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    Traumatic Brain Injury Found in Maine Gunman Could Have Wide Ramifications

    Exposure to blasts, even at low levels, may play a much greater role in veterans’ mental health struggles than has been known, with implications for treatment strategies and for criminal justice.Shredded connections deep in the brain. Battered and scarred blood vessels that are no longer able to support neurons. Clumps of dead cell debris marking a long pattern of injury.The results of the autopsy of Robert R. Card II, the Army Reservist who killed 18 people, then himself, in the deadliest shooting in Maine’s history, left little question that his brain was profoundly damaged. But the finding raises other questions that have broad implications for the military and for the nation’s millions of veterans.Mr. Card was a grenade range instructor who never deployed to combat. He is not known to have ever hit his head in a serious car crash, he never played football, and he does not appear to have had any other accidents that might account for the damage to his brain.His only exposure came from routine training blasts on the training range — at a level that is supposed to be safe.If those blasts were still strong enough to profoundly damage his brain, as it appears happened, then how many other troops are being exposed to the same risk? How many veterans may be struggling with similar injuries that have gone unseen or been misunderstood? How should those veterans be treated if they seek mental health care, or are accused of crimes?“The implications are just so large,” said Frank Larkin, a former Navy SEAL and sergeant-at-arms of the U.S. Senate, whose son, Ryan, also a Navy SEAL, died by suicide and was found to have extensive brain damage from blasts.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Does Therapy Culture Help or Hurt Us?

    More from our inbox:Trump Pardoning Himself? An ‘Appalling Idea’Trump’s WeightImproving Access to E-BooksGraphicaArtis/Getty ImagesTo the Editor: Re “Hey, America, Grow Up!” by David Brooks (column, Aug. 11), about how an emphasis on trauma makes adults immature:As a psychiatrist, I feel that Mr. Brooks makes several valid points regarding trauma but fails ultimately to thread the needle.A good psychiatrist or therapist identifies the real trauma in a patient’s past — typically from events in childhood at the hands of parents or other family members — while simultaneously discouraging the kind of victim mind-set that displaces past pain onto present-day scapegoats.The goal is to illuminate the real trauma, which requires re-evaluating what is often an idealized remembrance of one’s upbringing, so that the patient can stop projecting malice onto anyone and instead regain a sense of agency. As the saying goes, those who forget the past are condemned to repeat it.If we fail as a culture to acknowledge the well-established long-term consequences, both physical and psychological, of legitimate trauma, we will wind up creating more people who identify as victims, not fewer.Christopher BaileyKirkland, Wash.To the Editor:One thing David Brooks’s good column leaves untouched is how much resistance to the hyperinflation of “trauma” there has been among psychotherapists themselves.In 1967, Anna Freud, Sigmund Freud’s daughter, wrote that the concept had become so “carelessly used” that its “blurring” could lead to “abandonment and loss of a valuable concept.” In 1978, psychiatrist Henry Krystal, an Auschwitz survivor and founder of contemporary trauma theory, said flatly that the use of the term “has become so loose that it has become virtually useless.”Of course, “trauma culture” has a life of its own, independent of psychiatric or psychological knowledge. And no small number of therapists have fully cashed in from Trauma, Inc., which is, indeed, big business.But my sense is that, even in the culture at large, “trauma” hype may have run its course. What follows may be greater “maturity,” as Mr. Brooks and many others would hope, or it may be just the next form of mishegoss.Henry GreenspanAnn Arbor, Mich.The writer is an emeritus psychologist at the University of Michigan.To the Editor:Wouldn’t it be nice if David Brooks’s ideas about how people should “throw off some of the tenets of the therapeutic culture” and “weave their stable selves through the commitments to and attachments with others” in order to build a culture of maturity were realistic?But try telling that to people who have grown up in poverty, who have never had adequate health insurance or medical care, who grew up in families rife with violence and abuse, who live in communities with chronic gun violence, and who have to drop out of high school to give birth to a baby.What can you weave in there? And who can you attach to when your life and the lives of those around you are a mess, and you live in a world that you have little hope of escaping?Debra KuppersmithDobbs Ferry, N.Y.The writer is a psychoanalyst.To the Editor:David Brooks made some excellent observations about our country’s growing narcissism. But he missed a key prescription for change: helping Americans develop a sense of purpose.This starts with treating challenges as temporary setbacks and harnessing our talents and efforts in the service of something bigger than ourselves. We need to lose the “me” and find the “we.”Studies show that people who feel a sense of purpose in their lives — through family, friends, work or community — are overall more resilient and report a greater sense of well-being. This message feels especially urgent for adolescent girls in America who are experiencing record levels of isolation, depression and suicidal thoughts.Until Americans commit to a purpose-driven mind-set, we will continue to wallow in our current obsession with victimization and search out cheap ways to validate our self-worth.Suzanne ChazinChappaqua, N.Y.Trump Pardoning Himself? An ‘Appalling Idea’Haiyun Jiang for The New York TimesTo the Editor: It has become commonplace to suggest that one difference between a state and a federal conviction of Donald Trump is that Mr. Trump could not pardon himself from a state conviction if he is elected president, implying that he could pardon his own federal offenses. It’s long past time to stop giving this appalling discussion of self-pardons any air.A president pardoning himself for his own crimes is the very definition of unchecked power. Revolutionaries called it tyranny, which in this context is a better word. The idea that our executive has so much power that the rule of law does not apply to him because he could forgive himself betrays what the Revolutionary War was about.The Constitution separated the powers of the government into three branches. It empowers Congress with the legislative power and the courts with the judicial power. The idea that a president could make himself immune from both other branches — in the furtherance of a crime — is inexcusable.Mr. Trump has floated this idea before and some allies are resurrecting it again. It’s born in the brevity of the Constitution’s pardon power. But it flouts both the rule of law and the separation of powers essential to the Constitution. We should be outraged.Andrew J. KennedyMonroeville, Pa.The writer is a lawyer.Trump’s WeightTo the Editor: Re “Trump Is Booked at Jail in Atlanta in Election Case” (front page, Aug. 25):Donald Trump weighs only 215 pounds? Forget the mug shot T-shirts; his campaign should be selling whatever brand of scale he’s using.Alan RutkowskiVictoria, British ColumbiaImproving Access to E-BooksAnn Johansson for The New York TimesTo the Editor: Re “What Does It Mean to Own a Book?” (Business, Aug. 13):I would like to thank David Streitfeld for his piece shining a light on the innovative and visionary work done by Brewster Kahle and the Internet Archive. In the discussion about the complexity of providing digital access, the work of our nation’s libraries and nonprofits like the Digital Public Library of America that support them should not be overlooked.Public libraries across the country offered access to over a billion digital e-books and half a billion digital audiobooks in fiscal year 2021. They circulated 460 million digital items and spent nearly $600 million to provide that access. And these numbers continue to grow.Mr. Streitfeld rightly points out that many titles are increasingly expensive for libraries to acquire, especially those from the “big five” publishers, which only offer licenses that are limited to a certain number of loans or length of time. However, the Digital Public Library of America works with hundreds of midsize and independent publishers to offer more reasonable terms including, for example, a perpetual one-user-at-a-time license that functions much like library ownership of a print book.Right now, legislators in several states are working with librarians to draft legislation that would enshrine the rights of libraries to acquire digital content on reasonable terms.Libraries need our support to ensure that as the transition into a digital world continues, access to knowledge becomes more and not less accessible.John S. BrackenChicagoThe writer is the executive director of the nonprofit Digital Public Library of America. More

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    After His Arraignment, Trump Lashes Out

    More from our inbox:‘A Great Day for Liberals’ in Wisconsin and ChicagoA Renewed Interest in Freudian PsychoanalysisLos cargos contra Trump representan la culminación de una investigación de casi cinco años de duración.Dave Sanders para The New York TimesTo the Editor:Re “Trump Charged With 34 Felonies” (front page, April 5):After Judge Juan M. Merchan warned at Donald Trump’s arraignment that all parties must refrain from making statements about the case with the potential to incite violence and civil unrest, what does the former president who can’t keep his mouth shut do during his speech a few hours later?He says hateful things about Judge Merchan and his family, and vilifies District Attorney Alvin Bragg, District Attorney Fani Willis in Georgia and the special counsel Jack Smith.And one of the former president’s sons put a photograph of Judge Merchan’s daughter on social media — a clear invitation to violence.It’s time for the former president to be gagged. And when he speaks out with hateful words again, a contempt order and jail time may put a sock in his mouth. About time.Gail ShorrWilmette, Ill.To the Editor:Crowd size has always been important to Donald Trump. It is the metric he uses, along with TV ratings, to measure his impact, to gauge his popularity, to feed his ego.The crowd that showed up Tuesday at his arraignment was hardly composed overwhelmingly of Trump supporters. It looked as if the media and anti-Trump people more than countered his base.No matter how Mr. Trump spins it, no matter how many times at his future rallies he proclaims an overwhelming showing of support in New York City, the camera doesn’t lie.It was good to see him cut down to size Tuesday. For the first time in his adult life he could not control the narrative. He called for a massive protest, he predicted “death and destruction” if he was charged, and he got neither.Len DiSesaDresher, Pa.To the Editor:The April 5 front-page headline “Even as Biden Has Oval Office, Predecessor Has the Spotlight” is a statement that is true only because your newspaper and other media outlets allow Donald Trump to occupy center stage.This behavior of the media has been mentioned many times before, and many believe that the tens of millions of dollars’ worth of free publicity provided to Mr. Trump during the 2016 campaign contributed to his winning the election.It is now 2023 and we are facing an election that could well decide the future of America. I am therefore requesting that The Times stop paying so much attention to Mr. Trump (we’ve heard everything he has to say many times before) effective immediately.David SommersKensington, Md.To the Editor:I felt a real jolt seeing the photo of former President Donald Trump seated at the table in a Manhattan courtroom. It was the jolt of the norms of American justice falling back into alignment.Christopher HermanWashington‘A Great Day for Liberals’ in Wisconsin and ChicagoJanet Protasiewicz, the liberal candidate in Wisconsin’s Supreme Court election, during her election night party in Milwaukee on Tuesday. She ran on her open support of abortion rights.Jamie Kelter Davis for The New York TimesTo the Editor:Re “Liberal Wins Wisconsin Court Race, in Victory for Abortion Rights Backers” (news article, April 5):While New York and the nation were fixated on the circus that was Donald Trump’s arraignment, a special election was held in Wisconsin that decided whether conservatives or liberals would control that state’s Supreme Court. Janet Protasiewicz, a Milwaukee County judge, won the race and gave liberals control of the highest court in Wisconsin.Wisconsin is an important swing state, and this new balance of power in the court will have dramatic effects on abortion rights, potential election interference and how election districts are drawn. Conservatives, who have had control of the Supreme Court, will no longer be able to gerrymander voting districts to favor Republicans, nor will they be able to successfully challenge the results of a free and fair election.While this is only one state, we may see similar results in other swing states like Michigan, Pennsylvania and, yes, even Texas. Donald Trump is to Democrats the gift that just keeps on giving.Henry A. LowensteinNew YorkTo the Editor:Three news stories from your newspaper indicate that Tuesday was a great day for liberals and progressives: “Trump Charged With 34 Felonies,” “Liberal Wins Wisconsin Court Race, in Victory for Abortion Rights Backers” and “Rejecting a ‘Republican in Disguise,’ Chicago Voters Elect Johnson as Next Mayor.”While conservative Republicans are obsessed with culture wars and MAGA, progressives are making political headway. Let’s hope that we continue on this march to liberalism till our nation is free from prejudices, curbs on reproductive and gender freedoms, relentless gun-related violence, etc.Michael HadjiargyrouCenterport, N.Y.A Renewed Interest in Freudian Psychoanalysis Photo Illustration by Elizabeth Renstrom for The New York TimesTo the Editor:Re “Back to the Couch With Freud” (Sunday Styles, March 26):It is true that people “see what they want in Freud.” Thus, a younger generation might think Freud “gay friendly” because a 1935 letter declared, “Homosexuality is nothing to be ashamed of, no vice, no degradation.”However, the article omits that Freud went on to describe homosexuality in that same letter as an “arrest of sexual development.”Freud’s theory that gay people suffered from psychological stunted growth rationalized many decades of discrimination in which openly gay men and women were refused psychoanalytic training because they were “developmentally arrested.” Only in 1991 did the American Psychoanalytic Association change its policies refusing admission to gay candidates.I am glad that Freud is having a renaissance. However, any reading or interpretation of his work should not ignore the historical context in which he lived and the ways, for better or worse, in which some of his theories have been used to discriminate.Jack DrescherNew YorkThe writer, a clinical professor of psychiatry at Columbia University, is the author of “Psychoanalytic Therapy and the Gay Man.”To the Editor:I was pleased to see New York Times coverage of the “Freudaissance,” which I have been a joyful participant in for more than a decade now, both personally and professionally.One of the understandings I have come to, having spent countless hours on both sides of the proverbial couch, in both psychoanalytic and cognitive behavioral contexts, is that these two approaches do not really diverge from each other as much as many tend to assume that they do.I see the C.B.T. founder Aaron Beck’s three levels of cognition (automatic thoughts, core beliefs and cognitive schemas) mapping neatly onto Freud’s topographical model of the mind (the conscious, preconscious and unconscious, respectively).And I see the dialectic behavioral therapy founder Marsha Linehan’s construct of the “wise mind” as an integration of the rational and emotional minds matching Freud’s structural model of the ego as a synthesis of superego and id.Different terms resonate differently in different generations and with different individuals, but rather than disproving or undermining Freud’s theories, I see today’s evidence-based approaches as indications that the father of modern psychology was apparently onto something more than a century ago.Rachel N. WynerWest Hempstead, N.Y.The writer is a clinical psychologist. More