For well you know that it's a fool who plays it cool
By making his world a little colder.
Polonius: My lord, I will use them according to their desert.
Hamlet: God's bodkin man, much better. Use every man after his desert, and who shall scape whipping?
1. Nassir Ghaemi, M.D. has another thoughtful post on his Psychology Today blog about psychiatry's financial and pharmaceutical imbroglio. As he argues, it is impossible to expel drug companies from psychiatric research and education altogether; too much of value would be lost. Rather, analogous to Wall Street overreach in general, what is needed is much stricter regulation, oversight, and cultural change.
He contends that individual psychiatrists and patients ought to reform themselves by resorting to drugs only for clear-cut "diseases" and not for vague symptom management. It sounds great; the problem is the persistent ambiguity of psychiatric diagnosis. So long as mental disorders are not natural kinds but have elastic boundaries shading into normality, the inclination to use more medication rather than less will persist. Psychiatry has always had an identity problem inasmuch as there is no lasting social consensus about what psychiatrists should be doing. This is due to lingering scientific and philosophical confusion that doesn't appear likely to be settled to general satisfaction anytime soon.
2. The New York Times has an intriguing article today about self-handicapping, or engaging in self-defeating behavior in the interest of maintaining self-esteem. This is obviously usually unconsciously motivated; an academic example would be skipping class or failing to study for an exam so that, if or when failure occurs, one can explicitly or implicitly have the consolation, "It's not as if I really tried."
This is a fascinating process because it rings so true and yet feels so, well, self-defeating. As the article notes, this kind of behavior "works" well in the short term (with respect to maintaining self-image) but not so much in the long term, when routine practitioners come to be viewed as whiners and slackers. And yet we seem to know people who undertake this strategy not merely as regards specific tasks, but also with major life projects. If one sabotages significant relationships or careers, one escapes ever "really" being tested.
If, as seems unlikely, one wins out despite apparent attempts at self-defeat, then things look great. Actually, one of the evolutionary hypotheses for substance abuse frames such behavior as an attempt to demonstrate one's fitness despite evident impairment. Just as a peacock sends the message, "Look how tough I must be if I can pour this much energy into a glorious tail," risky intoxication sends the message, "Look how tough I must be if I can get things done despite being falling down drunk half the time." Both phenomena are extreme versions of showing off, in unconscious and evolutionary senses. Like much of evolutionary psychology, this substance abuse hypothesis may not be true, but it's interesting nonetheless.
How would one go about managing self-defeating behavior?. Life entails risk and the possibility of failure; there is no getting around that. But the self-defeatist arguably does what he does either because his self-esteem is too fragile for either modest failures or because, due to narcissistic inclinations, he consistently attempts tasks beyond his ability. The process would involve fortification of self-esteem with supported and gradual exposure to appropriate risk. Then--carpe diem. As always, this is a "day" easier talked about than "seized."