08/14/2007
Surge Working?
In Mr. Johnson;s post "What If The Surge Is Working?"
I aggree that we should not emmulate the republicans in any ways, but I do not see that the surge is working. While some progressives disscuss redeployment, or widthdrawl, not a single person left or right has stated what is required for any possible success to occur in the Iraq, or the region: a deep level of appreciation for the history, culture, and people of the region (aka T. E. Lawrence). Now, some will say that this is more liberal/lefty shite. I say that I am citing the only successful source of strategy: "The Art of War" by Sun Tzu.
Master Sun says that the best outcome in a conflict is to win without fighting. This can mean that we send proxies, or negotiate, or export our culture etc.. This is predicated on the concept of knowing your enemy and knowing yourself (to parapharase Sun Tzu). The only real solution at this time is to remove all visible military forces from Iraq. A good example of what this means is look at the Al-Quds and the Iraninan Revolutionary Gurad. They are in Iraq, but are invisible (they do not wear a uniform, they speak the language, they are intimate with the culture). The Iranians have at most a battalion of these troops in Iraq. And they are very effective.
Ideally, we should deploy two divisons (about 20-30k troops) of people with comprable skills. This allows roughly an A-Team (ie. a Green Beret unit) to be deployed with every major tribe. This is due to the fact that Iraq has devolved away from publilc justice into private revenge (ie. devolved from a nation state to a collection of tribes). It will take about two years to restablish the trust in public justice that would allow Iraq to become a nation state again. However, this state may not be the democratic beacon that is currently envisioned. Still it is the only way that the U.S. will have any influence on what kind of entity Iraq will become.
The surge is not working, and will never work. The ink blot strategy failed in Vietnam and will fail here. This is because we do not have the requisite force levels with the requisite skills (see above), or the time to accomplish the current objective of the stabilizing the region. Further, our opponents adapt faster than we as a nation state (with this current administration) are capable of. Any top down organization (this includes the conventional military, as well as any authoritarian types) will not be capable of Observing Orienting and Deciding quickly enough to compete. As proof, one should study the most recent Isreali war in Lebanon.
Basically, we can either face reality, which is that we started an overt conflict without knowing our oppostion and, therefore, we failed before we fired the first shot, or we can live in fantasy land and continue to spend blood and treasure (as well as deepen the problem by killing civilians and promoting injustice ie. accelerating the fall to barbarism). Marine General Mattis before his second deployment to Iraq understood that if the Marine's casualties exceed that of the civilian population then they were succeeding. This mirrors Britain's experience in Ireland. Since the surge started, we have not seen a slow down in the civilian casualties. The U.S. troop's casualties are miniscule compared to that of Iraqi civilians. By any measure the surge is failing. One may argue that there are communities where it is working, but this is an illusion. Any sane OpFor will understand that an occuping force can have local successes, but that said occupier cannot, by definition, be everywhere all the time.
This brings the last point I'd like to make. This administration believes in the Machiavellian concept that it is better to be feared that loved. Sun Tzu's answer is that when one is feared people will plot against you when you are not there, but when loved people will see to your best interest when you are not there. We have promulgated a policy of fear and intimidation (Aby Gharib). There is no military solution to this. Even with two division of Green Berets in country, there is now a climate of fear and hatred toward the U.S..
Again the only solution is to get the fuck out of Dodge now! Maybe, leave some SF troops and Field Officers behind, concentrate on meaningful humanitarian relief, talk to Irag's neighbors to find a solution that will benefit the Iraqis not the U.S. oil companies. This is a course of action that over a long time period may restore trust in the U.S. and allow for a positive future for the region.
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02/26/2007
Why we should not bomb Iran's Uranium Enrichment Facilities and Reactors
The U.S.'s plans to use air strikes against Iranian uranium enrichment facilities and nuclear reactors, is a very bad neocon wet dream. This opinion is based on a cursory analysis of the "unintended" consequences of said air strikes.
Many sites are underground bunkers, which the administration is targeting with B61 mod 11 nuclear weapons. While the yield is around 10k tons (TNT equivalent), the issue is the radioactive fallout. I have worked in the nuclear arms industry, and all underground test are performed within a reinforced concrete structure that is then buried. Notice there is no entrance hole! Any hole would be a path of least resistance that would allow the resulting plasma to escape. The effect would be similar to a filled balloon's gas escaping through the input nipple. Hence a burrowing nuclear weapon like the B61 mod 11 would vent skyward (presuming that this was delivered by air), thus assuring that some radioactive material would reach the upper atmosphere and irradiate the entire planet. The heavier fallout would fall more locally on Iran, Iraq, Europe, China, Afghanistan and Israel the actual levels and pattern would depend heavily on weather patterns, time of day etc..
Jangle Uncle was a subsurface test of a 1.2kt yield device. The purpose was to model the effects of a 23kt ground penetrating weapon. The picture below shows the results. A B61 mod 11 weapon is about eight times the yield of the test. The yeild is about twice that of a GBU-28.
From the very cursory analysis above, it is clear that the use of a B61 mod 11 weapon on Iranian targets holds great risk for those few allied countries we have in Europe and the Middle-East as well as any non-combatants (including Israeli citizen, Iranian citizens, and Russian citizens) to be of any use. However, without the B61 mod 11 the U.S. will not be capable of destroying the underground facilities that we do know of. There is the additional risk that we do not know the locations of all the enrichment facilities, and reactors.
What I find offensive about this subject is that when the Israelis bombed (see Operation Opera) the Osirak light-water nuclear materials testing reactor (MTR), they did so before the fuel had been loaded into the reactor for fear of fallout, but no talking head, blogger, or leader has given even cursory thought to the consequences of attacking a functional uranium enrichment facility, or reactor loaded with fuel. Apparently, It is very easy to advocate air strikes to "safeguard" people, but not so easy to seriously assess the consequences of these air strikes. It is precisely the "unintended consequences" (read lack of appreciation for the effects of one's actions) that will cause harm to the very people we are attempting to "safeguard". While Chernobyl was an accident, using many B61 mod 11 weapons on Iran would be premeditated murder and fratricide.
The only real course of action is to honestly negotiate with Iran. This means negotiations without preconditions. This means sitting down at the table with Iran before they capitulate to the U.S.'s demands to cease and desist uranium enrichment.
04:45 Posted in Blog | Permalink | Comments (0) | Email this | Tags: foreign policy, war, nuclear war, Iran., GWOT, terror
07/09/2006
ADD & ADHD Myths (How Superficial Knowledge Leads to a Failure to Appreciate)
In Susan Kaiser Greenland J.D.’s “Are We Turning Our Kids Into Speed Freaks? “, and in Deborah Lynn’s, “On Ritalin and Real Treatment”
We have a good examples of misconceptions based on superficial knowledge. While for everyday conversation, superficial knowledge is adequate it is not when one is a healthcare professional as is Ms. Deborah Lynn. For Dr. Greenland, who teaches “focused attention through mindful awareness practices to children”, superficial knowledge of ADD and ADHD is criminally negligent. Both authors deprecate the use of medications that have proven effective in treating a complex and difficult dissorder. Both focus on an FDA advisory that reports on a number of deaths associated with stimulant drugs used to treat ADD and ADHD.
"Thus, if we pay enough attention to a certain experience, it eventually becomes part of the brain's hard wiring. In a very real way, the more we focus attention the better we get at it because the brain is rewiring itself toward focused attention. As a result, those areas where we focus grow stronger and those areas where we do not focus become weaker."
The myth is that one is unable to focus because they lack the discipline. In Dr. Greeland's case she believes that with enough discpline, an ADD or ADHD person will be "cured". The truth is that ADD/ADHD people can and do hyperfocus on things that interest them. The operative words to take note of (non-ADD/ADHD people) is "that interest them." Things that you or society decide should be of interest to a person with ADD/ADHD may not be of interest to them. Sorry. No ammount of discipline will change that fact.
Typically, an ADD or ADHD person will try to focus on things that do not interest him or her. The result typically is an ADD or ADHD person that fallen asleep. Brain imaging scans and functional neuroimaging have shown that the more an ADD or ADHD person attempts to focus on an uninteresting subject, the less activity that is registered in the prefrontal cortex.
This presents parents, society, and the ADD/ADHD person with an inherent conflict of interest (no pun here). This is most evident in an educational setting. Specifically, education based on the Prussian model (rote memorization, emphasis on following directions, punishment oriented (physical , mental and emotional), with emphasis on verbal skills, and “a strict education in ethics, duty, discipline, and obedience”). As the Prussian system was designed to produce a population that could be used as soldiers for the Prussian military, it prepares the individual to be at home in an authoritarian society (obedient).
Oddly, the USMC has determined that the most effective form of education is a hands on approach that incorporates audio, visual, and corporal elements. Further, recent studies have shown that learning and memory are closely tied to emotions. Along those lines the USMC has long incorporated live fire training. These exercises are extremely effective and the lessons learned are retained over very long periods of time. The National Training Centers use similar methods, without live fire to achieve very good results as well. The point is that I have experienced some of these teaching methods and I will say that they held my attention even without the medications.
While the above paragraph may seem to be off topic, it is not. What we call ADD/ADHD may not be a disorder per se. Meaning that those of us with ADD/ADHD tend to be more adventureous/risk seeking etc.. What we do best is focus attention on the novel, making implicit connections with what we observe, how we are oriented (orientation is used as Col. John Boyd used it in "Patterns of Conflict" as a many sided amalgam of genetic, culture, education, and experiences that combine to form our view of the world) and finally acting. Our brain structure (lowered prefrontal cortex activity as seen of fMRI scans) decreases the time to traverse the Observe Orient Decide and Act (OODA) loop. As a hunter gatherer, or a soldier (yes a Marine qualifies here), or fighter pilot (John Boyd) this is a distinct advantage. And from archeology, we know that in a tribal society, hunters and warriors would typically comprise anywhere from 10% to 35% of a population. Natural selection would indicate that, for many thousands of years longer than we have had to deal with the above mentioned Prussian school's authoritarian orientation, we would have been selecting for people who would be better warriors and hunters. Therefore, current estimates of ADD/ADHD occurances of 5%-15% would seem to be conservative.
Strategy
A mental tapestry of changing intentions for harmonizing and focusing our efforts
- as a basis for realizing some aim or purpose in an unfolding and often unforeseen world
of many bewildering events and many contending interests
— John R. Boyd
One thing to note is that Boyd is extremely precise in his wording. As always a picture is worth a thousand words ()
Dr. Greenland's opinion is not based on any form of science, or rational thought. It is based on a premise that Methylphenidate HCl is bad. She believes that we can train our childeren to socially acceptable without the drug:
"We tell our kids that practice makes perfect and the more they do something the better they will get at it. The same theory applies to the workings of the brain. Research shows that focused attention creates physical changes to the brain by systematically rewiring it. Thus, if we pay enough attention to a certain experience, it eventually becomes part of the brain's hard wiring. In a very real way, the more we focus attention the better we get at it because the brain is rewiring itself toward focused attention. As a result, those areas where we focus grow stronger and those areas where we do not focus become weaker."
The falacy of this is that it only works if the ADD/ADHD individual is interested in focusing on what is presented (interest will induce hyper-focus), and ignores the lower prefrontal cortex activity which is the primary problem of ADD/ADHD. Ms. Greenland shows a lack of appreciation for the real issues of ADD/ADHD: The inability to preempt actions which society deems unacceptable.
From personal experience, I can say that it is not the lack of desire to focus on topics, subjects, people, etc. that are personaly uninteresting but the resultant effect: The harder one tries to focus on an uninteresting object the more energy that one must expend which ultimately leads to unconciousness. Also from personal experience, the inability to preempt actions has both saved my life, and caused me endless grief. The grief is most often caused in social situations where a question is asked and I respond, without thought, with a truthful answer. In other words, I have answered the question before I have had a chance to decide to answer the question.
Ms. Greenland clearly has no first hand experience with ADD and ADHD. Her belief that "if we pay enough attention to a certain experience, it eventually becomes part of the brain's hard wiring" and "if we're looking for long-term solutions, training attention the old fashioned way (as practiced by contemplatives for over 2500 years) makes much more sense, at least for those willing to give it a try" does not take into account two factors: rewiring can only occur when that neural net is actually traverse (used), and the fact that the fMRI shows the more effort that is put into focus the less brain activity occurs.
The ADD and ADHD brain has no inhibitor switch that fucntions on the unconsious level. Normal people have this. Normal people have no frame of reference to appreciate the advantages and disadvantages of having this inhibitor. Because of this, most normal people believe that with more effort ADD/ADHD people can be normal. And that when they fail to be "normal" it is caused by a lack of morale fortitude. What normal people do not appreciate is that while inhibition can be accomplished, there is a great cost in energy and sanity. That cost can be so high that in some individuals it will preclude all other interactions. I challange Ms. Greenland to constantly, and conciously monitor all her thoughts and actions. I guarentee that unless she is the Dali Lama or one of the Zen maters I have known that she will be insane inside a month.
I have practiced martial arts and zen since age four. While this has been helpful, it has not mitigated the lack of inhibition. However, it has made me aware that other cultures value ADD/ADHD's lack of inhibition. In Zen it is nutured, and developed. Zen seeks to achieve the state where thought and action are one. Oddly, this sounds like classic ADD/ADHD. Ms. Greenland has clearly shown that she is not a serious student of the "contemplative arts". Zen’s real goal (at least in Japan) was to offer a society’s most aggressive individuals a path to be a useful part of that culture. To be socially acceptable. The road, or way (Do) imparts an appreciation for all things, an ability to cut down illusions, and to be able accept (hopefully, sometimes to reduce) the suffering that is life. The methods to achieve this are many and varied. Many involve martial pursuits as the most aggressive will gravitate toward the arts of war. By embracing these arts, the Zen practitioner can not only be invincible in war, but more appropriate and useful to society that he protects. He/She can be transformed from an engine of social destruction to a implement of peace. Not having an inhibition switch helps in this endevor. So it is often what a culture values that determines the acceptability of ADD/ADHD type behavior. The Prussian school system’s emphasis on “ethics, duty, discipline, and obedience” does not tolerate ADD/ADHD behavior well. On the other hand, live fire drills tend to hold an ADDer’s attention. Go figure.
One should note that the Prussian school model considered Albert Einstien “a slow learner, possibly due to dyslexia, simple shyness, or the significantly rare and unusual structure of his brain (examined after his death)”, and expelled Thomas Alva Edison (“His mind often wandered and his teacher Reverend Engle was overheard calling him "addled"”). Both men had a talent for making connections between disparate disciplines and integrating them into new devices and paradigms. They both likely had ADD/ADHD and both succeeded despite all the prejudices and difficulties that society placed in front of them.
If we embrace the methods of Ms. Greenland what human assets are we losing?
While I do believe that help in the form of training is valuable to people with ADD/ADHD, I do not believe that we should deprecate, or give up a useful treatment path. One size does not fit all. A better course of action than attempting to limit treatment options for ADD/ADHD patients would be to to promote a change in attitudes regarding ADD/ADHD. We have much to offer society, but from the very begining modern society tells us that we are not valueable. We do not conform. It is our fault. We lack morale fortitude. Unfortunately, the reality is that it is not our fault. We do have value. What we do threaten is orthodoxy, and authoritarianism because we often make connections that are not obvious to normal people (Einstien, Edison).
I would advise Ms. Greenland that the next time she posts an article which is as uninformed as this, that she not make the title so prejudicial. I would also advise that she do her homework about the subject she writes about, and that if she advocates a value that she should lead by example (the contemplative arts are intended to develop appreciation, banish illusions, and reduce suffering) as opposed to the authoritarian leadership style of "do as I say not as I do".
While I have so far disscussed Dr. Greenland’s short commings, Dr. Lynn’s are also along the same vein.
Dr. Lynn
Issue 1. Dr. Lynn's view is that ADD/ADHD is "rare" and that medication provides only a "quick fix".
Dr. Lynn wrote:
The above statement implies that Dr. Lynn hopes that the fear engendered by the revelations that 25 people have died over four years while taking an ADD/ADHD perscription will give people pause when seeking medication. This is on its face an inappropriate, uncompassionate, and maybe unethical.
It is true that the NIH recomends that a combination of behavior and chemo therapies be used as this is "superior" to either modality alone (see Issue 4 below). However, wishing that these 25 deaths will discourage people from seeking medication because it is not a "quick fix” to complex problems fails to recognize that a partial solution, in this case medication, is better than no solution. I believe that a coralary to do no harm would be some help is beter than none.
The longer one waits to help the ADD/ADHD patient the more the damage done to that person's mental health in the form of secondary mental illnesses (depression, etc.) and the longer the neural nets have to hardnen into an inappropriate configuration. The medications will allow the patient to notice more than without medication. Most will attempt to adapt to this new information. This will be a long and painful process which eventually may lead to less resistance to behavior treatments to supplement the the medication. It seems to me that it is Dr. Lynn that is seeking a "quick fix."
As to the "rare[ness]" of ADD/ADHD the NIH itself indicates that 5% of the population has ADD/ADHD. The most likely rate is 5-15% so the NIH is being conservative. If the occurrence ADD/ADHD is 5-15% of the population then the term "rare" is inappropriate as this would be a minimum of 1 out 20 people. At the minimum rate of 1 in 20 the we should expect to see about 1.5 cases per class assuming a classsize of 30 (which is a low number of students per class). Is it any wonder that every american family with school age childern has had contact with an ADD/ADHD child?
Issue 2. Possible dangers of Ritalin.
I suggest that a full reading of the article in question be done before anyone speaks out on the dangers of Ritalin
Almost 80 people over four years were adversely affected by all prescribed ADD/ADHD perscriptions. Later in the article with regards to the linked deaths:
Tragic. However, according to the American Heart Association for 2003, the U.S. suffered 943 deaths due to cardiovascular diseases per 100,000 population. Even with the worst case of 1.79 cases per 1,000,000 population nonfatal cardiovascular or cerebrovascular problems reported in adults treated with amphetamines the difference is almost three orders of magnitude! Or about 1000 times more cases of non-ADD/ADHD perscription related cardiovascular deaths to ADD/ADHD perscription related deaths (deaths in which a patient was perscribed an ADD/ADHD drug).
According to one article "Sudden Death from Cardiac Causes in Children and Young Adults", by
Richard R. Liberthson, M.D. in the New England Journal of Medicine, Volume 334:1039-1044, April 18, 1996,Number 16
For young athelets the above article states:
This rate, for the general population, is one to two orders of magnitude higher than the worst case rate quoted by the FDA. Further, a number of the deaths were found (postmortum) to have undiagnosed cardiac or hypertension conditions. In essense, the risk of sudden cardiac failure when properly using an ADD/ADHD perscription medication is 10 to 100 times less than the risk to the general population and four times less than "unscreened young runners" (as above the sudden cardiac death rate is 1 per 250,000).
While these ADD/ADHD deaths are tragic, they are less than the rate for the general population, and less than the rate for unscreened young athletes.
Details of the Canadian decision to suspend the use of Aderall (an Amphetamine salt) can be found at http://www.hc-sc.gc.ca/dhp-mps/alt_formats/hpfb-dgpsa/pdf/medeff/adderall_xr_hpc-cps_e.pdf.
Issue 3. Parents of ADD/ADHD childeren need therapy.
ADD/ADHD is a genetically coded (See Issue 5). This indicates why Dr. Lynn (who should know this!) believes that the parents of alleged ADD/ADHD childern need therapy , and I believe many times medication (see "A family based study implicates solute carrier family 1-member 3 (SLC1A3) gene in attention-deficit/hyperactivity disorder", by Turic D, Langley K, Williams H, Norton N, Williams NM, Moskvina V, Van den Bree MB, Owen MJ, Thapar A, O'Donovan.
Issue 4. Ritalin is just a "quick fix" to ADD/ADHD.
Dr. Lynn wrote:
"Ours is a culture that has been seduced by the "quick fix". But no matter what they tell you on TV, we don't get in shape without exercising and emotional/cognitive/mind-brain problems aren't cured by a little yellow pill."
ADD/ADHD is a real brain disorder as seen by fMRI scans (see http://www.adhd.org.nz/neuro1.html ) (http://www.uth.tmc.edu/schools/med/psychiatry/msi/chdr2/A...) (and the NIH http://www.uth.tmc.edu/schools/med/psychiatry/msi/chdr2/A...). Methylphenidate as well as all other effective ADD/ADHD medications address the issues of under stimulation of the prefrontal cortex, caudate nucleus, and the globus pallidus by normalizing the dopamine pathways (http://www.adhd.org.nz/Ritalin.html). Without methylphenidate, the patient has little chance to focus on what you want him/her to.
The "quick fix" that Dr. Lynn denegrates is essential to allowing an ADD/ADHD patient the opportunity to rewire his/her neural network through therepy. That is why the NIH's current recommended treatment is the COMBINED chemotherepy AND behavior treatment. The combined treatment was considered superior to either behvioral or chemo treatment alone. From a systems stand point this makes absolute sense in that the drugs allow the patient to focus on the behavioral treatment. Therefore, ADD/ADHD drugs are essential to the treatment of the disorder. They are not a "quick fix".
I do aggree that many insurance companies will reimburse for the drugs and put severe limits on reimbursement for behavioral treatment. This is criminal as the NIH is clear on which treatment modality is "superior"!
As stated above in issue 1, it is better to have some treatment than no treatment. While I understand Dr. Lynn's frustration, the fact remains that a healthcare professional requires the patients, and the clinical detachment to assess the strategic situation inorder to best advocate for one's clients.
Issue 5. Evolutionary and genetic causes (or reasons for) ADD/ADHD.
There are numerouse studies on the genetic basis of ADD/ADHD ( see "A family based study implicates solute carrier family 1-member 3 (SLC1A3) gene in attention-deficit/hyperactivity disorder", by Turic D, Langley K, Williams H, Norton N, Williams NM, Moskvina V, Van den Bree MB, Owen MJ, Thapar A, O'Donovan MC. ADD/ADHD is passed to you from your parents (the corellation is about 80%)!
ADD/ADHD prevelance indicates that it is a selected trait. Most ADD/ADHD males are more inclined to be adventurous. Many engage in high risk behaviors. In a hunter-gatherer culture this would be the hunters and not the gathers. Hunter-gatherer cultures will typically have from 5-15% of its population as hunters. No it is not a coincidence that the numbers coincide to ADD/ADHD incidence. By the time a "normal" human has decided to throw that spear, an ADD/ADHD individual will have tossed the spear and have started charging toward the target. He/She is able to do this because there is no inhibition (see fMRI scans in Issue 4). This is the hard wired behavoir that we, as a society, wish to change.
As a Psychiatrist (MD), one should be more compassionate toward your patients, more clinical in your assements, and more current in your understanding of the disorders you treat. I would be very hesitant to be treated by someone with the level of knowledge and compassion that you have demonstrated.
Conclusion
What does this have to do with the igniferroque method? It is illustrative of the fact that most subjects worth studing are complex., and that to appreciate them requires more than a superficial knowledge of the subject. Only at these deeper levels of understanding can one know your self and know your opponent. For example, if you were to have an ADD/ADHD individual under your leadership how would you treat that person? Without the afforementioned appreciation, you may decide that this person has no value, or no morale conviction? You too may be seduced into believing that one can “train attention through individual effort” as Dr. Greenland believes or fail to do due diligence like Dr. Lynn has. You too may believe that this person is, therefore, not trying hard enough. Or you could accuire the knowledge about ADD/ADHD yourself and use the talents that have been delt you.
Information is ammunition.
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