Veil, Talk Therapy, Wasabi, Selective Memory

Tom Friedman の "Longitudes and Attitudes" を終わった。

... [There] is nothing in the Koran that dictates that women have to be veiled – it is a cultural thing, a conservative desert Bedouin thing. (p. 359)

ホント？

"The Tiananmen Papers" (Edited by Andrew J. Nathan and Perry Link) を始める。

Deep impact

Mar 3rd 2005
From The Economist print edition

A way of switching depression off

ROB MATTE, a 38-year-old Canadian laboratory technician, suffered from severe depression for 20 years. He had tried everything: psychotherapy, anti-depressant drugs (several varieties) and a gruelling three-week course of electro-convulsive therapy. Nothing worked. Then his psychiatrist told him about an experimental operation using a technique called deep-brain stimulation (DBS) that was being conducted at Toronto Western Hospital, in Canada. In spite of the risk of brain haemorrhage, infection or seizure, Mr Matte signed the consent form. For him, the next step would have been suicide.

Mr Matte is one of six people who have been part of this pilot study into the use of DBS for treating depression. It is being carried out by Helen Mayberg, Andres Lozano and their colleagues at Toronto Western. Their results have just been published in Neuron, and though the sample is small, the outcome is astonishing. For Mr Matte and three others, the treatment worked completely. As soon as the electrodes implanted in their brains were switched on, they noticed a difference. Mr Matte describes how everything in the room became brighter. Lights and colours seemed more vivid. His depression vanished so dramatically that it left him feeling terrified—and it remained vanished, not only for the six months of the study, but also for the six months since it was completed. And none of the patients involved has experienced noticeable cognitive impairment as a result of the operation.

The study was conceived when Dr Mayberg discovered, using a brain-scanning technique called positron-emission tomography, that an area of the brain called the subgenual cingulate is overactive in patients with depression. This got her thinking. Neural overactivity is known or suspected in several other conditions, including chronic pain, dystonia, epilepsy, Tourette's syndrome, essential tremor, obsessive-compulsive disorder and Parkinson's disease. All of these illnesses may be treated with DBS. And in the case of Parkinson's disease it is known that the treatment dampens neural activity.

That is what happened in the successful cases in this experiment, too. Indeed, not only did electrical current fed into the subgenual cingulate suppress its activity, it also re-invigorated activity in the frontal cortex, the hypothalamus and the brainstem—all areas which themselves become dampened in depression.

There is a price to pay. Not only do patients have electrodes implanted in their brains, they also have a battery implanted into their chests (in the case of men) or their stomachs (in the case of women, to avoid damage to the breast tissue). But that is a small charge for resisting suicide.

According to the World Health Organisation, depression is the leading cause of disability in the world. Of the estimated 121m people who suffer from it, 15-30% have "refractory" cases like those treated by Dr Mayberg and Dr Lozano—that is, they do not respond to any treatment. If bigger studies prove this new approach to treating refractory depression works on even a fraction of that fraction, neurosurgeons could be in for a busy time.

Talk is cheap

Apr 14th 2005
From The Economist print edition

And surprisingly effective

FOR almost a century after Sigmund Freud pioneered psychoanalysis, "talk therapy" was the treatment of choice for many mental illnesses. Artists and writers lined up to lie down and be analysed, and the ideas of Freud, Jung, and other influential psychiatrists permeated the intellectual world. They also seeped into the popular consciousness, and still pop up today whenever someone talks of a subconscious desire, a Freudian slip, a death wish, or an Oedipal complex. But advances in neurology, and especially in pharmacology, have called such therapy into question. When psychological and emotional disturbances can be traced to faulty brain chemistry and corrected with a pill, the idea that sitting and talking can treat a problem such as clinical depression might seem outdated.

Robert DeRubeis of the University of Pennsylvania and his colleagues beg to differ, however. They have conducted the largest clinical trial ever designed to compare talk therapy with chemical antidepressants. The result, just published in Archives of General Psychiatry, is that talking works as well as pills do. Indeed, it works better, if you take into account the lower relapse rate.

The study looked at a relatively modern type of talk therapy, known as cognitive therapy, which tries to teach people how to change harmful thoughts and beliefs. Patients learn to recognise unrealistically negative thoughts when they occur, and are told how to replace them with more positive ones. It may sound too simplistic to work, but other studies have shown it can be used to treat anxiety, obsessive-compulsive disorder and eating disorders. Dr DeRubeis wondered just how effective it really was for depression.

In the study, 240 patients with moderate to severe depression were divided into three groups. One group was treated with cognitive therapy, a second with Paxil, an antidepressant drug, and members of the third group were given placebo pills. (Those in the second and third groups did not know whether their pills were placebos or not.) After 16 weeks of treatment, the results for those on cognitive therapy and drugs were identical. Some 58% had shown perceptible improvement. By contrast, only 25% of those on the placebo improved. That was encouraging. But the really surprising advantage of cognitive therapy is that it seems to keep working even after the therapy sessions are over. A year after treatments ended, only 31% of those who had received it had relapsed into their former state, while 76% of those who had been given antidepressants, and then been taken off them, had done so. Even patients who stayed on antidepressants for the intervening year did not do any better than those who had taken cognitive therapy and then quit.

If Dr DeRubeis's study can be replicated (an important "if" in a soft-edged discipline such as psychotherapy), it has implications for the way clinical depression should be approached in the future. One consideration, at least in America, where the study was done, is that many medical-insurance companies that are willing to pay for antidepressant drugs nevertheless refuse to pay for psychotherapy. A successful replication of the DeRubeis study ought to change that—not least because cost-benefit analysis shows that while cognitive therapy is more expensive than drug treatment to start with (since it involves extended one-to-one sessions with a highly paid specialist), it is cheaper in the long run because prescriptions do not have to be refilled indefinitely.

Which is not to say that cognitive therapy will suit everyone with depression. According to Dr DeRubeis, it is still likely that some patients will respond better to drugs than conversation. The next breakthrough might be a way of working out in advance who fits which treatment.

韓国「サシミ、ワサビ抜き」　釜山の教授らが日本語排斥運動　「定着しててもダメ」（西日本新聞）

【ソウル１９日原田正隆】竹島領有権や歴史教科書の問題をめぐり反日・嫌日感情が広がっている韓国で、水産分野の専門家が、「サシミ」など海鮮料理関連で数多く残る日本語を排斥し、韓国語に置き換える運動を始めた。

韓国センソンフェ（サシミ）協会会長も務め、地元で「サシミ博士」と呼ばれる釜慶大（釜山市）の趙永済（チヨヨンジエ）・水産学科教授は、地場焼酎メーカーの後援を受けて、日本語がよく使われる魚や料理の写真とともに、韓国語への置き換え例を紹介するポスター三千枚を作製。四月一日から、釜山市や慶尚道の海鮮料理店などに配布中だ。

置き換え例によると、「サシミ」は「センソンフェ」、「ワサビ」は「コチュネンイ」、「サワラ」は「ハクコンチ」、「アナゴ」は「プンチャンオ」、突き出しは「プヨリ（副料理）」―になる。

「サシミ」「ワサビ」「スシ」などは国際的な言葉として定着しているが、趙教授は韓国の通信社・聯合ニュースに対し「わが民族の自尊心回復のため、この地だけは、これ以上、日本語のはんらんを放置できない」と述べ、新たに二種類のポスターを作製予定という。

勝手にしたら…。キムチは「朝鮮漬」で統一かな。

各地の嫌がらせは「テロ」　中国大使館幹部（共同）

在日中国大使館の黄星原参事官は１９日、都内の同大使館で記者会見し、中国で反日デモが拡大して以降、日本各地の中国関連施設に薬きょうが入った郵便物が届くなど嫌がらせとみられる事件が続いていることについて「テロ、破壊行為」だと強く批判、日本政府に「謝罪と賠償、犯罪者の処罰と事件の再発防止」を強く求めていく考えをあらためて強調した。

参事官は送られてきた脅迫状などを示しながら、大使館をはじめ関連施設の職員らが「正常な業務を妨げられ、生命の脅威にさらされている」と指摘。各施設への脅迫電話などもあるという。

日本人が怒っても当たり前ちゃう？

China's Selective Memory

By Fred Hiatt, the Washington Post
Monday, April 18, 2005; Page A17

China, a permanent member of the U.N. Security Council, has made clear that it doesn't think Japan is deserving of similar status.

You might wonder why not. After all, Japan is one of the world's largest contributors of foreign aid and most generous backers of the United Nations, a successful democracy for more than a half-century, with a powerhouse economy and a constitution that forbids aggression.

But here's the problem, Chinese Premier Wen Jiabao explained last week: "Japan needs to face up to history squarely." After another weekend of anti-Japanese protests and riots in China, China's foreign minister yesterday amplified that "the main problem now is that the Japanese government has done a series of things that have hurt the feelings of the Chinese people... especially in its treatment of history."

Truth in history is an interesting standard for great-power status. One intriguing response would be for Japan to embrace it and suggest politely that, if China wants to keep its Security Council seat, it ought to do the same.

There's no doubt, as Premier Wen implied, that some Japanese have a hard time admitting the terrible things their troops did in China, Korea and other occupied Asian countries before and during World War II. Apologies sometimes seem to be mumbled, and textbooks sometimes minimize past crimes.

Recently, for example, Japan's education ministry approved a textbook that refers to the 1937 Nanjing Massacre as an "incident" during which "many" Chinese were killed, though some estimates of civilian deaths run as high as 300,000. News of these textbooks helped spark the anti-Japanese riots in Chinese cities.

But put the issue in some perspective: Many textbooks receive ministry approval in Tokyo, and no school is forced to use any particular one. Issues of war guilt or innocence, and of proper historiography, are debated endlessly and openly in Japanese newspapers, magazines and universities. Some Japanese demonstrate against politicians who won't go to Yasukuni Shrine -- where Japan's war dead, including some who were judged war criminals, are honored -- while other Japanese demonstrate against politicians who do go.

Compare this to the situation in Premier Wen's China. There is only one acceptable version of history, at least at any given time; history often changes, but only when the Communist Party decides to change it.

For example, according to a report by Howard W. French in the New York Times last December, many textbooks don't mention that anyone died at what the outside world knows as the 1989 massacre of student demonstrators near Tiananmen Square. One 1998 text notes only that "the Central Committee took action in time and restored calm." Anyone who challenges the official fiction is subject to harsh punishment, including beatings, house arrest or imprisonment.

And if the 300,000 victims of the Nanjing Massacre are slighted in some Japanese textbooks, what of the 30 million Chinese who died in famines created by Mao Zedong's lunatic Great Leap Forward between 1958 and 1962? No mention in Chinese texts; didn't happen.

Well, you might say, how a nation treats its internal history is less relevant to its qualifications for the Security Council than whether it teaches its children honestly about its wars with other nations. A dubious proposition, but no matter; as the Times found in its review of textbooks, Chinese children do not learn of their nation's invasion of Tibet (1950) or aggression against Vietnam (1979). And they are taught that Japan was defeated in World War II by Chinese Communist guerrillas; Pearl Harbor, Iwo Jima and Midway don't figure in.

"Facing up to history squarely" isn't easy for any country. Americans don't agree on how to remember the Confederacy. Russia can't yet admit to Soviet depredations in the Baltic republics. And, yes, Japan too often sees itself purely as a victim of World War II.

But in countries that permit open debate, historical interpretations can be constantly challenged, revised, maybe brought closer to the truth. In dictatorships that use history as one more tool to maintain power, there's no such hope.

China's Communists used to find it useful to vilify Russia in their history texts. These days, for reasons of China's aspirations to lead Asia, Japan makes a more convenient villain. Next year might be America's turn. The reasons may be complex, but none of them has much to do with facing history squarely.