Michigan Cuts Funding for Training Psychiatrists
Kim Norris, Detroit Free Press- 1/25/2002

Two months ago, Yousha Mirza, who was in the last year of his psychiatric residency at Wayne State University and ready to specialize in child psychiatry, suddenly found himself casting about for a new place to train. In November, the state eliminated all the funding for the programs that train most of the psychiatrists at Wayne and Michigan State universities, leaving the future of the programs in doubt and their participants in limbo. "It was not a good holiday season for us," said the 27-year-old resident.
    An executive order signed by Gov. John Engler cut and shifted $540 million from the 2002 state budget. Casualties of the cuts included the psychiatric residency programs at the two universities. At the 11th hour, a solution was found that restored half the money to both programs, ensuring the current residents they would complete their training. But it left in doubt the long-term future of the programs that train many psychiatrists that go into public practice in the state's underserved areas. Under the reduced funding, the universities have to cut faculty and recruit fewer residents, at least in the short term.
    Although the executive order technically eliminated $1.5 million from Wayne State's psychiatric resident program and $500,000 for MSU's program, the impact was far more severe as the state-provided money was matched by the federal government. Consequently, the universities lost twice that. The effects were devastating. Residents in the middle of their programs did not know if they could complete their training.
    After four years of undergraduate school, four years of medical school and 3 1/2 years of resident training, Dave Van Holla suddenly didn't know whether he'd be able to finish. The native of Iron Mountain had planned to do his fourth year in the Upper Peninsula and set up a practice in the area, which is hungry for doctors. Suddenly, he and his fellow residents were going to have to look elsewhere for their training.
    But, under a plan adopted to restore some funding, the schools put up the money the state used to provide and it is being matched by the federal government. "I don't think this is a good long-term solution, but it will save the program for next year and give us time to come up with a long-term solution," said Manuel Tancer, interim chairman of the department of psychiatry and behavioral neurosciences. "We can only get the $1.6 million back in this solution. So in terms of new dollars, it's only half," Tancer said. "Residents are relieved and back to concentrating on what they are supposed to be doing, which is learning," Mirza said.
    State Sen. John Schwarz, a Battle Creek Republican, who serves on the health policy committee, said it was unlikely officials recognized what might happen to the programs when they made the budget cuts. "Even though fair warning was given, there was not an acute enough appreciation on the part of the executive branch that people need psychiatric care, and much of that care is given by these residents," said Schwarz, one of few physicians in the Legislature. He noted that the solution is only temporary. "We still have to look at 2003, which is another whole story," he said.
    Longer term, the outlook is murky. The state Department of Community Health, which offered the programs up to the budget-cutting knife, noted that no other Michigan universities or graduate medical training programs receive special funding for psychiatric training. "There are other programs in place . . . residents being trained in psychiatric residency that are not at those two universities," said Geralyn Lasher, Michigan Community Health Department spokeswoman. "They don't have a separate line item from the state, and there's no reason why those two universities can't" operate the same way," she said.
    But Kathleen Gross of the Michigan Psychiatric Society said the special funding for MSU and Wayne State has its roots in efforts by the state to create its own incubators for training doctors who will go into public psychiatry in many of the state's underserved areas. Mirza said that during his third year of residency, he had a caseload of more than 100 patients whom he treated at DMC's Sinai Grace Hospital and two other Detroit clinics for a full 12 months.
    Of the 60 doctors who graduated from Wayne State's residency program between 1997 and 2001, 48 of them, or 80 percent, stayed in Michigan. Nearly half of those went to work in community health centers or state facilities, according to Beth Ann Brooks, residency training director in psychiatry and child and adolescent psychiatry at Wayne State. Michigan State residents and faculty operate a teaching clinic on its East Lansing campus that gets 700 patient visits a month, Van Holla said. MSU grads staff the community mental health agencies in Clinton, Ingham and Eaton counties, and the university is a recruiting bed for western, northern and mid-Michigan doctors, who set up practice in many of the state's rural areas.
    Even with some of the money restored, the psychiatric programs have taken a hit. At Wayne State, some faculty have been laid off and others put on reduced time schedules at reduced salaries. The psychiatric department has more than 100 faculty members, including 80 full-time professors, said Tancer, who added: "There will be further cuts" in the next few months. Right now we have more faculty than we need for the size residency we have. We still have a $1.5-million deficit." Ultimately, Tancer said, "We're going to recruit fewer people over the next years. We're not entirely sure how many."
    The difference will not immediately be noticed, although in the long term, there would be fewer psychiatrists for Michigan. "It's hoped that in better economic times we can expand the program again," Tancer said. But that is far from certain. "The psychiatric residency program issue is a metaphor for other problems we will be facing in the 2003 budget," Schwarz said. There are going to be lots of other problems -- health care, transportation, public safety, education. "The dollars just simply aren't there."

Anger Management: Taking Simple Steps to Avoid Losing Control
Redford Williams, ABC News- 1/25/2002

Today's sentencing of Thomas Junta of six to ten years of imprisonment for the beating death of fellow hockey dad Michael Costin signals a tragedy that hits close to home not only for their families but also for many average Americans. Who among us has not experienced negative reactions ranging from mild annoyance to rage in response to the unfavorable events of everyday life? Both Junta and Costin had previous arrests for assault, but there are ample examples of perfectly "normal" men — it's almost always a man — succumbing to the impulse to lash out in violence at those we perceive to be a threat.
    While those who harm others must be subjected to justice, it has become clear that the threat of punishment is not a deterrent to violent acts. The assistant manager of the ice rink testified that when Thomas Junta, after being ejected, stormed back into the rink, "his face was very red" and "his hands were clenched." Such a state is not conducive to the cool, rational consideration of possible consequences of continuing the fight.
    Anger management skills are critical tools that we all need if we are to keep other families from losing their fathers.  But how do we learn such skills? Thomas Jefferson once said, "When angry count to 10; when very angry count to 100." When we lash out, with or without the tragic consequences suffered by Michael Costin, it is the lower part of our brain — the so-called "reptilian brain" — that has hijacked our body. But, humans have a cerebral cortex that gives us the capacity to reason, if we give it a chance. When angered, we can command our cerebral cortex to evaluate our anger — to determine if we need to take action to right a wrong, or to change our reaction to the situation.
    I recommend the "I AM WORTH IT" exercise. "I" reminds you to consider if the situation is important to you. Is it worth your continuing attention?  "A" asks you to reflect upon the appropriateness of the anger response in light of the objective facts. Would other reasonable people have a similar reaction?  "M" calls for you to ask yourself if the situation is modifiable. Is there anything you can do to change the situation so that you are not so angry?  "WORTH IT" asks that you reflect on whether or not it would be worth it to take some action to change the situation. The jerk who is tailgating you at 70 mph might back off if you tap your brakes, but he might retaliate with a .357 magnum (should he carry one), or he may try to pull in front of you and then slam on his brakes. It isn't worth your life. Better to pull over and practice a relaxation exercise!
    Any "No" to the "I AM WORTH IT" questions means you need to change your angry reaction. Four "Yes" answers, on the other hand, means this is one of those times when you should do something. It doesn't mean that, like 007 you've been given a license to kill, however. It means that you need to practice — as calmly as possible — assertion, by asking the other person to change the behavior that is bothering you. Or you could engage in problem solving to come up with some ways to get to your destination when your flight has been canceled. If Mr. Junta had known to ask himself these four "I AM WORTH IT" questions before storming back into the rink, his answers might have led to a far better outcome.

Group Therapy May Help Fibromyalgia Patients
Charnicia E. Huggins, Reuters News Service- 1/25/2002

NEW YORK -- Group psychotherapy may decrease depression and fatigue among individuals with fibromyalgia, new study findings suggest. And some patients may even feel less pain after the therapy, according to researchers. Fibromyalgia, a chronic condition estimated to affect 2% of Americans, is marked by pain in the muscles and around the joints and is often accompanied by depression and fatigue. The cause is unknown, but researchers have found pain-processing abnormalities in the spines and brain stems of some people with the condition.
    "Persons with fibromyalgia...should ask their healthcare provider for psychological services available to them to possibly assist in improving physical symptoms as well as psychological distress," lead researcher Dr. Frances J. Anderson, of St. John's Regional Health Center in Springfield, Missouri, told Reuters Health. Anderson and her colleagues investigated the effect of group psychotherapy in a study of 59 people with fibromyalgia. All participated in a one-year outpatient fibromyalgia treatment program and an 8-week course on coping skills. In addition, 35 elected to participate in a 90-minute psychotherapy session each week for 14 weeks. The remaining patients were used as a comparison group. At the end of the 14 weeks, the psychotherapy group reported less depression, fatigue and morning tiredness than they had at the start of the study, according to the investigators. Further, in comparison to their initial reports, they had a more positive attitude about their condition and also perceived themselves more positively. They also had an improved outlook on their interactions with others and felt they had a greater "support system," the study findings show.
    What's more, some individuals also reported feeling less pain after the psychotherapy, the researchers note. The "simplistic" explanation for this finding is that "the more isolated you are and the more you focus on your pain, the more pain you're going to experience," Anderson said. "With social support, people feel more connected, (have) more meaning in life, feel less depressed (and), therefore, experience less pain." In light of the findings, "people with fibromyalgia, particularly when experiencing depression, might benefit from participation in group psychotherapy, in combination with other aspects of a fibromyalgia treatment program, including coping skills classes," Anderson said.
    Anderson's results are not surprising, according to Dr. Sandra Sephton of the University of Louisville School of Medicine in Kentucky, who was not involved in the study. It "makes sense" that psychotherapy would have effects such as decreasing depression since it is "specifically targeted to depression," she told Reuters Health. On the other hand, Sephton pointed out, the study had a "strong bias" because the study group chose to receive the psychotherapy instead of being randomly assigned to receive it. "People who want to do it are much more likely to benefit from it," she said. The findings were presented recently in San Francisco at the annual meeting of the Association of Rheumatology Health Professionals.

Accusers' Accounts Tell of Abuse And Its Scars
Michael Rezendes & Matt Carroll, Boston Globe- 1/26/2002

New evidence in the lawsuits against convicted child molester John J. Geoghan and leaders of the Boston Archdiocese provides chilling accounts of the former priest's alleged sexual abuse of children - both boys and girls - and the long-term trauma they say they suffered. The sworn statements by Geoghan's accusers, made in response to questions by lawyers for Cardinal Bernard Law and church officials, also provide more evidence that the church knew of Geoghan's sexual compulsions in the early 1970s and possibly the late 1960s.
    In one of the statements, Francis Leary of Roslindale said Geoghan repeatedly abused him in 1974 after encouraging him to take a job doing yard work at St. Andrew's Church in Jamaica Plain - in once instance ordering him to recite a prayer, the Hail Mary, while molesting him. ''I also remember that Father Geoghan told me that I was special and that I should not tell my mother about what he had been doing to me,'' he said. In other instances, parish officials allegedly witnessed Geoghan and Leary together in the church rectory - once while Geoghan was sexually abusing the child. ''I recall that on one occasion when Father Geoghan led me up to his room, an older nun was standing on the bottom of the stairs,'' he said. ''I also recall that on another occasion when I was in Father Geoghan's room, a priest with gray or white hair came into the room and told Father Geoghan to stop molesting me. I do not know this priest's name.''
    Leonard Muzzi Jr., in a separate sworn statement, said that in the late 1960s he discovered Geoghan in his Hingham home at the bedside of his son, with his hands under the blankets. Muzzi said he ordered Geoghan out of his house and told him to never return, only to arrive home on a subsequent evening and find Geoghan sitting on his couch with his three children. At that point, Muzzi said, he called St. Paul's Church, where Geoghan was assigned, asked for the person in charge, and ''told this person that he had caught Father Geoghan with his hands under his son's'' bedclothes.
    In sworn statements of their own, Geoghan's superiors at St. Paul's said they could not recall any such complaint made about Geoghan in the late 1960s. But Richard Sipe, a former priest and psychotherapist, told the Globe that Geoghan received treatment for sex abuse at the Seton Institute in Baltimore at about that time. Sipe was on staff at the institute but did not treat Geoghan. Geoghan's pastor at St. Andrew's, Rev. Francis H. Delaney, also said under oath that he could not recall anyone making a sexual abuse complaint against Geoghan. But when a lawyer for Geoghan's accusers showed Delaney a copy of a letter the pastor had written describing such a complaint, Delaney's memory was refreshed.
    In the August 1979 letter to Bishop Thomas V. Daily, administrator of the archdiocese, Delaney reported that a Jamaica Plain woman had made ''serious charges of a moral nature'' against Geoghan and another priest, but also attacked the woman's credibility. Delaney said the charges were not to be believed, describing Geoghan as ''an outstanding, dedicated priest who is doing superior work'' and as ''a zealous man of prayer who consistently gives of himself in furthering the cause of Christ.''
    In one case, Dolores Scott, who lived with her three sons and three daughters in the Archdale housing development in Roslindale during the mid-1970s, said she first encountered Geoghan through a boy who now says the former priest had molested him. One of Scott's daughters, Leona, said in a statement that Geoghan exposed himself to her and her half-sister while sitting with them on the couch in their living room in 1975. ''Father Geoghan's pants were open and his penis was exposed and he was masturbating,'' Leona Scott said in her statement. While he was doing this, she added, Geoghan asked ''if her brothers took baths together and washed each other.''
    Dolores Scott, Leona's mother, said that the first time she saw Geoghan, he was sitting in a car with Peter Mendez on a street near the Archdale development. Mendez, an altar boy at St. Andrew's, introduced her to Geoghan, Scott said, and before long Geoghan was a routine presence in her home. At one point, Scott said, Geoghan told her that he was teaching her sons about puberty ''and that they should know what was happening to their bodies.'' But she said she had no idea that he was exposing himself to her daughters and abusing her three sons. Nor did she know that Geoghan was also abusing Mendez, she said.
    In his own statement, Mendez said Geoghan would often invite him into the church rectory and fondle his buttocks and genitals while wrestling with him and bouncing him on his lap. In one instance, Mendez said that Geoghan, while hearing his confession, asked if the altar boy had sexual relations with his sister or brother. Mendez also said that Geoghan, while visiting his home, watched while he and his brother took baths. He also said that Geoghan once took a shower with the boys, had them compare body parts, and told them not to tell their mother about the incident.
    Many of Geoghan's accusers said they had suffered long-term emotional trauma because of Geoghan. For instance, Leary, who was abused as a 12-year-old at St. Andrew's, later married and started a family. But after years of emotional difficulties, he suffered a 1999 nervous breakdown and lost his job. ''I was evicted and had to sleep in a friend's garage,'' Leary said. ''I became homeless and had to give my wife custody of my son.'' In a seven-page evaluation, Leary's psychiatrist attributed the breakdown to abuse by Geoghan.
    Yesterday, in a related development, Boston police spokeswoman Mariellen Burns said that police had received no communication from the Archdiocese, or from any church official, during the mid-1980s when the police Sexual Assault Unit investigated Geoghan for allegedly fondling or molesting two youths. Burns said police decided not to go forward with prosecution because the parents of the victims said they would not cooperate.

Outdoors Exercise Helps Combat the Winter Blues
Jim DuFresne, Ann Arbor News- 1/26/2002

If you're feeling tired, lethargic or depressed lately you may be suffering from a winter condition known as seasonal affective disorder (SAD). SAD is the result of the biochemical changes that take place in the human body when it is deprived of normal amounts of daylight. "It has to do specifically with the shorter daylight hours of winter and not whether it's a sunny day or a cloudy day," said Dr. Robert Bielski, who conducted a series of studies on SAD patients for Michigan State University in the late 1990s. "We think in some people (less daylight) triggers reactions like those that occur in mammals that hibernate," Bielski added.
    An extensive survey on the East Coast in the mid-1990s revealed two-thirds of the participants had some symptoms of SAD; Bielski believes Michigan has a similar rate. "Probably two to three percent (of those people) have really severe cases where it interferes with their lives," Bielski said. Shorter days trigger changes in the production of two key brain chemicals -- melatonin, a hormone that induces sleep, and serotonin, a neurotransmitter that keeps people alert and upbeat. Both are linked to the pineal gland at the back of the brain, a light-sensitive organ which receives signals from the eyes. Biochemical researchers have found that as sunlight exposure increases, the body produces more serotonin, the reason you're still raring to go at the end of a long summer day. But as exposure to sunlight decreases, the pineal gland produces more melatonin -- that's why many people feel so listless in the winter.
    The most common symptoms of SAD are: Difficulty falling asleep on a regular schedule, oversleeping, lethargy, fatigue and a lack of energy, a craving for sweets or carbohydrates that often leads to overeating and weight gain, no sexual desire and depression. Although Dec. 21 is the shortest day of the year, researchers say there's a lag in the body's reaction to diminishing daylight. For that reason SAD affects people the most from mid-January through February. For the vast majority of people SAD merely involves a mood swing or a lack of energy that is written off as "cabin fever."
    But for some SAD is a serious illness that can lead to an inability to hold a job, spousal abuse, alcoholism and even suicide. "I've had patients who every winter had lost their job because they literally could not get out of bed," Bielski said. In Alaska, where daylight in the winter can range from five hours in Anchorage and two hours in Fairbanks to none at all in Barrow, SAD is suspected of driving down economic productivity from November to February. "People up here get very depressed, very moody in the winter," said Karin Nierenberg, who moved from Ohio to Healy, Alaska in 1990.
    Because of her location north of the Alaska Range, Nierenberg sees only four hours of daylight in January and part of February and never sees the sun for six weeks during the winter (December and January) because it is blocked out by the mountains. "When I first moved here I was suffering from severe headaches, stomach aches and other ailments that only occurred during the winter," Nierenberg said. "When I talked to people about it I realized I was just depressed from the lack of light."
    Treatment for serious cases of SAD includes clinical sessions called phototherapy, where patients sit in front of a bank of intense lights. Others turn to medication, including Prozac, to combat depression. For the rest of us, the solution is relatively easy -- go outdoors and exercise. So, take a break to leave the office and get in a brisk 20-minute walk outside. Or go to the park with a pair of cross-country skis or snowshoes and spend a half hour skiing or walking through the snow. You can also call your local nature center. Most have regularly scheduled walks, snowshoe treks and ski outings on their trails. "For people who are suffering from mild conditions of SAD outdoor activities are probably the most helpful thing they can do," Bielski said. Nierenberg also combats SAD by surrounding herself indoors with lots of bright lights and plants. "Our electric bill is sky high in the winter," Nierenberg said. "But now it's to the point where I really enjoy the winter. I look forward to it because it's a nice down time in Alaska."

Youth Who Killed Mom Tries to Tie It to Her Pre-Natal Alcoholism
Associated Press, 1/26/2002

WHITE RIVER JUCNTION, Vt. -- Paula Easton-Stanard's cocaine and alcohol use during her pregnancy nearly 20 years ago could have caused her teen-age son to kill her, two psychologists have told a judge. Laird Stanard, 19, is trying for the third time since July to get the 25-years-to-life sentence he got for killing his mother reduced. He gunned down Easton-Stanard and tried to kill his father while home on Christmas break from his Maine prep school in 1999.
    At a hearing in Vermont District Court on Friday, Stanard's lawyer asked again for a sentence reduction this time in light of the new evidence about his mother. Family friend Tracey Becken testified that Easton-Stanard had a substance abuse problem before, during and after her pregnancy with Laird. Easton-Stanard frequently drank alcohol at parties and ''often at lunch at her house,'' Becken said. ''There was no change when she was pregnant. ... In my opinion she was a heavy drinker.'' Easton-Stanard also used cocaine between five and 30 times between 1980 and 1982, Becken said. William Stanard, Easton-Stanard's husband and Laird's father, sat on a bench in the back of the courtroom for the hearing.
    Becken said she met Easton-Stanard in the early 1980s when both women were living in the Newport, R.I., area.  Becken was addicted to cocaine during those same years, she said under questioning by Windsor County State's Attorney Robert Sand. ''She (Becken) was not in good mental or physical condition in the summer of 1982, the critical time period we're talking about,'' Sand said in his closing argument. ''She is a poor historian.'' But Stanard's lawyer, P. Scott McGee of Norwich, said Becken's willingness to expose a turbulent part of her life made her testimony more credible.
    Friday's hearing also included testimony from two psychologists who agreed that Stanard's mental instability at the time of the shooting could have been a result of his mother's substance abuse while he was in the womb. William Stanard and the Easton family oppose any sentence reduction, Sand said. Hudson is expected to rule in the coming weeks.

A Book Review of "The Truth Will Set You Free " by Alice Miller
Daphne Merkin, New York Times Book Review- 1/27/2002

Genuinely idyllic childhoods are as rare as sunny days in Seattle. Those of us who have had good-enough childhoods should call ourselves lucky, but what's to be done with an irredeemably bad childhood? Given the requisite talent and ambition, it's always possible to spin gold out of dross and thereby convert pain into art. Without unhappy beginnings, we probably wouldn't have half the literary works we do, from Samuel Butler's "Way of All Flesh" to Frank McCort's "Angela's Ashes." (Edmund Wilson's wound-and-bow theory of creativity holds true for other fields as well: we wouldn't have Ingmar Bergman's "Fanny and Alexander" or Louise Bourgeois's sculptures, either) Most adults, however, don't emerge from traumatic backgrounds and go on to write mesmerizing accounts of the scars inflicted. They're more likely to make do by repressing their memories and imagining that they had it easier than they did, or even by idealizing the parents at whose hands they have suffered. The majority simply hobble around, scattering misery, and handing on the damage to the next generation. None of them, according to Alice Miller, guru of wounded inner children everywhere and the author, most recently of "The Truth Will Set You Free," will succeed in escaping the shadow of their past.
   Miller, a Swiss psychoanalyst, burst into public awareness in 1981 with a slim treatise called "The Drama of the Gifted Child." (First called "Prisoners of Childhood," the book was cannily retitled by the author, presumably to flatter its readers.) I still remember the passionate response evoked by Miller's account of the childhood trauma that was inevitable in even the most well-meaning families; it seemed there was almost no one who couldn't identify with the notion of having once been a lonely or tormented captive in the hands of inattentive, neglectful or outright abusive parents. Friends I considered to be paragons of mental health, or I knew to have had overindulgent mothers and fathers, treated as nothing short of revelatory the book's plain-spoken insights into the unwittingly brutal behavior that Miller claimed is regularly shown the "tender, budding self" of the average child.
    In retrospect, the book's impact--it has sold more than 800,000 copies--can be accounted for in part by its accessible rendition of basic but often murky psychoanalytic concepts like "repetition compulsion," "maternal mirroring," "splitting" and the "false self." The book's audience in waiting--those desperate overachievers who compensated for early sorrow by fixating on the "intoxication of success" rather than facing up to their "unmet childhood needs"-- didn't hurt either. What self-respecting narcissist of a reader wouldn't want to be a member of a club predicate don a rarefied sort of victim status, in which underlying depression was warded off by "increased displays of brilliance"?
    But by far the largest reason for the book's effect was its timing: much of what Miller was getting at--which is that battered or deprived children grow up onto enraged or disaffected adults who frequently become monsters themselves--is now, at least in theory, an accepted part of the cultural dialogue. Twenty years ago, though, the unsettling implications of her message about the "unrestrained use of power" that is accorded caregiving adults had not yet become a commonplace. "The Drama of the Gifted Child" must be credited with providing a way--in those far-off days before all families were deemed dysfunctional until proved otherwise--for the general public to borrow from the calibrated language of professionals in order to describe the hidden realm of their feelings. Indeed, Miller could be said to be the missing link between Freud and Oprah, bringing news of the inner life, and especially the subtle hazards of emotional development, out of the cloistered offices of therapists and into a wider, user-friendly context.
    From the start, Miller's work met with resistance as well as admiration, particularly from those who carried the banner of biological determinism in the never-ending nature-nurture debate. Nor did it help that some of her assertions seemed questionable or that her case histories, even taking into account the general malleability of this genre, were loosely adduced and suspiciously contoured to fit her theories. There were also some who resisted the implacable monocausality of an outlook in which everything from Alphonse Daudet's manner of death to the rise of Nazism can be traced back to childhood suffering. There is precious little resilience in the world according to Miller--next to no possibility of rising heroically above desolate circumstances. And there is scant allowance made for the ordinary imposition of parental influence--referred to disapprovingly in "The Drama" as "value selection"--in which one sort of behavior (sharing toys, say) is encouraged and another (grabbing someone else's toy) is frowned upon and which of necessity favors the adult view over the young child's.
     With each successive book (she has written nine in all), Miller continued to advance her key beliefs--namely, that all artistic endeavor is purely compensatory, rather than an expression of innate creativity, and that all the world's ills, including he existence of tyrannical leaders, can be traced back to tormented childhoods. In her second book, "For Your Own Good," she used the example of Hitler's brutal treatment at the hands of his martinet father--as well as the recollections of authoritarian upbringings by high-ranking SS officers--to explore the human fallout of what she termed "Poisonous pedagogy." This was a style of child-rearing derived from a popular series of 19th-century manuals written by Daniel Schreber, a German doctor (whose son, a paranoid judge, wrote a memoir that became the basis of one of Freud's early case studies), which emphasized breaking the child's will at the earliest moment. The advice that Miller quotes is indeed hair-raising, but her sense of righteous horror seems to overlook the fact that the whole notion of children having rights of their own, worthy of respect and protection, is itself not much more than a century old.
    More disturbing than Miller's lack of historical context, however, was an ever more discernible grandiosity of both tone and purpose. She wrote as if no one had come before her--no one, that is, with sufficient temerity to expose the evil perpetrated in the name of parenthood--and peppered her books with fulsome letters paying her homage. Her convictions began to sound more and more like obiter dicta, and her attitude was as intemperate as her logic was invincible: either you were with her or you weren't, and if you weren't--if you hadn't given up your illusion of having had a happy childhood--it could only mean that you were in denial.
    Somewhere along the way to positioning herself as the lone courageous voice in a wilderness of self-deluding wimps, Miller broke with the Freudian tradition; her declaration that Freud had abandoned his seduction theory because of his inability to confront his own demons earned her the admiration of that famous Freud-basher Jeffery Masson. (Miller goes so far as to suggest that Freud developed cancer of the jaw in reaction to having silenced himself on the subject of child molestation.) In "Banished Knowledge" (1990) she claimed to have found therapeutic salvation in the breakthrough method of someone named J. Konrad Stettbacher, to whose own book "Making Sense of Suffering" she contributed both a foreword and an afterword--only to retract her endorsement of his regression therapy in a later book. In "Thou Shalt Not Be Aware" (1985) Miller criticized Melanie Klein for popularizing the notion of the hostile infant and thereby condemning the child and sparing the mother, and in "Paths of Life" (1998) she voiced doubts about the efficacy of Arthur Janov's primal therapy, which she had previously been a fan of. Even Wilhelm Reich, whose concept of emotional armor she acknowledges, ultimately disappoints because of his focus on infantile sexuality--which, no surprise, Miller sees as his way out of dealing with the sexual exploitation he endured at the hands of a maid when his mother committed suicide. One couldn't help wondering, a bit uneasily, if anyone met her standards besides herself.
    "The Truth Will Set You Free" is a demonstration of the dangers inherent in setting oneself up as a seer. Miller takes her role as avenging angel utterly seriously, with the result that her thinking has ossified into an ideology consisting of a handful of reductionist premises, some dubious scientific evidence and any number of vague claims. She restates her earlier belief that without the presence of a "helping witness" to empathize with or stand up for them, abused children run the risk of turning into mass murderers, and that "major writers, philosophers and artists" owe their inspiration to experiences of emotional or physical violation. Declaring that this book is an expression of "my identification with Eve," she faults the story of Creation, and its prohibition against seeking forbidden knowledge, with originating the concept of the disciplinarian parent in the form of a punitive God. None of this would appear to be very new, but to listen to Miller she has stumbled on an invaluable insight with her discovery that the Bible was written by men who presumably "had been through some unpleasant experiences at the hands of their fathers" and were thus unconsciously led to create the "cruel scenario" of the Garden of Eden.
    Miller's cartography, then, is bleak as ever, with a new emphasis on recent neurological studies indicating that early mistreatment can result in both hormonal changes and brain lesions: "A number of researchers," she airily observes, "have established that neglect and traumatization of baby animals invariably leads to both functional and structural deficiencies in their brains. Gradually this effect is being found to be true for human babies as well." Similarly, she asserts that battered children store memories of corporal punishment in their bodies, which later cause them to take revenge--sometimes (as in the case of Hitler, Stalin and Mao) in a global fashion. One of the frustrations of reading this writer has always been her free and easy way of appropriating other people's research. In this case the issue is less whether these sorts of mind-body interactions are possible (I tend to think they are) than the enormously speculative use that Miller makes of findings that are uncertain to begin with. She attributes all manner of illness, including intestinal disorders and autism, to repression and denial. There is no human catastrophe, from the massacres in Rwanda to the reign of the Romanian dictator Nicolae Ceausescu, that can't be accounted for by a simplistic citation of child-rearing gone tragically wrong. Meanwhile, she persists in her habit of uninhibited self-endorsement--quoting from worshipful correspondence, directing readers to her Web site and continuing to chide all the imposing figures who have explored the psychic world of children before her (this time around it's D.W. Winnicott) for remaining trapped in their own defense mechanisms.
    In what is perhaps the most disconcerting anecdote of all, Miller tells us that she wrote a letter to Pope John Paul II, confident that he would be moved to action after she opened his eyes to the reality of child abuse. Miller is irked that the pope himself did not answer her letter, but what really gets to her is that the reply she received failed to acknowledge the significance of her work: "Nowhere did this response from the Vatican refer to the important information and insights I had written about in my letter. Obviously the person I had asked to forward my letter and whose job it is to screen the mail was unable to relate to its contents. It is also conceivable that the information it contained aroused in them memories of their own upbringing, prompting them to dismiss my request out of hand.
    The pity of it is that we end up dismissing the message along with the messenger. Miller's excesses--the bombast and imperiousness, the fanatic refusal to make distinctions along a continuum of harmful child-rearing--have served to diminish her perspective to one of easily parodied alarmism. It is an unfortunate irony that Miller's own autocratic and, ultimately, very Teutonic approach has largely worked to obscure what is genuinely important about her campaign to awaken the world to "the panic of the beaten child." True, she has earned a devoted cult following, and has influenced legislation against the use of corporal punishment in Germany. But I have the impression that she is not taken seriously outside a group of true believers, and not only because, as she would have it, most of us are resigned to living in darkness about the parents who have misshaped us. Miller's wish to make people more aware of the long-ago hurts that drive them and to bring an end to the cycle of generational abuse is undoubtedly a worthy one, but she stops at casting blame, without going on to provide a practicable solution. Perhaps there is none, except to try to come to terms with the damage done. Our flawed parents have had less than perfect childhoods, too; if we were to take Miller at her dire word, we would have to go back and reconstruct the entire human enterprise, which is unlikely to happen anytime soon.

A Book Review of "A Life: Jane Addams " by Jean Bethke Elshtain
Christine Stansell, New York Times Book Review- 1/27/2002

When Jane Addams died in 1935, she was the most venerated woman in America. A pioneering social worker and a tough and visionary liberal, Addams rode out years of vilification for her pacifism and labor sympathies to win, in 1931, the Nobel Peace Prize for her leadership of the women's international peace movement. "Jane Addams and the Dream of American Democracy" presents Addams as an exemplary public intellectual, as serious as, say, her contemporary Herbert Croly. Jean Bethke Elshtain seeks to rescue the great reformer from her reputation as a prim Lady Bountiful and to make her example and her ideas newly available for our own needs.
    Addams was born in 1860 in small-town Cedarville, Ill., to a prosperous Quaker family imbued with dedication to the antislavery cause. Her beloved father, John Addams, was a Republican state legislator, a friend of Lincoln's, who taught his daughter that party politics could not just contain but also advance idealism. Even though as a woman she was disfranchised much of her life, she would learn to work shrewdly in rough-and-tumble electoral politics, first in Chicago, later with Theodore Roosevelt's third-party Progressives in 1912. Addams's mother died when she was young; raised by a stepmother whom she never fully loved, she nourished herself on classics--Dickens, George Eliot, Shakespeare, "The Pilgrim's Progress"--and concocted her own blend of socially conscious Christianity. Elshtain sketches a moving portrait of Addams's morally precocious childhood. Bereft of her mother, Elshtain argues, the bookish child "never forgot what it meant to be frightened and all at sea." That knowledge would become the source of her great empathy for the immigrants she met in Chicago, people also at sea.
    A fortunate member of the first generation of middle-class girls to go to college, she spent four heady years at a nearby seminary, thrilling to the intense study and the company of other idealistic young women. But graduation in 1881 offered no egress to a wider life--there were few professions open to educated women--and Addams returned home, to take up her filial duties and wait for some suitor's proposal. She would later call the expectations about young women's destiny "the family claim" and she collapsed under its weight. Her father's death precipitated a debilitating breakdown into inertia and despair.
    A tour of Europe in 1887 roused her. In London, she came upon Toynbee Hall, a settlement house opened by Oxford men seeking to alleviate the terrible poverty of the East End. Chicago, she believed, could use something similar. Acting on her own--her stepmother disapproved--she, along with a woman friend, found a spacious house at the edges of the tenement district and started their own settlement, inviting unmarried women of similar conviction to join them. Hull House was, from its inception, "no prison of refined domesticity," as Elshtain puts it nicely, "but a parlor of affectionate and expansive worldliness." The settlement ministered to a neighborhood of the poorest immigrants, Sicilians, Irish, Bohemians, Greeks and Russian Jews, the miserably paid workers in the meatpacking houses, steel mills and sweatshops whose labor was fueling Chicago's rise.
    From the beginning Addams's philosophy of philanthropy was respectful and pragmatic. She was familiar with the uplifting roles that Protestantism offered a young lady, but without fuss she rejected the missionary's do-goodism, the charity lady's presumption and the Social Gospel ministry's assumption that the well-off know best. Elshtain shows how brilliantly she remade charity work into a democratic social ethics that required, indeed extolled, a citizenry's responsibility for the poor outside the framework of Protestant conversion and conformity to middle-class norms.
    Addams had a keen eye for the practical needs of the poor. Over time, Hull House developed an enviable list of services: day nurseries, kindergartens, English classes, public baths, a boarding house for single people. But Addams also honored the immigrants' cultural appetites, both to hold onto their own traditions (Italian opera, for instance) and to acquaint themselves with the new. Hull House sponsored music groups, theater ensembles, handicraft workshops and reading clubs. Elshtain sketches a captivating bustle of activity: "If you were a resident, it would not be at all unusual to move over the course of a day from reading George Eliot, to debating Karl Marx, to washing newborns, to readying the dead for burial, to nursing the sick, to minding the children."
    Jane Addams's life has inspired many rich interpretations of her feminism, her private life with women and her ties to the political left. But no one has systematically examined her writing. Elshtain, a political theorist, sets out to rectify this neglect with close readings of Addams's ideas about class relations, urban democracy and social duties. The subtitle "A Life" is something of a misnomer, since readers coming to Addams for the first time will search in vain for a biographical narrative. Rather, Elshtain, working frequently in circles and often in the present tense, draws out what she sees as the essential truths Addams discovered. Addams was not a student of politics or philosophy, but she was a reader, and Elshtain grounds her ideas in a Protestant tradition of moral thinking that runs through literature. Stressing the influences of John Bunyan and George Eliot, Elshtain takes Addams's reminiscences of her childhood and life at Hull House, her essays on citizens' responsibilities and her vignettes of life with the poor and finds in them an integrated set of proposals about the claims of citizens on each other and the role those claims can play in building a culture of democracy. From this grows, Elshtain maintains, a theory of moral development; that theory, reduced to bare bones, holds that better selves result from helping others, and better cities, too.
    If this sounds like a Sunday school lesson, it's because Elshtain is exclusively, and at times narrowly, interested in the strain of Addams's thought that comes from late Victorian Protestantism. For all her interest in modern America, Addams was never drawn to modernity's ambiguities. Elshtain sees this as a good thing. To be sure, it was Addams's insistence on the home truths of the 19th century--especially her distrust of self-realization outside a framework of the higher good--that earned her the reputation in later years, even among the politically sympathetic young, of sermonizer and Puritan. But Elshtain believes that Addams's convictions can be the basis for contemporary revival for a broader Christian social ethics: "For Addams, it is in giving the self that one truly discovers oneself."
    In her bountiful sympathies for Addams, Elshtain creates a series of delicate and luminous exegeses. But a little of this goes a long way. As Elshtain's stately summaries of Addams's pronouncements roll on, her voice winds around her subject's, creating odd moments of piety, homiletics and over-generalization: "Without a mooring in a moral purpose, life scatters, falters, and dries up"; "The modern city degrades what should be exalted." At her weakest, Elshtain infers lessons for today: at times, she seems to advocate a thousand-points-of-light return to some golden age of private philanthropy, something that Addams, a progressive convinced that good government must expand its provisions for the unfortunate, would never have endorsed. Paradoxically, Elshtain's recuperation ends up creating not a political intellectual but a Protestant saint.
    But at her most astute, Elshtain gives a moving account of a stunningly creative woman occupied cognitively, emotionally and spiritually with the ways an elite in the cosmopolitan society riven by inequality might offer succor to others. Addams's dream of American democracy, based not in a loose collection of strivers but in a web of sympathetic, mutually respectful citizens, seems an artifact of a bypassed moment. Still, her life experiment in giving significant form to "unhistoric acts" of altruism has not been superseded. Elshtain's book supports, a hundred years later, the young girl's apprehension that "there's power in me."

Schools Have Responsibilities That Go Beyond Grades, Say Experts
Melinda T. Willis, ABC News- 1/28/2002

Alison Goller says her problems began at the start of her sophomore year, when a group of students on a Web site labeled her the "ugliest girl" at her Los Angeles-area high school. The harassment intensified with the circulation of a false rumor that claimed she had been videotaped having sex with several boys. Although there was no truth to the story, Goller says she was branded a "slut" and a "whore." Goller, 17, was harassed by students at her school so severely that she eventually transferred to a different school. Now, a pending lawsuit over the matter raises questions about the role that schools should play in preventing students from ostracizing other students.
    When Goller confided in her mother, Cathy Adams, about her problems at school, her mother took action. "I called the school and they set up a meeting," Adams told ABCNEWS' Diane Sawyer on Good Morning America. "I told them that I felt that there were several incidents that had happened over a few months, and I thought it was a pattern that was getting worse as it went along." Adams says she was told the school would investigate, but that she was never informed of the outcome of the investigation. She also says her daughter suffered retaliation from other students as a result of the inquiry. The situation at school got so bad that Goller told her mother that she just couldn't go back. They made arrangements for her to stay at home. "I felt like nothing was going to be done," Goller says. "I felt like the only thing I could do was leave school."
    Now the family is suing the Las Virgenes Unified School District, alleging the school failed in its duty to protect Goller from the sexual and gender-based harassment that took its toll not only on her grades, but on her mental state as well. "The last three months before she left school, I was being told by her [physicians] that she was bipolar," Adams says. "What does that tell you about stress and what stress can do to you?" The school district maintains it has acted appropriately and responded to inquiries from ABCNEWS with a written statement from McCune and Harber, the law firm representing it. "The District did in fact intervene and conduct investigations at that time. The Los Angeles Sheriff's Department, at our request, also conducted an independent investigation with the same findings and results. Based on these and other efforts, the District is confident that it will be exonerated in this action," the statement said.
    Some are wary of making student social concerns the responsibility of educators on any level. Many believe that schools cannot police problems, which are primarily social and developmental in nature, no matter how vicious they are. But child development experts and parents say social development is a key component of the educational process. "While adults look at schools as being academic and educational experiences, most children and youth look at school as social experiences," says Judith Myers-Walls, associate professor in child development studies at Purdue University in West Lafayette, Ind. "The social learning that takes place in schools is critical, and may be more useful in the long run than the math formulas they are learning." Schools already sponsor and encourage social activities such as school dances and athletic events, which some parents see as key opportunities for social learning. "If you can educate them about their role in sports, then you can educate them about how to treat another person," says Aileen Foster, a mother of two from Connecticut.
    Additionally, experts say social issues are not independent from academic concerns. Continued harassment and bullying can seriously affect a student's performance in class, making it hard to maintain good grades. "[Harassment] represents a significant distraction to the learning process," says Kendall Johnson, a high school teacher and author of Trauma in the Lives of Children and School Crisis Management. "If on no other grounds, the stated scope of practice of the schools is to deliver education to the kids ... that's enough reason to intervene and to act." While most agree that schools should not bear the sole responsibility for a student's social development, experts say they offer an opportunity to view children and adolescents in contexts that parents may not be privy to. Kids usually don't tell their parents that they are being bullied, not to mention the fact that they may be bullies themselves.
    So what steps can schools and parents take to assure that the social environment within schools is healthy and conducive to learning? "Ideally, the school would create a culture in which students would do some self-governance and would respond to actions like [bullying or harassment] by telling others that it is not funny," says Myers-Walls. "Kids need help learning what to do, not only what not to do." Some schools, for example, present students with a written code of conduct when they enter, establishing an environment in which students know what behavior is acceptable and what the consequences are for behavior that is not acceptable. Schools should also establish an atmosphere where students turn to authority figures if they are being harassed, experts say. "The school has to say to these kids, 'We won't tolerate it, the only way we can stop it is if you tell us, and we won't let people retaliate against you for telling,'" says Adams.
    And Alison Goller says her experience of harassment in high school has taught her that speaking up is OK, despite the retaliation she encountered. "If you're a kid and this is happening to you, please tell someone because you don't deserve it and no body else does," she says.

Family of MIT Student Who Committed Suicide Sues for $27 Million
Denise Lavoie, Associated Press- 1/28/2002

QUINCY, Mass.-- The family of a student who committed suicide at the Massachusetts Institute of Technology by setting herself on fire filed a $27 million lawsuit Monday accusing MIT administrators and counselors of negligence. Elizabeth Shin, 19, a biology major from Livingston, N.J., died in April 2000 in her dormitory room. She had received treatment through MIT's counseling and support services for more than a year before her death.  In the lawsuit, Cho H. Shin and Kisuk P. Shin claim school administrators and health services counselors failed to properly deal with obvious signs of mental illness shown by their daughter, who had repeatedly threatened to commit suicide. The school has denied any wrongdoing.
    On Feb. 12, 1999, Shin tried to kill herself by taking an overdose of Tylenol with codeine and spent a week receiving inpatient psychiatric treatment at a hospital, the lawsuit said. After that, she repeatedly cut her arms and wrists, the Shins said. The Shins claim MIT officials should have notified them of their daughter's worsening mental health. ''If they made even one phone call to warn us what was going on, Elizabeth would be with us now,'' Kisuk Shin said Monday.
    Shin's mother said her daughter never showed symptoms of depression before starting at MIT. But MIT officials last week said that Shin had experienced serious emotional problems since high school. ''Many people at MIT had offered as much help and support as they could to her,'' MIT lawyer Jeffrey Swope said in a statement Friday, when the family announced plans to sue. The family's lawyer, David DeLuca, said MIT officials explained they did not contact Shin's parents because of confidentiality laws, specifically the federal Family Educational Rights and Privacy Act that protects the privacy of a student's education records. Kenneth Campbell, a spokesman for the university, would not comment on DeLuca's claim. Since 1990, 12 students have committed suicide at MIT. A report issued by an MIT committee in August concluded that the university needs to make ''significant changes'' in its mental health services.

Domestic Violence Behind the Shoji Screen
Mark Magnier, Los Angeles Times- 1/29/2002

TOKYO -- Kimiko tells her story with calm detachment. How her husband beat her dozens of times during their 32 years together, raining blows down on her face, thighs and stomach, pounding her back with wooden boards, kicking her hard enough to break a rib. When he wasn't abusing her body, he tortured her spirit, making her feel ugly, awkward and worthless and forcing her to attend to his every whim. "I was a slave," says Kimiko, who asked that her last name not be used out of fear that her ex-husband might track her down. "No, it was worse than that. Even slaves have more freedom than I had." Until recently, abuse victims such as Kimiko were all but invisible in Japan, ignored in a society in which laws are largely made by middle-aged men and people learn not to notice bruises, sunglasses and other telltale signs of domestic violence.
    Late last year, however, Japan became the last major industrialized nation to formally recognize the problem, enacting legislation aimed at preventing such violence and protecting its victims. Particularly shocking for many Japanese as the issue has gained prominence is how widespread domestic violence--known here as DV--is and how high up the social ladder it extends in a society long proud of its civility, refinement and understated emotions. Japan's first nationwide survey on the topic, done by the government Cabinet Office in 1999, provided a wake-up call when it revealed that one in 20 Japanese wives had suffered life-threatening violence at some point during marriage, while four times as many had endured some sort of physical abuse.
    Since the new law went into effect Oct. 13, complaints to police have jumped 50%, to about 1,500 a month. Some of the cases can be attributed to stress caused by higher unemployment, experts say, but a larger factor in the increase appears to be a greater willingness to report abuse. "The idea is finally spreading that you don't have to put up with DV, that it's all right to speak out," said Mariko Mitsui, chief of a government Gender Equality Center in Osaka.
    Changing the law is one thing. Changing culture and social traditions is quite another. At the root of Japan's long-standing myopia toward domestic violence, say counselors, activists and victims, is a conspiracy of silence, an assumption dating back to samurai days that the way a husband treats his wife behind the shoji screen is his business. Japan's tepid first steps toward recognizing and treating domestic abuse--decades after its Western counterparts--are part of a sea change here. Experts say shifting values and social structures are gradually empowering weaker members of society, encouraging some to question male-dominated traditions and the often-substantial social price Japan has paid for its material success.
    "Many people still view women as property of their husbands," said Kazuhito Shinka, a deputy director with the central government's Gender Equality Bureau. "There's been a view that legal issues shouldn't intrude on the family." Japan found itself rather embarrassed on this count three years ago when Shuji Shimokochi, then a 51-year-old consul general, was charged with punching his wife in the face during a fight at their residence in Vancouver.
    Questioned by Canadian police, he reportedly dismissed the incident as "a Japanese cultural issue," claimed that his wife deserved to be struck and told officers that the matter was not serious. Domestic violence experts say the mind-set of Shimokochi, who was shipped off to a think tank affiliated with the Japanese government, is all too common.
    Noriko Yamaguchi, an official with the Batterer Intervention Assn., a Tokyo civic group, blames in part a system that offers almost no counseling or treatment for the abuser. Japanese men are brought up not to show emotion or reveal weakness, Yamaguchi said. "If they finally do show something of themselves, it all too often comes out through anger," she said.
    There also is a long-held misconception in Japan that domestic violence is largely a problem of the poor and uneducated. "In fact, it's often lawyers, policemen, bureaucrats and professionals doing it," said Stephanie, a counselor for Japanese and foreign victims at Tokyo's HELP Asian Women's Shelter and hotline, who asked that her last name not be used out of concern for her safety.
    Hiroko Sato once told reporters that she had been beaten repeatedly by her husband, former Prime Minister Eisaku Sato, who in 1974 received Japan's only Nobel Peace Prize.
    Women's groups say the new law leaves much to be desired. It carries no penalties, leaves treatment to a legion of competing agencies, provides little new funding and limits restraining orders to cases of physical abuse, not sexual or psychological damage. Furthermore, it protects only battered wives, not their children, opening the door for husbands to grab offspring and use them as leverage. Spousal rape, which is a crime in all 50 American states, is not illegal here.

System of Shelters Far From Sufficient
The nation's shelter system also is woefully inadequate. Japan plans to set up a nationwide network of government facilities in April by converting existing halfway houses for prostitutes. It also plans to hire more outside counselors after complaints that bureaucrats doing the job are cold, insensitive, even reproving of victims. But many of the new government shelters are expected to continue housing prostitutes as well, adding to the social stigma felt by abused wives. And the locations will be well known to batterers as well as victims because the shelters are frequently in prominent government buildings. Until now, the vacuum has been partially filled by about 35 nonprofit shelters nationwide. Some are little more than an extra room in someone's house, and most lack basic security systems. Visitors to these tiny enclaves, when allowed in at all, are required to cover their eyes and endure maze-like trips designed to hide the location from violent husbands. "Financially, we face great difficulty," said Kazuko Hirakawa, founder of the modest Feminist Therapy Center and shelter in Tokyo. "Compared to the U.S., we're working with almost nothing." The HELP emergency shelter, located in an older neighborhood of Tokyo, houses as many as 15 women and children. The bedrooms are small, many lined with bunk beds. Victims are sometimes forced to double up. Yet this is one of Japan's best and largest facilities.
    Finding the courage to leave an abusive husband and being lucky enough to secure a spot in a shelter still leave many hurdles to be surmounted. In Japan's recession-battered economy, women often have few skills employers want. Ritsuko Nomoto, a longtime victim of domestic abuse and now a counselor, recently started a small restaurant called Saya-Saya to give battered women jobs, but it's a drop in the bucket. "Every woman thinking of leaving worries about finances," said Nomoto. "Women find themselves forced back into abusive marriages because they can't earn a living." Beyond that, most landlords won't rent to a single mother; such discrimination is widely tolerated in Japan.
    Over several hours, 61-year-old Kimiko, a mother of two grown daughters, described in measured phrases her three decades of abuse. Family court records in Japan are confidential, and Kimiko refused to provide her husband's whereabouts, given her deep-seated fear that any contact could lead to his finding her. She said she hopes to die without ever speaking to him again. Details of her story, however, matched those provided by a longtime confidant. Her attorney said the court agreed to handle all financial negotiations without direct contact between the parties because of the obvious trauma Kimiko had endured. Domestic violence counselors say stories such as Kimiko's are increasingly common as more people seek professional help. "I just want other women to avoid what I went through," Kimiko said.
    The problems started shortly after her arranged marriage in 1965 to a hard-working, seemingly responsible man. He started breaking things--a transistor radio, plates, a rice cooker. Then he began throwing objects at her. Eventually, all pretense of decorum broke down as he attacked her physically, a pattern that would define their marriage. At various times, he choked her, swung her by the neck and threatened her with a kitchen knife before stabbing a box of tissues and telling her, "Next time it'll be you." "Sometimes he beat me once a year, sometimes several times," she said. "If he'd been violent all the time, I would have left him much earlier."
    But the psychological abuse was unending. He was possessive and watched her every move. He complained about the way she spoke, what she wore, how she comported herself and the way she served meals. Virtually every night after work, he cross-examined her about whether she had left the house that day, when she had returned, whom she had seen. To make sure she stayed in the house during the day, he made her tape a long list of television programs and called at random times. When he was home, incoming calls were an immediate cause for suspicion. He would drill her about who called, what they talked about, why a conversation lasted so long. He accused her of laughing at him behind his back. A look he didn't like was enough to set him off.
    `Each night he drank, forcing her to sit attentively as he rambled on or snapped at her, his words slurred by alcohol. She risked a beating or verbal attack if she read, looked away or hesitated when he demanded more sake or fresh ice. Once, after a rare visit to her family, she returned to find he had cut up her clothes with scissors. Particularly humiliating was his habit of making her kneel before him for no apparent reason.

Shame, Fear, Reticence All Protect a Secret
Shame and fear on her part and an unwillingness to speak out--shared by those around the couple--protected their secret. He upended a huge cupboard one day, and the entire family--including his mother, who lived with them--acted as though nothing had happened. Although neighbors in the upscale, densely populated community must have heard the blows, crashes and screams coming from the house over the many years, Kimiko said, they never asked what was wrong. "It's such a delicate matter in Japanese society to intrude," she said. "It's part of Japanese custom."
    One day, Kimiko's then-teenage daughter worked up the courage to call the police, but Kimiko forced her to hang up, fearing her husband's retribution. The police traced the call, and she told them her children had been playing with the phone. Over the years, she developed survival tactics. Foremost among these was doing what her husband wanted, averting her gaze, remaining as inoffensive as possible. Now and again, she thought about leaving, but she worried about money, what the neighbors would think or--even well after her daughters had moved out of the house--how it would affect the children. The prospect of giving up everything was simply too daunting. "I was cornered," she said. Even death started to look attractive. "I hoped that he or I would die, get cancer, have a terrible accident, that something heavy would fall on his head," she said. "That was the only way I could imagine getting away from the suffering."
    When her husband retired in the mid-1990s, Kimiko convinced herself that their problems would disappear once his work stress was gone. Instead, things got worse. His time at work had at least given her a few hours of peace each day. Now she found herself subject to abuse for most of her waking hours. Studious by nature, her husband filled his days with economics courses, reading and playing go, a Japanese game of strategy, all on a strict timetable. And she respected his diligence and desire to improve himself. But he refused to extend her the same courtesy, preventing her from attending classes or joining a club, discouraging her from seeing friends and relatives. One day, he punched holes through her guitar with a large pair of scissors and threw it out the window. About the same time, he flew into a jealous rage after she ran into a friend, kicking Kimiko repeatedly and breaking one of her ribs.
    Those two events convinced Kimiko to escape. Deciding to start life over in her late 50s was incredibly difficult. But in times of doubt, she stood before the bathroom mirror and asked herself whether she wanted to be battered into her 60s and 70s. She set a date several months in advance. A brochure she had read advised battered women to leave in warm weather, so she chose a spring day, started reading psychology books on the sly and got in touch with a psychiatrist. As her deadline approached, she sent a few boxes of clothing and photo albums to close friends and relatives.

A Heart-Pounding Final Departure
Putting money away in advance would have tipped her husband off, so she waited until the day she left to withdraw several thousand dollars from a savings account. That day, she dutifully prepared lunch for her husband and his mother and left just before noon for a "dental appointment," carrying only a small shopping bag and a day pack. Her heart pounded as she walked out the door, terrified he would notice something was different. She stayed in a shelter for five months, started receiving counseling and attended support groups. She found a small apartment and took vocational training courses. After months of searching, she found a job as a building superintendent earning $800 a month--not enough to live on. Her lawyer successfully pressed her husband to provide $1,050 a month in support, and her financial dependence on him has so far kept her from suing for divorce under Japan's less-than-generous laws.
    Kimiko remains afraid of her husband. She hasn't even told her daughters where she is. But she also feels free for the first time in decades. "I feel so happy that I've escaped a life of terror," she said. "I'm free. I'm free."

Jury Selected to Hear Yates Case
Pam Easton, Associated Press- 1/29/2002

HOUSTON -- Nearly a month into jury selection, attorneys in the case of a Houston mother accused of drowning her five children have settled on 12 jurors to hear the capital murder case. The 12th juror - a woman - joined Monday the seven other women and four men who will decide the fate of Andrea Yates, who faces two capital murder charges for the June drowning deaths of three of her five children. "It can either be that there is something wrong with her or that she is a really bad person," the woman who became the 12th juror, said of Yates during questioning Monday. "I don't know what the problem is."
    State District Judge Belinda Hill increased from two to three the number of alternates that still must be selected and a new group of 60 potential jurors was trimmed to 35 based on questioning. A total of 240 people have been summoned for questioning. Eight of the 12 jurors selected for the panel indicated they had children of their own, including one of two women who said they had psychology degrees. Testimony is expected to begin in mid-February after a break to allow attorneys a chance to regroup following jury selection.
    Yates, who during previous court hearings has remained quiet and barely moved, has been much more alert, talkative and mobile lately. On Monday, she suddenly popped out of her seat when the court was in recess and headed to a water cooler, delivering a drink to her mother-in-law before a bailiff asked her to return to her seat. Later, her husband, Russell Yates, was ordered out of the courtroom after conversing with his wife during a break. He is under investigation for possibly violating a judge's order not to discuss the case publicly.

Marijuana's Effects: More Than Munchies
Linda Carroll, New York Times- 1/29/2002

Dawn was 12 when she started smoking marijuana with her friends. It was just something the cool kids did to relax and forget their problems, she says. But after a while, the cigar-shaped "blunts" she smoked also seemed to make learning difficult. "I would just forget school stuff," said Dawn, now 17. "I'd learn something one day and the next day I'd have no idea what the teacher was talking about." At first Dawn, a Long Islander, limited her marijuana smoking to the weekends, but soon it became an everyday habit that ultimately landed her in a residential treatment program run by Phoenix House.
    The debate over whether marijuana is harmful and habit-forming, as Dawn found, or a fairly benign intoxicant, is an old one. And until recently little research had been done to settle the controversy. For several decades, research in marijuana lagged that for other illicit substances, as scientists focused on the drugs like cocaine and heroin with more obvious addictive qualities and more drastic and dire effects on users. But in the past decade, and in particular over the last year or so, interest in cannabis has surged, driven in part by the debate over medical marijuana use for pain relief, nausea and loss of appetite by people with AIDS, cancer and other debilitating diseases. In addition, experts are intrigued by the discovery of molecules that naturally occur in the body, known as endogenous cannabinoids, or endocannabinoids, which are remarkably similar to the active ingredient in marijuana.
    Researchers have discovered that receptors for the endocannabinoids are sprinkled liberally throughout the body and the brain, suggesting that they play important roles in regulating a variety of processes. Recent research into the ways that cannabinoids regulate appetite, pain and memory may not only shed light on the abundance of sensations experienced by marijuana users--the mellow, the munchies and the fuzzy memory--but may help scientists develop new, more directed medications to help control appetite, ease pain and improve memory. Scientists have also learned that the drug, which an estimated 70 million Americans have at least tried, may be highly addictive to a small percentage of those who use it.
    Marijuana smokers report a diverse collection of sensations, and researchers now suspect that is because the drug's main active ingredient--delta-9-trans-tetrahydrocannabinol, or THC--is so similar in shape to the endocannabinoids, which are involved in many body and brain functions. Dr. Rachel Wilson, a researcher at Caltech, discovered when she was at the University of California at San Francisco that endocannabinoids played an important role in the hippocampus, a part of the brain involved in learning and memory, according to a report published this spring in the journal, Nature.
    No one has figured out exactly how endocannabinoids are used in the hippocampus, but based on the abundance of cannabinoid receptors in this part of the brain and on the experiences of marijuana users, Dr. Wilson suspects that these molecules help lay down new memories by strengthening the connections between nerve cells. But when the brain is flooded with cannabinoids through marijuana use, forgetfulness results, Dr. Wilson said. It is probably a case to too much of a good thing, she added. When cannabinoids are abundant, every experience becomes strongly linked in our minds, she believes. But when everything is marked for memory, the system is overwhelmed and nothing is remembered. Dr. Wilson and others also reported last year on another important role played by cannabinoids. They appear to tone down the production of certain neurotransmitters, acting like the brakes of a car when the system is racing too fast.
    Another study published this last year in Nature may explain why marijuana users get a case of the munchies. An international group of researchers found that mice that were genetically engineered to be deficient in cannabinoid receptors ate 40 percent less than normal mice. And in a separate experiment, the researchers showed that an interplay existed between the cannabinoids and leptin, a hormone that produces satiety. In the study, obese rats that were genetically modified to have low levels of leptin produced higher amounts of endocannabinoids. When the rats were given leptin, the endocannabinoid levels dropped.
    Yet another study on cannabinoids published last year may explain why marijuana makes people feel good. According to the study published in Science, cannabinoids, through a complex chain of events, rev up the dopamine system. Like other addictive substances, marijuana appears to hijack brain circuitry that evolved to help people find their way back to a food source or sexual partner. Normally the neurotransmitters and receptors "are doing a long, slow dance," Dr. Wilson said. "Drugs of abuse crash the party and bring the booze."
    Perhaps the most contentious issue has been the question of whether marijuana could be addictive. For the many Americans whose experience with marijuana was pleasant and brief, it may be hard to believe that the drug can be strongly addictive. But scientists focusing on cannabis have come up with a complicated picture. While a majority of people seem to be able to quit, there appears to be a small segment of the population--some 10 to 14 percent--that can become strongly dependent on the drug. And some addiction experts fear that this possibility will have serious consequences for the young, noting that addiction among teenagers is on the rise in certain cities (New York and San Francisco among them). Marijuana use in teenagers like Dawn can block social development and derail career plans, said Dr. Alan I. Leshner, former director of the National Institute on Drug Abuse.
    People often fail to notice that a friend or neighbor has a marijuana problem because the consequences of cannabis use are less striking than those associated with other drugs, said Dr. Alan J. Budney, associate professor at the University of Vermont and director of its Treatment Research Center. "You don't see the severe acute consequences you get with alcohol or cocaine," Dr. Budney said. "People don't embarrass themselves. They don't wreck the car. They don't spend all their money on a binge. "That doesn't mean it's not addictive. It can be insidious. It gets into your lifestyle and then you can't get it out."
    For years, even addiction experts have argued over the effect of cannabis. "There is still some debate regarding the degree, or extent, or magnitude of dependence and what the real consequences of that dependence might be," said Dr. Billy R. Martin, a professor and chairman of pharmacology at Virginia Commonwealth University in Richmond. One sticking point was the absence of an animal model. Bur slightly over a year ago scientists at the National Institute on Drug Abuse showed that monkeys give themselves THC in amounts comparable to that inhaled by people who smoke marijuana, according to a study published in Nature Neuroscience. Such self-administration of drugs by animals has been shown to be a hallmark of addictive substances.
    And more recently, reports have described a withdrawal syndrome that can last several weeks, another sign of addiction. In a study that followed heavy marijuana users, Dr. Budney found that when people quit using the drug, they experienced a host of unpleasant symptoms, including craving, decreased appetite, sleep difficulty, weight loss, aggression, anger, irritability, restlessness and strange dreams. Often these symptoms drove people back to using the drug, said Dr. Budney, who noted that the marijuana withdrawal syndrome was very similar to what cigarette smokers experienced when they quit. Still, compared with alcohol, the physical side of marijuana withdrawal is mild, experts say.
    Nevertheless, for those with a predisposition to be hooked by cannabis, the pull of the drug is intense. For Mark, a restaurant owner from Vermont, the craving for cannabis was too strong to ignore. Mark, 40, started smoking it when he was 13 and was smoking daily by the time he hit college. "When I woke up I genuinely didn't feel well until I smoked," he said. Although he tried many times to quit over the years, he did not succeed until he attended a treatment program.
    Still, not everyone is convinced that marijuana is a threat. "Everything is relative," said Dr. Donald Jasinksi, a professor of medicine at the Johns Hopkins medical school and director of the Center for Chemical Dependence at Johns Hopkins Bayview Medical Center. "Does it destroy as many lives as alcohol? No. Does it kill as many people as cigarettes? No. Does it have as many deaths associated with aspirin overdose? No.
    Mark, however, wistfully wonders what his life might have been like without marijuana. "I'm the only one in my family who wasn't an Ivy Leaguer," he said. "I went to a crummy college. I should have been right up there with the rest of them"

Study Links Anxiety, Depression and Strokes
New York Times, 1/29/2002

Middle-aged men who suffer from psychological problems like depression and anxiety are much more likely to die of strokes than men who do not, a study reports. But they are no more likely to suffer nonfatal strokes. The explanation can be only a matter of speculation, said the authors of the study, which appeared in the January issue of Stroke, the American Heart Association journal. But they offer several theories. One holds that the strokes suffered by men under psychological stress may simply be more serious. Another suggests that the men's mental state may make it harder for them to recover.
    The article, whose lead author was Margaret May of the University of Bristol, is based on long-term study of men in Caerphilly in Wales. After observing the men and their health for 14 years, the researchers found that those whose survey answers indicated psychological distress were three times as likely to have fatal strokes as those not suffering the distress.
    Psychological stress has long been linked to cardiovascular disease like strokes and heart problems. But the exact relationship remains murky. No one knows whether anxiety or depression lead to the disease, whether it is the reverse or whether the same underlying neurological conditions cause all the problems.