I know online it seems that people don't change their ideas … but our ideas can change quite quickly. And so to cancel people for tweets that they made years ago, potentially even things that they said last week, I think is just to lie to yourself. It lacks a certain self-examination that I think is crucial.
If everybody was to act as though they've never said something homophobic, especially if you've ever grown up in a strongly religious family, I think you could be telling porkies [lies].
We talk so much about mental health and how important it is, and how we have to remember that mental health is just as important as physical health. And then to discard people at the first sign of something we dislike — the two don't marry very well to me.
We undermine how easy it is for us to become the people that we dislike. With a different circumstance, a different upbringing, a different culture, how I could easily become a lot of the things that I dislike or find harmful.… I'm much more interested in the root causes as opposed to the symptoms.…
We should always remember that just because something is popular doesn't make it good.… Sometimes popularity is just a measure of how much people aren't thinking. If your advocacy or activism is motivated by the fear of being canceled, then you will adopt the popular belief. Mob culture is very terrifying. But … if you are committed to trying to make the world a better place, or your community a better place … you have to be prepared to think for yourself.
1994 was a great year for me because that's when I started really discovering and learning to play music, around age 13. And 25 years ago today, March 8, 1994, was a great day for music, because that's when Soundgarden released Superunknown, and Nine Inch Nails released The Downward Spiral.
These weren't just some of the better records by a couple heavy, alternative bands of the mid-'90s. They were that, but they were something more. Listening to them now brings us back to a time when a rock band could be massively successful while daring to break out of formulas and challenge listeners.
Here are 5 highlights from each album.
"Spoonman" is the first Soundgarden song I ever heard, so to me it will always feel like the essence of Soundgarden and the starting point for the band, even though it was the 8th song on their 4th album. I love the jarring juxtapositions of different keys and time signatures.
The song was about a California- and Seattle-based street performer, Artis the Spoonman, who’s seen and heard performing in the video. He’s the only person we see in motion; the band members are shown only in photos.
It's more about the paradox of who he is and what people perceive him as. He's a street musician, but when he's playing on the street, he is given a value and judged completely wrong by someone else. They think he's a street person, or he's doing this because he can't hold down a regular job. They put him a few pegs down on the social ladder because of how they perceive someone who dresses differently. The lyrics express the sentiment that I much more easily identify with someone like Artis than I would watch him play. . . .
I think we were fairly smart with "Spoonman" in that you really don't see us that much in the video. You see various pictures of us, but it's not quite the same as having us in your living room all the time. We're trying to maintain some degree of mystique about Soundgarden, I guess. I remember back when I was a kid, long before MTV, and the only way to see my favorite bands was to go to their concerts. It was an incredible experience. MTV has helped a lot of bands, but they've also helped rob a lot of groups of that special mystique. It's tough when you can see a great rock band on TV one second, then hit the clicker and be watching a soap opera or a sitcom the next. That's what rock and roll has become for some people.
"Fell on Black Days" seems to peel off the heavy outer surface of Soundgarden and reveal something more contemplative underneath. After Chris Cornell died at age 52, it was hard to hear him sing, over and over again: "How would I know that this would be my fate?"
Within one week after Chris Cornell's death in 2017, I listened to Soundgarden's last 4 albums straight through, then listed my 20 favorite Soundgarden songs. I wrote:
I . . . felt overwhelmed by the ocean of extraordinary material — relentlessly innovative and challenging, often jagged and angular, mostly heavy and dark, occasionally with gentle or bright spots, but never tranquil, always disturbed and searching for something better.
I ranked "The Day I Tried to Live" their #2 song, and their best from Superunknown. Cornell explained what he meant by the song:
It's about trying to step out of being patterned and closed off and reclusive, which I've always had a problem with. It's about attempting to be normal and just go out and be around other people and hang out. I have a tendency to sometimes be pretty closed off and not see people for long periods of time and not call anyone. It's actually, in a way, a hopeful song. Especially the lines "One more time around/Might do it," which is basically saying, "I tried today to understand and belong and get along with other people, and I failed, but I'll probably try again tomorrow." A lot of people misinterpreted that song as a suicide-note song. Taking the word "live" too literally. "The Day I Tried to Live" means more like the day I actually tried to open up myself and experience everything that's going on around me as opposed to blowing it all off and hiding in a cave.
"Black Hole Sun" is by far the band's best-known song, which can make it hard to listen to with fresh ears. The song has a clear Beatles influence: the verse sounds like the chords could have been written by Paul McCartney and the vocal melody by John Lennon. Soundgarden's lead guitarist, Kim Thayil, once said:
We looked deep down inside the very core of our souls and there was a little Ringo sitting there. Oh sure, we like telling people it's John Lennon or George Harrison; but when you really look deep inside of Soundgarden, there's a little Ringo wanting to get out.
"Head Down" (written by the bassist, Ben Sheperd) is an engimatic departure from the usual hard rock of Soundgarden. Acoustic and electric guitars, bass, and drums intermingle in delightfully unexpected ways.
After Nine Inch Nails debuted in 1989 with the relatively accessible Pretty Hate Machine, then put out a sledgehammer of a record with the Broken EP in 1992, The Downward Spiral was a relevatory merging of the poppier and heavier elements of NIN, with a more exquisitely pieced-together production. The concept album about a suicidal man starts out with the hard-driving "Mr. Self Destruct," sounding not far from Broken. But then the second song, "Piggy," lets us know this is not just another Broken. The eerie synth tones floating over a cool-jazz rhythm section, providing the incongruous backdrop for the singer's obsessing over how "nothing can stop me now," sound like nothing we had ever heard before from NIN.
NIN is virtually a one-man band consisting of Trent Reznor in the studio, but the frenetic drums that disrupt the jazz vibe of "Piggy" are the only time he played real drums on the record. A different drummer gives an amazing performance of the song in this live video.
"March of the Pigs" is so heavy you might not notice that most of the heavy parts are in 7/8 time (so you can steadily count to 7 and keep following the beat — except when he throws in an extra beat). The heaviness subsides into a rare moment of brightness on this otherwise bleak album: "And doesn't it make you feel better? . . . And everything is all right."
"Closer" is probably the most famous NIN song, even though one of the main words in the chorus had to be muted when it was played on the radio. (Here's the unedited version of the video — I can't embed it on the blog because it has fleeting artistic nudity.)
"The Becoming" uses disturbing noises to evoke "this noise inside my head."
The 13th song, "The Downward Spiral," describes the suicide. Then the album comes to a close with the slow, stark "Hurt," a song of staggering emotion. The most often quoted lyrics are probably the first lines, about self-harm. I prefer to focus on the hopeful last verse, where the singer (the ghost of the man who just killed himself?) looks back at his life:
If I could start again
A million miles away
I will keep myself
I would find a way
And wow, the combination of music and video on that last line . . . !
I remember having a conversation with two friends of mine who were both big NIN fans, and one of them commented that NIN is so depressing. The other friend and I immediately and almost in unison responded that we don't feel depressed at all listening to NIN. Precisely because Trent Reznor is working through so many negative feelings so intensely, his music can be profoundly energizing in a way that can make cheerful music seem beside the point. ("And doesn't it make you feel better?")
In my post on my favorite Soundgarden songs, I quoted Chris Cornell expressing a similar sentiment: "I’ve always liked depressing music because a lot of times listening to it when you’re down can actually make you feel less depressed." I'm sorry he couldn't find that kind of uplift on the terrible night when he killed himself right after Soundgarden played its last concert.
But I'm glad NIN is "still right here," playing famously great live shows after a remarkable 30 years, keeping some of the most strangely beautiful music of 1994 alive.
Our message to men: Admit your toxic masculinity, and start having a conversation about how men can improve themselves!
Our message to white people: Admit your racism and privilege, and start having an honest conversation about race — however difficult and uncomfortable that might be!
Our message to people with mental illness: We need to remove the stigma so you can talk openly about your mental health!
Our message to a white man who publicly admits to the time he was so racist and mentally unwell that he wanted to kill a black man just for being a black man, then realized the error of his ways and made an effort to improve himself: Stop talking about that! You're not allowed to say that in public!
The Oregon shooting is a tragic reminder that the laws on the books are woefully inadequate.
The article says:
The National Alliance on Mental Illness and the Substance Abuse and Mental Health Administration caution against creating special laws aimed at the mentally ill, including laws related to gun violence. SAMHSA indicated that subjecting the mentally ill to extra scrutiny perpetuates the misconception that the mentally ill are especially violent. This stigma, mental health professionals warn, increases the tendency of the mentally ill to avoid treatment and counseling. Though this is a valid concern, the safety of the public must be weighed against it.
But if that's a "valid concern" weighing against barring the mentally ill from owning guns, how are current laws "insane," as the headline says? If there were a law saying no one who's been diagnosed with a mental illness (or any mental illness out of a certain list) can own a gun, wouldn't this predictably cause many people who want to own guns to avoid getting any mental-health treatment? And if mental illness is so strongly linked to mass shootings, then couldn't discouraging gun enthusiasts from getting treatment lead to an increase in mass shootings?
Oliver Sacks, the neurologist and writer, has died of cancer at 82.
Here's the New York Times obit. (A video about Sacks will automatically start playing when you click the link. I've removed links from this block quote, and added some links.)
Oliver Sacks, the neurologist and acclaimed author who explored some of the brain’s strangest pathways in best-selling case histories like “The Man Who Mistook His Wife for a Hat,” using his patients’ disorders as starting points for eloquent meditations on consciousness and the human condition, died Sunday at his home in New York City. . . .
Dr. Sacks announced in February, in an Op-Ed essay in The New York Times, that an earlier melanoma in his eye had spread to his liver and that he was in the late stages of terminal cancer.
As a medical doctor and a writer, Dr. Sacks achieved a level of popular renown rare among scientists. More than a million copies of his books are in print in the United States, his work was adapted for film and stage, and he received about 10,000 letters a year. (“I invariably reply to people under 10, over 90 or in prison,” he once said.)
Dr. Sacks variously described his books and essays as case histories, pathographies, clinical tales or “neurological novels.” His subjects included Madeleine J., a blind woman who perceived her hands only as useless “lumps of dough”; Jimmie G., a submarine radio operator whose amnesia stranded him for more than three decades in 1945; and Dr. P. — the man who mistook his wife for a hat — whose brain lost the ability to decipher what his eyes were seeing.
Describing his patients’ struggles and sometimes uncanny gifts, Dr. Sacks helped introduce syndromes like Tourette’s or Asperger’s to a general audience. But he illuminated their characters as much as their conditions; he humanized and demystified them. . . .
“I had always liked to see myself as a naturalist or explorer,” Dr. Sacks wrote in “A Leg to Stand On” (1984), about his own experiences recovering from muscle surgery. “I had explored many strange, neuropsychological lands — the furthest Arctics and Tropics of neurological disorder.”
His intellectual curiosity took him even further. On his website, Dr. Sacks maintained a partial list of topics he had written about. It included aging, amnesia, color, deafness, dreams, ferns, Freud, hallucinations, neural Darwinism, phantom limbs, photography, pre-Columbian history, swimming and twins. . . .
“I love to discover potential in people who aren’t thought to have any,” he told People magazine in 1986.
Other books included the best-selling “An Anthropologist on Mars” (1995), about autistic savants and other patients who managed to thrive with their disorders; “The Mind’s Eye” (2010), about the ways people compensate for brain injuries; and three books about specific neurological conditions: “Migraine” (1970), “The Island of the Colorblind” (1997) and “Seeing Voices” (1989), a look at language perception among the deaf. . . .
Dr. Sacks’s accounts of neurological oddities found a wide popular audience and were adapted for Hollywood, the theater, even opera. Robin Williams portrayed a Sacks-like doctor in the 1990 film version of “Awakenings,” and the novelist Richard Powers based a central character on him in his 2006 book, “The Echo Maker.” The 2011 movie “The Music Never Stopped” was adapted from “The Last Hippie,” one of the case studies collected in “An Anthropologist on Mars.” An opera based on “The Man Who Mistook His Wife for a Hat,” with music by Michael Nyman and a libretto by Christopher Rawlence, had its premiere in London in 1986 and was staged at Lincoln Center in New York in 1988. . . .
A skilled pianist, Dr. Sacks often wrote about the relationship between music and the mind, eventually devoting a whole book, “Musicophilia” (2007), to the subject. Dr. Sacks disagreed with the Harvard psychologist and author Steven Pinker’s view of music as “auditory cheesecake, an evolutionary accident piggybacking on language,” and pointed to its ability to reach dementia patients as evidence that music appreciation is hard-wired into the brain.
“I haven’t heard of a human being who isn’t musical, or who doesn’t respond to music one way or another,” he told an audience at Columbia University in 2006. “I think we are an essentially, profoundly musical species. And I don’t know whether — for all I know, language piggybacked on music.”
Referring to Nietzsche’s claim that listening to Bizet had made him a better philosopher, Dr. Sacks said, “I think Mozart makes me a better neurologist.” . . .
After several early flings, he wrote [in his 2015 memoir], he settled into a period of celibacy that lasted 35 years before he found love late in life. He is survived by his partner of eight years, the writer Bill Hayes. . . .
In 1989, interviewing him for “The MacNeil/Lehrer NewsHour,” Joanna Simon asked Dr. Sacks how he would like to be remembered in 100 years.
“I would like it to be thought that I had listened carefully to what patients and others have told me,” he said, “that I’ve tried to imagine what it was like for them, and that I tried to convey this.
“And, to use a biblical term,” he added, “bore witness.”
He also bore witness to his own dwindling life, writing reflective essays even in his last days. On Aug. 10, his assistant, [Kate] Edgar, who described herself as his “collaborator, friend, researcher and editor” as well, wrote in an email: “He is still writing with great clarity. We are pretty sure he will go with fountain pen in hand.”
Several days later, a valedictory essay titled “Sabbath” appeared in The Times. In it, Dr. Sacks considered the importance of the Sabbath in human culture and concluded:
“And now, weak, short of breath, my once-firm muscles melted away by cancer, I find my thoughts, increasingly, not on the supernatural or spiritual, but on what is meant by living a good and worthwhile life — achieving a sense of peace within oneself. I find my thoughts drifting to the Sabbath, the day of rest, the seventh day of the week, and perhaps the seventh day of one’s life as well, when one can feel that one’s work is done, and one may, in good conscience, rest.”
In the aftermath of the tragedy at Sandy Hook, the NRA called for a "national database" of the mentally ill, against which new gun sales can be checked. Similarly, President Obama has consistently advocated that Congress do something to prevent the mentally ill from possessing guns.
The general public's thought process seems to be something like this: Anyone who would use a gun to murder children must be crazy -- and crazy people should not have access to guns in the first place. But it is impolitic to use the word 'crazy,' which sounds too loaded, too politically incorrect. The polite way of expressing such a sentiment is to declare that 'mentally ill' people should not own guns.
Contrary to the general public's ignorant abuse of the term, though, 'mentally ill' does not mean 'crazy.' The term covers an extremely broad spectrum of disorders whose symptoms and causes vary significantly. Paranoid schizophrenia is classified as a mental illness, but so are Attention-Deficit Hyperactivity Disorder, and anorexia nervosa. The real question, then, becomes: Which mental illnesses should disqualify a person from owning a gun, and by what grounds do we justify singling out the people who suffer from them?
And this is where the argument starts to fall apart. As is usually the case, crafting a specific, viable policy plan is a bit more difficult than making empty emotional pleas to do something. While people with severe mental illnesses -- such as paranoid schizophrenia or major depression -- are somewhat more likely than the average person to commit acts of aggression, they account for only 4 percent of all violent crimes. Virtually all people with severe mental illnesses are just everyday men and women, no likelier than you or I to commit an act of violence. Of course, the authorities should investigate any credible claims of violent tendencies, but this is true regardless of the status of the suspect's mental health. The logic of a blanket policy targeting the mentally ill is identical to the logic of racially profiling Arab Muslims at airports.
My own experience as the close friend of a young woman with severe mental health issues has taught me that politicians, insurance companies, and the general public are astonishingly unfamiliar with what such people's day-to-day lived experiences are like. One of the most debilitating issues that my friend confronts is simple ignorance: Misconceptions about mental health issues are frighteningly common, and they can cause problems in school, work, and family life. Most mentally ill people have the ability to live normal lives -- but only with a network of support....
Michael Fitzpatrick, the director of the National Association for the Mentally Ill, expressed hope that President Obama's call for dialogue would help combat the stigma against the mentally ill. It hasn't, and it won't -- and it's easy to see why. The framing of this 'dialogue' is in the context of Sandy Hook; that is: in the context of violence and fear. What message does it send to the public that we only bother to talk about mental illness after an act of mass murder against children has taken place? The central question of the dialogue should be "How can society help those who suffer from mental illness?" But the dialogue as it has actually happened has centered around the question, "How can society protect itself against crazy people?" That's no way to craft good public health policy. It's time to stop scapegoating the mentally ill -- and start looking for real ways to help them.
You can't be a self-actualized human being while afflicted with crippling boredom. It's affecting millions -- you are not alone. And we know that there are chemicals in the brain that relate to boredom, so, since it's chemically-caused, you can't be held responsible for it. If you want to reverse this disorder, you may benefit from our very expensive drug. Make sure to see an expensive Mental Health Advocate to see how you can pay to get this drug and correct your disease of boredom.
The patient, "Tony," was convicted, at age 17, of causing grevious bodily harm. (This was in Britain.) He started creating a new persona for himself by plagiarizing from any sources he could find — movies like A Clockwork Orange, a biography of Ted Bundy — so that he'd be sent to a psychiatric hospital instead of prison.
It worked. But Tony instantly regretted it and tried to get out.
It is an awful lot harder, Tony told me, to convince people you're sane than it is to convince them you're crazy.
"I know people are looking out for 'nonverbal clues' to my mental state," Tony continued. "Psychiatrists love 'nonverbal clues'. They love to analyse body movements. But that's really hard for the person who is trying to act sane. How do you sit in a sane way? How do you cross your legs in a sane way? . . ."
"[T]hey saw how well behaved I was and decided it meant I could behave well only in the environment of a psychiatric hospital and it proved I was mad."
I glanced suspiciously at Tony. I instinctively didn't believe him about this. It seemed too catch-22, too darkly-absurd-by-numbers. But later Tony sent me his files and, sure enough, it was right there. "Tony is cheerful and friendly," one report stated. "His detention in hospital is preventing deterioration of his condition."
This article looks at the question. The most striking finding: in a metastudy of 19 studies, "18 found that belief in a genetic or biological cause was associated with more negative attitudes to people with mental health problems. Just one found the opposite, that belief in a genetic or biological cause was associated with more positive attitudes."
"We hope that these findings will help overcome the stigma associated with ADHD . . . . Too often, people dismiss ADHD as being down to bad parenting or poor diet. As a clinician, it was clear to me that this was unlikely to be the case. Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children."
As Goldacre observes, anyone who's been campaigning against the stigmatization of mental health disorders seems have a severely mistaken assumption about people's attitudes toward mental health. If you believe someone's behavior comes from their genes, you won't necessarily be more inclined to forgive them. You might look down on them more: it's a problem with the whole person, not just a one-time decision they made. (That may be a very simplistic way to look at it. But I'm just describing how people in general might think; I'm not approving of these views.)
If you've read the post from a few weeks ago about whether addicts have a choice in their behavior, you might be interested in this rebuttal and the original author's response, which gets surprisingly personal.
Speaking of personal, the commenters over here unflinchingly give us some snapshots of their experiences. Here are a few that stood out:
Michael said...
I stopped drinking 20 years ago because I am/was addicted to alcohol. I doubt seriously that alcoholism is a "disease" but I do not doubt that if you quit drinking the desire to drink will go away. Give a monkey a number of drinks every day and the monkey will become addicted to alcohol. Not because he didn't get enough bananas when a baby and not because he had a bad home life but because he drank too much alcohol with too much regularity. Our therapeutic culture has transformed a fairly simple solution (quit drinking) into a very complicated solution(quite drinking after you find out why you drink). I commend to all Theodore Dalrymple's book "Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy" which supports the view that the industry built around "recovery" is very invested in the notion that addictions to drugs and alcohol are nearly impossible to overcome without the help of therapy, medical supervision, etc.
themightypuck said...
I've gotten off heroin and pain meds and it was never a problem. The hardest drug for me to quit was crystal meth but I got off that as well. The most painful drug for me to quit was xanax which I had taken daily for 8 years as prescribed by a doctor for a legitimate health reason. That was hell for 3 days and dysfunction for 3 months. The only drug I have been unable to quit is alcohol and for the most part I don't abuse it (although I bet I'd live longer if it were illegal).
David said...
I learned about alcoholism up close and personal through by beloved but alcoholic second wife.
The argument about whether it's a disease is all semantics. If it's a disease, it's a treatable disease. The treatment is to stop drinking. There are lots of ways the treatment can fail, but unlike in other diseases, the treatment is ultimately in the hands of the patient.
Both this review and the one about children illuminate the same fallacy, which I'd paraphrase like this:
1. A certain behavioral/mental problem -- call it "X" -- is associated with brain activity in ways that can be observed and predicted.
2. Therefore, the solution to "X" must take the form of psychiatric/medical assistance; the solution cannot be individual free choice. (Indeed, even invoking that concept may be detrimental.)
There's a lot that could be said about why this is a fallacy and why it's so common. The question of free will lurks under the surface of the discussion, though Satel understandably sticks to talking about science, policy, and history, and hardly touches the philosophical problem. Here's what she says about the fallacy:
[M]uch of the public, and a dismaying number of psychiatrists, psychologists, and neuroscientists, mistakenly believe that if a behavior is influenced by genes or mediated by the brain then the actor cannot choose his actions. While every behavior has a biological correlate (and a genetic contribution) and every experience that changes behavior does so by changing the brain, the critical question, Heyman wisely says, is not whether brain changes occur (they do) but whether these changes block the influence of the factors that support self-control. . . .
Heyman uses the phenomenon of addiction to make a profound point about neuroscientific progress in general. "The implication is that as we learn more about a disorder," he writes, "the more likely it is to be thought of as a disease" -- and, consequently, as a condition whose course cannot be modified by its foreseeable consequences. Indeed, reconciling advances in brain science with their meaning for personal, legal, and civic notions of agency and responsibility will be one of our next major cultural projects.
Progress in brain science will also force a confrontation with the fact that the common interpretation of pathological behavior is often informed by a primitive form of dualism. If biological roots can be found, then we reflexively think “disease”—as in the obliteration of choice-making ability. The mechanical “brain disease” rhetoric is a symptom of the growing tendency to privilege neuroscientific explanations as the most authentic way of understanding human behavior.
In addition to logically explaining why that's a fallacy, Satel also says that the people who came up with the idea that addiction is a disease and is incompatible with self-control were motivated by political and financial concerns (and probably emotional impulses):
In fairness, the scientists who forged the brain disease concept had good intentions. By placing addiction on equal footing with more conventional medical disorders, they sought to create an image of the addict as a hapless victim of his own wayward neurochemistry. They hoped this would inspire companies and politicians to allocate more funding for treatment. Also, by emphasizing dramatic scientific advances, such as brain imaging techniques, and applying them to addiction, they hoped researchers might reap more financial support for their work. Finally, promoting the idea of addiction as a brain disease would rehabilitate the addict’s public image from that of a criminal who deserves punishment into a sympathetic figure who deserves treatment.
Those concerns may be admirable. But having good intentions behind your account of reality hardly ensures that your account will be accurate.
Finally, I had never heard of this incident (which begins the review), and I'm surprised it isn't better-known:
In 1970, high-grade heroin and opium flooded Southeast Asia. Military physicians in Vietnam estimated that between 10 percent and 25 percent of enlisted Army men were addicted to narcotics. Deaths from overdosing soared. In May 1971, the crisis exploded on the front page of The New York Times: “G.I. Heroin Addiction Epidemic in Vietnam.” Spurred by fears that newly discharged veterans would ignite an outbreak of heroin use in American cities, President Richard Nixon commanded the military to begin drug testing. In June, the White House announced that no soldier would be allowed to board the plane home unless he passed a urine test. Those who failed could go to an Army-sponsored detoxification program before they were re-tested.
The plan worked. Most GIs stopped using narcotics as word of the new directive spread and the vast minority who were detained produced clean samples when given a second chance. More startlingly, only 12 percent of soldiers who were dependent on opiate narcotics in Vietnam became re-addicted to heroin at some point in the three years after their return to the states. “This surprising rate of recovery even when re-exposed to narcotic drugs,” said the epidemiologist who collected the data, “ran counter to the conventional wisdom that heroin is a drug which causes addicts to suffer intolerable craving that rapidly leads to re-addiction if re-exposed to the drug.”
Satel says our ignorance of this real-life experiment represents a case of "generational amnesia." It's easy to keep believing in a dogma if you don't look at any of the evidence that goes against it.
Saletan quotes a report by the University of Minnesota School of Medicine:
An 8-week, double-blind, placebo-controlled trial was conducted to evaluate the safety and efficacy of oral naltrexone for kleptomania. Twenty-five individuals with DSM-IV kleptomania were randomized to naltrexone (dosing ranging from 50 mg/day to 150 mg/day) or placebo. . . .
Subjects assigned to naltrexone had significantly greater reductions in . . . stealing urges (p = .032), and stealing behavior (p < .001) compared with subjects on placebo. Subjects assigned to naltrexone also had greater improvement in overall kleptomania severity. . . . Naltrexone demonstrated statistically significant reductions in stealing urges and behavior in kleptomania.
Saletan adds:
Naltrexone is better known as a drug for alcohol or drug addiction. Many of us, while accepting these addictions as diseases, continue to regard theft as a matter of personal responsibility. Should we rethink that distinction? If the same drug relieves both conditions, should we take kleptomania more seriously as an illness?
