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Beyond "Try Harder"

2/28/2023

Val's Take

Historically, Humans treat most HEALTH PROBLEMS as Evidence of the DISFAVOR of the God, GODS, FATE or MORAL FAILINGS:

because it wasn't clear to people what was going on;
they were AFRAID --- sometimes needlessly -- but NOT ALWAYS
AND Health PROBLEMS were often demanding:
- CARE from other people --
  - who even if they wanted to help --
    - didn't know HOW.

Addressing complex health problems often takes GENERATIONS OF HUMAN EFFORT to UNTANGLE.

I may think Dr. Palmer doesn't have it perfectly right --- but I do think he is RIGHT --

to get to the CELLULAR LEVEL, and
Start bringing in other SYSTEMS OF THE BODY
- when it comes to understanding Neuro-Developmental and Psychiatric Disorders, Metabolic Disorders, Auto-Immune Diseases, Cancer, Neuro-Degenerative Diseases and AGING.

BUT Dr. Palmer as most of us when we're FRUSTRATED resorts to:
TRY HARDER --- even when it is so clear we need better STRATEGIES than that.

We're really having a HARD TIME coming to terms with the DEVELOPMENTAL ASPECTS of Neuro-Developmental Differences and Psychiatric Disorders.

I'm not saying we can't ultimately get around those DEVELOPMENTAL ASPECTS, but
We tend to UNDER-ESTIMATE what it is really going to take.

That person sitting across from you is NOT YOUR CLONE --

they have STRENGTHS you may not have,
and WEAKNESSES you may not have --- AND
VICE VERSA.

I like Palmer but I don't think he has the BROADER UNDERSTANDING of Stanford's ROBERT SAPOLSKY and the Biological Basis of Behavior and the Implications, including the Justice Implications for that.

Big Think
Professor and Author Robert Sapolsky

I think theFree Will debate is there BUT misguided.

What Sapolsky GETS RIGHT is a COMPREHENSIVE VIEW OF THE BIOLOGICAL BASIS OF BEHAVIOR

"You are never really going to understand what is going on if you get it into your head that you're going to be able to explain everything with this is--

the part of the brain

the childhood experience

the hormone

the gene

or the evolutionary mechanism

---That explains everything.

"It doesn't work that way. Instead any behavior is the result of biology that occurred a second ago, hours ago, days ago -- a million years ago."
. . . .

"O000h it's complicated. Well, that's very useful.

"How 'bout, 'OOOh it's complicated and you better be really careful and really cautious before you think you understand the causes of a behavior, especially if it's a behavior you judge harshly.' "
. ------Prof. Robert Sapolsky Stanford

The Need for a New Integrated DSM

The Definitional Argument in Mental Health & Criminal Justice Policy

A Strength-Based Approach

Are Mental Illnesses Really Metabolic Disorders?

Dr. Chris Palmer

Director of the Department of Postgraduate and Continuing Education at McLean Hospital and an Assistant Professor of Psychiatry at Harvard Medical School.

Try Smarter, Not Harder

I think Mental Illnesses are often IDIOSYNCRATIC DYSREGULATIONS of Multiple Systems of the Body that are INTEGRATED.

Further, people with Bipolar Disorder seem to have been BORN WITH MORE REACTIVE CELLS.

Is it all about the Brain and the Central Nervous System, or the Immune System, or Metabolic Processes, or the Endocrine System, or the Microbiome --- or ALL OF THE ABOVE.

It seems to me that Maternal Immune Activation, Shared Genes, Epigenetics and Inflammation acquired during the lifetime are the BIG DRIVERS affecting MULTIPLE INTEGRATED SYSTEMS OF THE BODY.

Further, the Relationship between Neuro-Developmental Disorders and Psychiatric Disorders I think means that LIFESTYLE CHANGES will often help --- BUT MAY OR MAY NOT BE SUFFICIENT.

I think Dr. Palmer has some important, critical insights ---- On the other hand, psychiatry has really had a hard time understanding DEVELOPMENTAL DIFFERENCES for people with an IQ above 70.

I do think there is a certain OVER-REACHING for Dr. Palmer --- BUT I think he is making some legitimate points.

Paul Micallef -- Autism from the Inside

"My strategies tend to be very different than what work for other people.

"THE BEST THING FOR ME IS TO DO WHAT WORKS FOR ME."

If we have some great break-throughs in the treatment of Neuro-Developmental Differences & Psychiatric Disorders --

We should take advantage of them as ethically appropriate.

IN THE MEANTIME:

Saltz' recommendation to spend 80% of the time on STRENGTHS DEVELOPMENT, and
20% on Work-Arounds for Weaknesses

is probably pretty good.

Further, those STRENGTHS & WEAKNESSES are likely falling outside NEURO-TYPICAL RANGES.

The low to HIGH Grade PARANOIA in the Legal Profession ---Talking About Issues Openly

2/15/2023

There are many things about the practice of law that make TRUE PROBLEM-SOLVING problematic.

Unfortunately, there are REASONS for why the LEGAL PROFESSION finds itself in so many double binds.
HOLDING PEOPLE or ENTITIES ACCOUNTABLE is NOT THE SAME THING --- as PROBLEM-SOLVING.

PROVIDING FOR SAFETY in the 21st Century is a lot more complicated than holding people accountable
Evidentiary Rules of "RELEVANCY" --- often miss the ELEPHANT or ELEPHANTS in the room and that often makes problems WORSE --- NOT BETTER.

The Law often CODIFIES "US vs. THEM THINKING."

GOOD IDEAS can come from ANYWHERE --- regardless of ACADEMIC DEGREES or where one is on the POLITICAL SPECTRUM or whether someone is actually pretty close to us and we're COMPETING for the SAME LANE
there are enough LANES for EVERYONE if we're CREATIVE about this.

Props
/präps/noun1. respect or credit due to a person: informal"Erika gets props for the great work she did on the music"

Val's Take: I think the criticism of Pomerantz is UNFOUNDED --- BUT I think "PROSECUTIONS" rarely get to "ROOT CAUSES."

I think LEGAL ACTIONS can potentially get to "ROOT CAUSES" ---

if the LAW has the bandwidth to FACILITATE COMPLICATED Problem-Solving---
That often looks more like TRADITONAL NOTIONS of EQUITY and taking into account "the Totality of the Circumstances"
- I think in most cases if we take into account the "Totality of the Circumstances" certainly that we're aware of in the 21st Century ---
  - We're outside PUNISHMENT
- We're NOT OUTSIDE SAFETY or FAIRPLAY

[The ADA is in many ways on the FORE FRONT of this kind of approach with "REASONABLENESS STANDARDS" and "Inter-Active Processes" ---

Human Disability is COMPLICATED and there has been the need for a FAIR AMOUNT OF ADDITIONAL GUIDANCE whether in the form of
- Administrative Executive Regulations, and/or
- Agency Guidance]

The Statutory Law narrowly circumscribes the issues to put people on NOTICE--- it can feel UNMANAGEABLE to deal with larger issues until you realize you didn't SOLVE the larger issues.

AND THOSE CIRCUMSCRIBED ISSUES KEEP COMING BACK.
And you may have made them WORSE.

Whether we are for the PROSECUTION of:

"BIGWIGS"
Rich people
Law Enforcement
Poor People
or as many people as possible
- Those "prosecutions" often SHORE UP the RATIONALE for SECRECY and
- PUSH real PROBLEM-SOLVING further away.

The STATES aren't complying with Olmstead ---

BUT one of the REASONS they are NOT COMPLYING is that some of STATES' most EXPENSIVE OBLIGATIONS are OUTSIDE MEDICAID:
- Medicaid's failure to cover Housing for people needing LONG TERM CARE, and
- Medicaid's Rule Excluding Payment for IMDs (Institutes for People with Mental Disease).
  - I'm not a big fan of Institutes of Mental Disease but they are generally better than Jails and Prisons

Further, it is clearer in 2023 than it was in 1999 that most of the people who are incarcerated have some type of Cognitive Disability, most notably:

Brain Injury,
Neuro-Developmental Differences/Disorders going to Executive Functioning,
Psychiatric Disorders (that can be additional manifestations of the Neuro-Developmental Differences/Disorders),
and Substance Issues that are often related to one or more of the above.

[Additionally. large segments of the population are dealing with some type of Developmental Inflammation that can be made worse by the environment --- and there is unconscious bias in prosecutions --- the Community as a WHOLE has a large interest in addressing these issues as the PUBLIC HEALTH ISSUES they are.]

Additionally, while Assertive Community Treatment (ACT) has been around since the 1970s ---

I think it is becoming MORE CLEAR why ACT can be particularly helpful and is often worth the money.
It is providing SUPPORT for Executive Functioning Challenges that may not have resolved even if a Psychosis did resolve.

I do think people with Psychiatric Disorders and Neuro-Developmental Differences and Families can help with PRECISION targeting of services that could save the States and the FEDS money.

So on the one hand States have had 20 years since the Olmstead decision to deal with this ---

But the truth is States and the Feds didn't really appreciate what they were dealing with --
and if the truth be told --- neither did Individuals or Families.

Knowledge can also help get us out of the perceived need for SECRECY.

Transitional/ Translational Justice Monday

Beyond "Try Harder"

The low to HIGH Grade PARANOIA in the Legal Profession ---Talking About Issues Openly

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