started by a psychiatrist by the name of Bullock and was called Chestnut Lodge, because it was in a former lodge or hotel. The book I Never Promised You A Rose Garden was written by a former patient of Chestnut Lodge, and there is a song by that title, also. The hospital used the kinds of social techniques that Sullivan favored. They were known to specialize in serious, long-term cases, and some of their patients came from prominent and wealthy families who were concerned with confidentiality. A number of years ago, I found an article in the magazine of the Washington Post about a malpractice suite against Chestnut Lodge Hospital, Inc. There was a physician, a kidney specialist, who was suffering from severe depression. He could not work and could not function anymore. He was taken to Chestnut Lodge. They did not give him any anti-depressents, and instead of calling him "doctor" called him by his first name, which was a bit disrespectful. He got worse instead of better. A friend came to visit him and was alarmed by his condition and lack of progressive, so the friend arranged to have him transferred to Sherpard Pratt, a well-known, private mental hospital in Baltimore. They gave him medication and within a few weeks, the doctor was up out of bed, walking around, talking, and acting like his old self. He ended up suing Chestnut Lodge, and that resulted in articles on the state of psychiatry in a professional journal, Annals of Psychiatry, I think. In the article I read, a doctor said that despite the attempts at innovation and the attention that was once shown to what was being done at Chestnut Lodge, the patients for the most part were not improving. The techniques were not working. So on that point, I would have to somewhat disagree with my friend, Natural Lefty. This story has a sad ending. The institution had some negative publicity about the lawsuit, and insurance reimbursement for psychiatric hospitalization was becoming more difficult. Some time after the lawsuit, the younger Dr. Bullock sold his family's hospital to a non-profit mental health organization. Their mangement of it resulted in Chestnut Lodge going into bankruptcy and then closing. The original lodge building was going to be rehabilitated and turned into condo units, but there was a fire, suspected arson, and the old building was destroyed. So there you have a piece of modern psychiatric history. My sister lives not far from Rockville, and I was sort of curious about Chestnut Lodge, but it is no more.

Natural Lefty's picture
Natural Lefty 8 years 30 weeks ago

Robindell, I actually would not recommend Sullivan's no-medication, empathy based treatment as the primary treatment for all schizophrenics, but it seemed to work for some people, better than other treatments in those days before anti-psychotic meds were discovered. I think each case is different with schizophrenia. John Nash the Nobel Prize winner doesn't need medications because he can now distinguish his schizophrenic thoughts from his nomal ones, but that process took a long time and an astute mind. Most schizophrenics struggle without success to understand the thoughts inserted into their mental processes by their schizophrenia, and they misattribute them to a variety of sources, mostly external -- "They are trying to control my brain, etc." There are only 2 psychological disorders according to my imperfect understanding which really call for medication; those 2 disorders are schizophrenia, and bipolar disorder, both of which have more biological origins than other psychological disorders. Other disorders are normally more treatable with psychotherapy. Even with schizophrenia, I think that antipsychotic treatments are going more toward lower dosages which have fewer side effects.

The person in your example had depression, however. Psychotherapy is usually successful with depression, but of course not always. In those cases, antidepressants may help, but antidepressants sometimes backfire too, as do antianxiety drugs. My father was given an antianxiety drug a couple of years ago, and it made him worse.

Yes, it is R.D. Laing, not K.D. Laing. I have heard of him actually, I think he said that schizophrenia was a response to a crazy world, which is an idea I don't really agree with, but I think when people deal with dysfunctionality in the world around them, it does contribute to psychopathology of all kinds. The evidence on this is clear, but the evidence is also clear that schizophrenia only happens in people who have a genetic predisposition which makes it possible, then environmental circumstances trigger the actual event which involves neurotransmitters such as Dopamine and maybe Serotonin in the person's brain becoming overactive.

You are absolutely correct, Nimblecivit, that every field has skeptics as it evolves. Sometimes the skeptics turns out to be correct or at least have good points. This results in paradigm shifts or the incorporation of new ideas into the discipline. For instance, the contributions of people such as Laing and Sullivan were probably to result in psychologists considering all types of psychopathology as affected by the person's environment rather than being some sort of biological predisposition, which was probably the original inclination of early psychologists.

I need to find out what is happening with my father. It is difficult to think of him being in a nursing home. I think it has to do with the treatment process, though. My mother said it was supposed to be temporary.

nimblecivet 8 years 30 weeks ago

There are actually some outpatient treatment centers that are more comfortable than a hospital so hopefully that's what she's talking about.

Yes, I don't think Laing probably was working with an adequate concept of brain chemistry. Nevertheless, even when you take that into account, as I think you were saying, there are a complex set of factors involved that have to be taken into consideration on a case-by-case basis.

I was thinking of this in a sort of random thought process this morning. I was recalling one night when I was camping at the beach and some people were setting off fireworks. This caused me to think of the shot-registering devices the city has around the city, and a recent police shooting where they came out and said that these devices had recorded the shots which the individual had fired. Probably true, but my conspiracy-theory-type-explanation-mechanism kicked in, and when I recalled some marchers in a photo protesting the shooting it made me recall Eric Hoffer's idea of the "true believer". He argued that some people embrace radical politics because contemporary society does not offer "coming of age experiences". I don't know how much credence I give that idea, but there do seem to be some anti-cop types who would not be beyond setting off fireworks to distract cops from the scene of a crime. Did the cop shoot the guy even though he wasn't armed? Was the guy who was shot (a real "scumbag" apparently, but nevertheless a young man) in cahoots with the local anarchists? Did the cops shoot him and then fabricate the evidence that he had a gun, as a way to send a coded message to anti-establishment elements? Probably not, but I can't help but wonder about things like that sometimes. Anyway, if the anarchist types believe they can take on the state they are mistaken. But maybe they look at it as a form of "social networking" and they'll wind up giving up on revolution and working at coffee shops, record stores, and hair parlors.

Natural Lefty's picture
Natural Lefty 8 years 30 weeks ago

I am not sure how these outpatient treatment centers differ from the hospitals. Could you give me more information?

My impression of R.D. Laing is the same -- that he didn't know enough about the neurochemistry of schizophrenia to form an informed opinion, but there are clearly complex nature-nurture-self interactions going on there, and they differ from one case to another.

I have heard of the lack of coming of age experiences concept in developmental psychology. It has been used to explain everything from sports addictions to problems in male bonding, to gang membership, to radical political views, and I really think all of that is overblown. The fact is, that in a modern, scientifically based society, there is no place for any sort of universal, coming-of-age experience, and that is mostly a good thing. People are allowed to be themselves in modern society, rather than having to conform to a rigid set of behavioral standards and beliefs.

I am not sure what your point about the shooting is, but maybe these anarchic types are also seeking some form of male bonding and coming of age involvement in such acts, although I wouldn't put too much stock in that.

nimblecivet 8 years 30 weeks ago

Unfortunately I don't have a lot of actual information. As with a lot of things all I have is general impressions that I've somehow been left with. Although I try to examine information I come across as critically as possible, usually I am, as in this case, unable to provide specific references. If your mother is talking about a nursing home I would have to guess that it's because your father's health insurance (if any) won't cover an extended stay. The hospital in that case would want to refer him to a nursing home because that's usually the only option for a person who is relying on Medicare/Medicaid. Of course, that doesn't mean that your father would have to stay in the nursing home indefinitely, but you might want to look into finding a nurse practitioner to visit him while he's there and makes sure he gets the treatment he needs to get well as soon as possible. There are hotels that set up near outpatient clinics and hospitals. Most of these places from what I gather are occupied by those struggling with cancer, but you might be able to find an outpatient clinic that can handle your father's problem. But I don't know what the comparison would be price-wise between a hotel and a convalescent hospital. I would guess though that the latter would actually be more expensive out-of-pocket, but I would think it unlikely (though not impossible) that Medicare/Medicaid would pay for a hotel room; at least for an extended period. Medicare/Medicaid might pay for BOTH the convalescent hospital and outpatient clinic treatement, so that might be a good thing to find out: if it's an either/or thing that's when paying for a hotel might be worth it if it means that your father can get the treatment he needs from a clinic. So I guess from my limited knowledge of the situation and these things that this might be the crux of the matter, whether what you are able to spend out of pocket is better applied to a nurse practitioner to visit your father in a convalescent home or whether there's an outpatient clinic that can provide him treatement that you will be able to afford him access to, depending on what your insurance/Medicare/Medicaid will pay for. Gets complicated doesn't it? I don't look forward to when my father gets old; my brother dealt with it when my mother fell ill with pancreatic cancer. She died in an Italian hospital. I don't know the details, I can only hope the pain-killing treatements were effective.

Yes, I wouldn't put too much stock in any theory like a "coming of age" theory. That one especially reeks of ideological bias; I was even going to mention that I don't like Hoffer on the basis of the fact that Ronald Reagan did. So I certainly wouldn't offer a "coming of age" paradigm up as the basis of a prescriptive remedy for society's ills. But I do think at this point in our social evolution that those types of ideas are a potent force in our culture. Not necessarilly so much "coming of age" in and of itself but a proving of oneself as identifying with a category of "successful" or "not"; this is something that is determined I think for most people relatively early in life.

Natural Lefty's picture
Natural Lefty 8 years 30 weeks ago

Sorry to hear about your mother. My best friend in graduate school, Steve's mother died of pancreatic cancer around the time we were in graduate school, and it was horrible.

My parents actually have good, but expensive, health insurance. My mother said they didn't have to pay anything for the hospitalization, but she thinks they will have to pay something for the convalescent center. I think it's actually in the same place where my father was 2 years ago with anxiety issues, and he has been going there 3 times per week for group therapy ever since, so I think he prefers to be there. We tried to call my father yesterday, but nobody answered. We called my mother, and she said she had talked to my father yesterday and he was doing okay.

Yes, our system is very complicated, and expensive, and I think with all the wheeling and dealing that goes on in our culture, it reaches a point where it becomes burdensome for people to become informed consumers, and they probably end up paying more than they have to.

I think that "coming of age" issues or "rites of passage" are important to certain people, not others. For example, I think macho young guys (as in your example) tend to need rites of passage more than other people. Sadly, for some, this can mean going off to war, or joining a gang and assaulting or even killing someone. How do we as a society counteract this need? Socializing young males to be respectful, love women (not just sexually), and not macho types is my best guess. Norway has been doing a pretty good job of this, but now this right-wing nut popped up and wreaked havoc on some of its brightest people. My guess is that Norway will recover well from this incident and become even more committed to liberal values and to counteracting these right-wing, monocultural nuts.

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