Archive for the 'Sacred Cow dart board' Category

The informed shrug

May 1, 2018

In thinking ahead to CIMSA 2018, I have had to do a little soul-searching as a scientist. My first thought was, “holy ***! my deliverables aren’t ready yet, and it’s coming up fast!” My new thought is: “Whoa, dammit. Those deliverables won’t be ready any time soon. Why don’t you plan on going there to listen and learn?”


Because all I have is a desk review in progress: an incomplete annotated bibliography, a time-consuming search strategy, and some hunches that have yet to be substantiated. And when I finish, all I’ll have is one of dozens of new systematic reviews that get published EVERY DAY. Far more than these stakeholders have time to read and learn from. From the evidence landscape maps I glimpsed on the Africa Evidence 2018 website (which appears to have moved and left them behind, sadly), I gained a greater appreciation of the distance between the publication process and the implementation of evidence-informed decision-making in public health practice, and the potential for connectivity between these two fields of activity.

From a conference like CIMSA, I hope to learn more about how these decision-makers set their expectations for evidence reviews, what types of evidence they are looking for, how they hope to find it packaged, and how they go about sifting through the available evidence in their day-to-day routines.

One thing is for sure, I don’t want to be like the other guys. I don’t want my exhaustive efforts to synthesize the available evidence to end in an “informed shrug”. I see too many Cochrane reviews end like this: “Having reviewed 100 papers, we found 2 that were almost good enough to take seriously. Neither was conclusive. We hope that more research will be forthcoming in this area. Thank you.”

That’s not helpful. You don’t seriously expect me to believe that after reading 100 papers in a given discipline, you learned nothing useful that could inform the design of these wished-for additional studies, do you? Don’t just tell me they should’ve used blinding and randomized designs. Tell me what they thought they learned, too.

Use your best judgment – if they lied in the abstract about the effectiveness of the intervention, I don’t need you to repeat that sort of nonsense. But if they noticed contextual variables that were frustrating their implementation of the intervention and that may have contributed to its lack of effectiveness, by all means bring that data to light in your review! In other words, show me that you were actually paying attention when you read the papers, not just skipping to the results sections after glancing at the methods.

Anger as food and the gods

March 5, 2018

After a long hiatus, I am hoping to get back to blogging regularly again. I’ll start with one of Martha Nussbaum’s newer titles in philosophy, Anger and Forgiveness. I haven’t finished it yet, but here I only need to discuss the first few chapters.

Why am I reading about anger? I distinguish my favorite actresses from the pack on this criterion more than any other, for their facility with anger in performance. Qorianka Kilcher in Shouting Secrets, Elizabeth Banks in The Next Three Days, Vanessa Redgrave in Coriolanus, Cate Blanchett in Elizabeth.

Why not some other strength? Perhaps because this one is so unusual in a woman. Not in real life, certainly, but in a screen acting career.


In the director’s commentary track to Coriolanus, Ralph Fiennes is right to congratulate himself on casting Vanessa Redgrave in spite of her initial reservations about taking on the wronged mother’s role. Hers is the most explicit and profound line in the play:

“Anger’s my meat; I sup upon myself,
And so shall starve with feeding.”

Screenwriters often deny actresses access to much anger, especially when they have an ‘opposite number’ to adorn with their presence. Going straight to the heart of an outburst with convincing aggression, and making that move compelling without stripping it of ugliness, is rare. My Week with Marilyn builds up a vivid image of the alternative career track – an inwardly-collapsing vortex of vapid smiles enervated by wispy flights of fancy, all coif and no claws. What would capture my imagination, in contrast, would be to see Seneca’s Medea, quoted in the act of thrusting her children over the ledge (by Martha Nussbaum): “Do you acknowledge your wife?”

But is anger nourishing? Nussbaum finds it intrinsically unhealthy. Why then is it such a mark of distinction in a woman’s theatrical career, in my eyes?

Nussbaum deploys such vivid imagery sparingly in her treatise. She quickly puts to grass the daemons with whom she introduces her book, the “hideous” ancient Greek Furies who hounded survivors of blood feuds as tenaciously as Hamlet‘s Ghost, exhorting an infinitely reciprocal accounting in blood – revenge, always revenge. But her conceptual exposition of anger, its flaws, and their refractory reproduction in the scaffolding of conventional wisdom on forgiveness is compelling and of practical importance.

Giving anger’s definition in terms of the content of the experience, Nussbaum refers us to Aristotle and decomposes his definition as follows:

  • Anger is at a slighting or down-ranking (e.g., by injury or insult)
  • Of the self, people close to the self, or one’s “circle of concern” (no indifference)
  • Wrongfully done (as opposed to an innocent accident)
  • Causing the agent pain (whether direct or sympathetic, physical or psychic)
  • Involving a payback wish (“retribution”)

She argues eloquently that this final criterion of what makes an emotion an angry one necessitates a philosophical rejection of anger – explaining that except in a status-obsessed world in which reversing an upset in pecking order is the be-all end-all of existence, this payback fantasy is worthless, as it does nothing to alleviate the pain or right the wrong or undo the past or improve the future prospects of one’s circle of concern.

She then ties this preoccupation with status, account-keeping and retribution into the formulaic “dance of forgiveness” extracted by the injured party, drawing on a rich handling of the Judeo-Christian confessional tradition for an etiology of the conventions we see in self-help books today for victims learning how to move through their anger. She moves on to deal extensively with one of my mother’s favorite books, The Dance of Anger, sympathetically and critically examining the therapeutic process in working with dyads where anger has become entrenched.

Ultimately, Nussbaum puts forward a radical rejection of both anger and forgiveness, even unconditional forgiveness, in favor of “unconditional love”. There is a problem here, however. Anger is incident-oriented, whereas love is person-oriented.

Nussbaum spends the second half of the book, which still lies ahead, elaborating on social justice applications of an alternative to anger which she terms the Transition, and defines as the forward-looking but incident-provoked emotional reaction going as follows: “How outrageous! Something should be done about that.”

In this way, she acknowledges the signal value and social fecundity of moral outrage, which she foreshadows in her introduction with a vignette about how the Greek gods domesticated the furies. Quoting Aeschylus, she describes how Athena strips these daemons of their hideousness, denies them access to human flesh and physically buries them under the foundations of the city, as so much fertilizer for the civil courts and political justice system.

This brings to mind Cavafy’s Growing Strong:

“He who wishes to strengthen his spirit,
must abandon reverence and submission. …
He will not fear the destructive act;
half the house must be torn down.”

Indeed, in an interview about portraying a serial killer taken by Alix Lambert for the anthology Crime, actor Michael Rooker is quite explicit about the connection between violent aggression and flourishing:

“With Henry, I saw it as nourishment. He’d see someone he’d like to consume and he’d go and take them and do what he wanted. He needed to nourish his spirit. His spirit, of course, was this flawed worm-in-the-brain kind of guy. When he was hungry, he ate. I love food, so it was a perfect handle to hook onto.”

Is this orality, the love-hate of infantile narcissism? Schizophrenia expert R.D. Laing emphasizes how preternaturally quiet in infancy his patients were, in contrast to a more well-adjusted infant’s “lusty crying” for the absent breast. Can infantile aggression, then, be a needful launching pad for some future psycho-social adjustment process?

I don’t have the answers here, but I want to close with a vignette from Richard Grant’s magnificent Sierra Madre travelogue, God’s Middle Finger. His early predecessor in the Sierra Madre travelogue genre, the Norwegian explorer Carl Lumholz, had also survived adventures sojourning with the cannibals of Queensland, and I will quote Grant at length in summarizing his disposition towards the natives.

“”What a misfortune it would be to die without having seen the whole world,” he wrote as a young man, shortly after dropping out of seminary school… In 1880, at the age of twenty-nine, he sailed to Australia to collect zoological specimens for the University of Chiristiania in Oslo and begin his self-appointed studies as a field ethnographer. He ended up spending four years in the Australian bush, one of them with a group of aboriginal cannibals … Mostly they preyed on other cannibal tribes, killing and eating men, women, and children alike. White people didn’t taste as good, they said, but the Chinese were delicious.

“Lumholz plied them with tobacco, for which they would do anything, and kept them in constant fear of his revolver. At first he was disgusted by their taste for human flesh and finally irritated because they talked about it so much.”

I like that account of Norwegian table manners at a cannibal convention.



“Pervy blin narkomom”

August 14, 2016

This summer I tackled my first real history book – real in the sense of first-class scholarship drawing directly on primary sources. The topic was 1930s Soviet industrialization, and the author is Stephen Kotkin. I chose Magnetic Mountain: Stalinism as a Civilization, the second of his books on Magnitogorsk, a large planned Soviet-era industrial and mining town. His first book deals with its more recent history, and I may read that one too, or one of his other titles about Russian history in the transition and post-Communist eras.

His research questions, in studying primary sources, included these: What was Russian about Stalinism, what was inevitable (inherent in the project of governance under communism), and what was idiosyncratic about it? This book is especially interesting in light of Putin’s heavy-handed efforts to rehabilitate Stalin, which can best be understood as reactionary conservatism, an attempt to reverse the demoralizing effects hindsight had on the Russian people during the late Communist era of de-Stalinisation, when so many skeletons were taken out of the closets to be buried.

I was largely unprepared for what I learned from this book, having always associated Russian Communism with American Socialism and the progressive movement. Maybe I shouldn’t have taken the movie Reds at face value. Socialists and other progressives were persecuted violently under Stalinism, as were any officials who questioned the official line, not to speak of rank-and-file Party members. And I was completely surprised to learn that Party membership was far from universal in Communist Russia. Apparently the Communist Party itself was made up of a highly selective new ruling elite – membership was tightly restricted, and yet at times during the Party’s history, Party members were the first to feel the brunt of a violent purge.

Kotkin paints a vivid portrait of everyday life for both workers and officials under Stalin, and the picture of a society in turmoil is engrossing. He documents ordinary workers’ adoption of communist values in everyday life as well as their grumblings, some violently suppressed and others blithely noted in passing by the keepers of official records. One witnesses rapidly rising expectations in terms of standard of living, and a glaring gap between these utopian promises and the reality on the ground. The lightning-speed eradication of illiteracy in the early years of Communism is documented alongside the extreme cultural paucity of the radical censorship regime. Promises to meet every citizen’s material needs are juxtaposed with images of famine, sometimes episodic and sometimes prolonged, but never equally distributed across the population.


It becomes difficult to see Stalinism as a civilization when it seems that everything we associate with civilization today was banned under Stalinism, with the notable exception of jazz (which was always considered suspiciously bourgeois, but never quite fell out of favor with the ruling elite). But Kotkin convincingly attributes a sense of ownership of the revolutionary project to the Russian people in this era, and a deep sense of popular commitment to the goals of rapid industrialization, however traumatic the pace.  As a sense-making project, the book is definitely a success.

Perhaps the most valuable lessons to be learned from this book are the lessons of the purges within the Communist Party – while the author barely describes the purges of non-Party members, which were in fact far more extensive. Very likely this bias reflects a bias within the official record, with far more evidence available from which to describe the Party purges vividly. Kotkin recognizes the “housekeeping” rationale of the iterative bloodbaths alongside the vicious cycle of recriminations and careerist incriminations fostered by Stalin’s murderous directive that the Party engage in “self-criticism”, a byword which survived as a tenet of Party ideology even into the Khrushchev thaw.

If there had been any “housekeeping” agenda at work in the purges, it was a desperate and double-dealing project from the outset. Take the example of an official “purged” for engaging in illegal trade with state resources in order to finance his mandated quota of services and goods provided. His motive was simple: he had orders to deliver, and no budget with which to work. And had he not found ways to meet his quota, very likely he would have been “purged” for nonperformance.

The vulnerability of the Communist elite can be explained by the redundancies built into the Russian government under Communism: there were two chains of command, the state pyramid and the Party pyramid. Every organ of the state thus operated under two chains of command, the ordinary one and the Party one, which was to serve as an ideological watchdog and which was liable for the successes and failures of its counterpart. Hence the redundant Party bosses could easily be painted as self-serving leeches on the system, if any flaw could be found in their performance.

The first to be purged were the ideological non-conformists, lumped indiscriminately under the banner of Trotskyists. Later purges associated their victims with the fascist threat from abroad, and accused officials lagging in industrial performance (or guilty of ruining their equipment in an overeager attempt to exceed its production capacity to meet official targets) of sabotage and espionage in one breath. Kotkin illuminates an enduring level of xenophobia and ignorance of the outside world that could explain how some officials were purged simply for having foreign-sounding names.

Yesterday I discovered an anecdote about Shostakovich and his Symphony No. 5 that illuminates the era of the Great Purge nicely. The symphony was written while the composer (living in Russia) had fallen into disfavor, in the late 1930s. His opera Lady Macbeth had been a great success until the day Stalin came to see it, but the composer was “white as a sheet” by the end of the performance. Stalin had laughed during an explicit sex scene and had later walked out. The next day Pravda carried a scathing editorial about the opera, and not until Symphony No. 5 brought the audience to their feet with tears in their eyes was Shostakovich restored in stature. You can judge for yourself what the symphony is about.

The Russian proverb I used as the title of this blog entry appears untranslated as an epigraph to Kotkin’s last chapter, and he says it is untranslatable. But I was able to find the source:

“‘How was that as a first try?’ asked Trotsky. [Vladimir] Mayakovsky answered with a devastating pun: ‘The first pancake falls like a People’s Commissar’ (pervy blin lyog narkomom), a play on the saying ‘the first pancake falls like a lump.’”

This and other gems make Kotkin’s description of the “little tactics of the habitat” under Stalinism a real page-turner, and I am looking forward to checking out more of his work. But for now I am chewing through Khrushchev’s memoirs, the first half of which are profoundly depressing in this context. Over and over again he shares anecdotes about directives from Stalin that he carried out against his own better judgment for fear of the consequences of gainsaying the boss. I’ve made it up to the point of Stalin’s death now, and I’m hoping the second half of the book will show up the author’s engaging personality more fully, out from under the shadow of pervasive sycophancy in an environment of totalitarianism.

Culture lag and family violence

July 6, 2014

If she were in treatment for her behavioral problems, my mother would probably be diagnosed with Borderline Personality Disorder. Her extreme reactions to perceived abandonment, her tendency to idealize or devalue those closest to her in black and white terms, her intense and mercurial mood swings and her propensity for violence all fit the clinical profile.

David Mallen writes about the intergenerational relationship problems that give rise to Borderline Personality Disorder on his blog about psychoanalysis, focusing on a concept called culture lag. This concept has to do with social transitions and regressive attitudes toward institutional change that hold some families back from the benefits of social progress.

In mapping the family trees of patients, he says, “one can often see just how far a family’s operating rules lag behind the current cultural norms. In anthropology, this problem is called cultural lag. The cultural progression in Western nations, which is mimicked within certain families, was thus: First, women really could not have careers at all. Then, they could have careers, but only when they were single. Then – and here is where many families with BPD members are stuck – they could only have careers when they had not yet had children. Then, they could have careers even if married with children, but they had to give priority to the husband’s career. Last, both men and women were entitled to the same freedom.”


Women of my mother’s generation, the baby boomers, had conflicted role models in their mothers – women who may have enjoyed careers during World War II, only to give that economic independence up again when their husbands returned home. Social pressure, the soft power exerted by men, was what brought them back into domestic roles.

Institutional change would shape the options of their daughters, with the advent of affordable hormonal contraception and, in 1988, divorce law reforms that made pursuing child support payments from absent fathers more feasible for single mothers. This had a profound effect on my childhood, since my father resisted child support payments but was ultimately compelled to make a meaningful contribution to our household expenses.

Whether her mother resented the care-giver role imposed on her generation or not, it’s clear my mother developed a love-hate relationship with the responsibilities of a single parent. She idealized her own power over me but expressed great bitterness about the financial sacrifices and time that parenting errands took from her other interests. The unpaid work of childrearing was all hers by default, a situation described in Affective Inequalities as a vacuum left to be filled largely by women in a market economy that places little socioeconomic value on “love labors”.

She had supported my father through graduate school, lost her second marriage while I was still a small child, and in the bargain she had somehow lost the right to pursue her own happiness – time no longer allowed for the self-indulgent. Everything that had mattered to her as a young adult – adventure, travel, culture, friends – took a backseat towards the doubled care-giving work of a career schoolteacher with a child at home.


The social obligations of care-giving roles fall out in an informal economy unregulated by contract law, where trading sex for instrumental support is still sanctioned and redress for cohabiting relationship violence is in conflict with housing insecurity problems on the part of dependent victims. Here culture lag is in full force, warping the social expectations and identity-forming experiences of parents and children alike.

The socially regressive tilt of the informal economy is formalized in a victim-blaming theory of domestic violence that posits “make-up sex” as the pivotal phase in a domestic violence cycle explaining why victimization is so often chronic – putting “gifts” in the fine print of the “kiss and make-up” phase of the cycle to trivialize the role of poverty in victimization. The prerogatives of homeowners to terrorize their dependents are institutionalized in the stigma this theory assigns to victims of intimate partner violence.

Neoliberalism’s patent indifference toward the needs of those who lack spending power of their own has sealed a glass ceiling over social progress in this respect. Parents can be pressed into sweatshop labor to keep up with the needs of their children, and oversight of their childrearing capabilities is scant. Those who don’t cope well with the stress have a free hand with their dependents, and are rarely penalized for taking their frustrations out on their children.


Gender theory could enrich the analysis of domestic violence and child abuse by getting past the gendered role expectations of the “domestic violence cycle” and seeing every participant in family violence as a potential aggressor. A female victim of child abuse can internalize attitudes toward violence that lead her to lash out in turn herself, and dependency relationships needn’t be heterosexual partnerships to take on dyadic chronic violence dynamics.

Queering the domestic violence cycle would shed light on these more diverse potentials for abuse and family violence. Queer theory treats identity as fluid and culturally produced rather than innate and static, and regards gendered roles as options rather than birthrights.

Abstracting the heterosexual dyadic stereotypes in domestic violence theory from the analytical frame and treating them as an artifact of cultural production foregrounds the ritual element to interpersonal violence, the sense in which violent incidents are all role playing games and BDSM themes are the scripts ordinary people avail themselves of during threat displays and mind games with their habitual victims.

Moving away from the subjective and into object relations theory, the socially constructed identities and entanglements of participants in family violence can be seen as market-mediated processes of individuation and transformation. Relationships with dependents, understood within the analytical frameworks of consumerism and adculture, unfold as status commodity spending patterns that are unstable precisely because the cash involved is fungible and every expense imposes a perceived opportunity cost.

The objectification of dependents and the sexualization of commodity display culture can imbue any relationship with the energies of frustrated libido, curbed by the same normative cues as aggression and hence prone to simultaneous, explosive release when the curb is relaxed (behind closed doors).

Hence the prerogative of fathers to rape their daughters, as if any sex object presumptuous enough to invite itself in were available to the homeowner’s consumption privileges. The logic is not much different from date rape, when the car is substituted for the house as the unit of personal space within which all guests are at the owner’s disposal. Fuzzy thinking’s mixed metaphors for everyday life blur getting in with giving consent, and even victims may second-guess whether or not such an assault counts as rape.


The problem-solving logics of governance and trade fail to make sense of love relations, which are predicated on tolerating tension even when it threatens to enmesh the individual with multiple commitments in the contrary experience of cognitive dissonance. Ambivalence about the limits of personal responsibility arises near those limits, and cannot be totalizing, or love does not hold sway.

But market pressures and hegemonic traditions shape love relations intimately, through the cultural contingencies that give rise to intimate relationships. The prerogatives of the informal expectations don’t just shape vulnerabilities, they also shape desires. A domestic violence theory that focuses on the failure to leave on the part of victims is one that fails to ask important questions about why aggressors initiate acts of abuse.

Love labors demand a profoundly forgiving attitude towards the burdens we impose on one another as care-giving needs. Joanna North explores the concept of forgiveness in detail: “What is annulled in the act of forgiveness is not the crime itself but the distorting effect that this wrong has upon one’s relations with the wrongdoer and perhaps with others.” A domestic violence cycle that lacks heterosexual stereotypes about role expectations would explain the chronic nature of cohabiting relationship violence in terms of conflict-resolution failure, the impossibility of forgiveness, and its distorting effects on the relationships between breadwinners and their dependents.

  • Forgiveness begins with introspection.
    • What was the nature of my mistake?
    • What are my beliefs about the mistake?
    • What emotions did I experience in the aftermath of the mistake?
    • How did I cope with the mistake?
    • What changes did I make in my practice as a result of the mistake?
  • The structure of a situation open to forgiveness requires reciprocation.
    • Forgiveness for the forgiver has three levels:
      • Cognitive: “I will stop thinking about the offense.”
      • Emotive: “I will cease to feel anger and hatred toward the offender.”
      • Behavioral: “I will not seek revenge.”
    • Remorse for the forgiven also has three levels:
      • Cognitive: “I will acknowledge and admit my wrongdoing.”
      • Emotive: “I will feel and express sorrow for what I did.”
      • Behavioral: “I will desist from committing that wrong again and make amends.”

An enduring sense of grievance and an attitude of hypocrisy towards conflict-defusing phases in the cycle of violence characterizes any abusive relationship, and as role expectations adapt to habitual conflict, leaning into the perceived injustice instead of attempting to resolve the cognitive dissonance of unresolved tension would become part of the identity-formation experiences of the participants.

An embodied sense of justice is like the aesthetic instinct, it respects harmony in appearances as an immediate goal, working with the available materials and their surface presentations to seek a resolution to dissonance. Hardening a position in response to tension is one way of coping with disruption in everyday life, and giving up on a relationship that isn’t going away is a real option in the ebb and flow of the intimate and mundane.

Ways of escape that are superficial are myriad, and escapist coping mechanisms allay the more brutal fears of exposure to the elements and the vicissitudes of strangers that represent the more practical barriers to freedom from abuse. The degree to which abusers also dissociate from the here and now, sustaining a fantasy about life with which reality can never compete and attacking scapegoats for their disappointments, makes the abusive home a plane on which the minds of the inhabitants rarely meet, finding each other confusing and untrustworthy at every turn.

If culture lag explains this stalemate, the time warp governing the informal economy reflects real shortcomings in institutional reform to protect vulnerable populations like women and children. Only further radical reform like universal basic income would redress the pressures neoliberalism brings to bear on affective inequalities, taking housing insecurity out of the equation.