NAMI is getting seriously scary. It is aligning itself with childhood drugging. Excuse me, but how exactly are pediatricians qualified to conduct mental health screening? The kinds of problems they will be picking up will not be with the people who end up with a diagnosis of schizophrenia at 20, but rather with children who are presenting behavioral problems, usually with justifiable cause. NAMI should be lobbying for non-drug interventions, such as family counselling. Oops, I forgot. NAMI insists that mental illness is biochemical in nature, therefore guaranteeing an income stream to pharma while letting parents off the hook. Shame, shame.
Kathlyn Beatty and wanting to be like Daddy
A reader commented on my recent post on Family Constellation Therapy. It is remarkable that she recognized her own experience in our Constellation – that the child is being protected by the mother from the father – and she reinforces her observation by asserting that others have experienced the same.
She writes:
“That family constellation post got me thinking… It’s the same feeling I used to have. That my mother stood like an insurmountable wall between me and my father. With her back turned on me. Actually, I used to have an audio-visual hallucination where I stood at the top of a gangway, trying to board the ship I knew, I would find my father on, my mother blocking the way for me. I tried to make her understand that I had to get onboard, in every language I knew. To no avail. She simply didn’t hear me. Horrid. Having a nightmare while awake. Did you watch “Family Life”? I think, it’s in the first or second part that Janice’s father tells the shrink that he felt like his wife stood between him and Janice.”
Is it true that I was protecting Chris in some way from his father, my husband? The Constellation doesn’t lie, but there can be many plausible possible interpretations. A Constellation, if the participants are willing, provokes honesty and clears the air. My husband might have felt instead that mothers are meant to be closer to their children when they are infants, but he did not. Instead, he rightly objected to what he perceived as my shielding his own son from him. Ian is not close to his own mother or father and perhaps he is trying to close that gap with his own son, to make Chris him.
Ian’s views of his own parents’ dynamics are at odds with how I see my own father and mother. I used to joke that I got my father “as interpreted by my mother.” My father wasn’t that comfortable with his daughters when we were young, except when giving advice or instructions. So, my mother would be the messenger of whatever it was my father was thinking. Depending on who is doing the observing (mother/father/child), the separation of Ian and me in the Constellation doesn’t have to be seen as malicious. It struck me as normal enough based on my family dynamics.
Family dynamics are complex, and there are many possible plausible explanations for what is going on. I choose to believe in just about any explanation that will allow us to move forward and heal. That’s the beauty of Family Constellation Therapy.
Which brings me to Kathlyn Beatty. Why are we not surprised about her wanting to become transgendered? Kathlyn is the oldest daughter of actor Warren Beatty and his wife, actress Annette Bening. From a Family Constellation point of view, the only surprise is in the details. You can’t predict exactly how the child will act out the assigned role. Warren Beatty, for anyone who has lived under a rock since the 1950s and hasn’t followed Hollywood, has bedded more actresses than there are grains of sand on the beach. In a town famous for its casting couches, Warren Beatty stood out. The clue as to why his sexual appetite was so prolific has got to lie somewhere in the annals of his family history. His sister, Shirley MacLaine, who looks a lot like her niece, judging from the photos, is as successful and well known as her younger brother, but as a actress and writer, not as a serial womanizer. Shirley MacLaine has some interesting spiritual beliefs, such as in reincarnation. She has also contributed a chapter to the book in which I have a chapter, Goddess Shift: Women Leading for a Change.
It’s easier to spot the parent/child connection within the Beatty family than it is in our own families, because the Beatty family is writ large. We all know what they’ve been up to. Daughter’s wanting to change from a woman into a man surely must have something to do with Daddy. Mummy’s side, no doubt, plays more than a bit part, too. Blame is one judgment that has no place here. German psychotherapist Bert Hellinger urges us to “accept what is.” Family Constellation Therapy could help here to get to the possible motivations behind this and possibly untangle Kathlyn and family’s unconscious desire for her to be just like Daddy.
On several levels, what Kathlyn Beatty wants to do is disturbing. The fact is she is only eighteen years old. To subject herself at such a young age to something that she may later regret is premature thinking. Sex changes involve surgery and a lifetime of powerful drugs. I suspect Kathlyn is too young to have anything but utmost faith in pharmacology. She has grown up in a world where Hollywood actresses, through the chemical magic of fertility treatments, can have twin babies past menopause. Face lifts are old school. Breast implants and botox are routine. To her, it would be like changing one’s wardrobe, perhaps a bit more involved, but I doubt she is seriously aware of the downside. Waiting a few years and delving into the psychotherapy behind this desire, might prevent an act she may come to later regret.
I sometimes wonder if today’s children who have opted, with their families’ enlightened blessing, to become homosexual in orientation, will turn around in later life and accuse them of failing to prevent them from going ahead with something they now think they were too young to decide. Fashions come and go. Be wary of becoming fashion’s victim.
The Emperor’s new clothes
This excellent Tracking the American Epidemic of Mental Illness – Part II by Evelyn Pringle, comes eerily close to my own perceptions of what was going on with the day program that Chris was enrolled in for two years in the European country where we live. When we joined the program in 2004, it had already been operating for ten years and was touted as a success – by the psychiatrist who ran it. As with the Portland Identification and Early Referral (PIER) program, there was no follow-up as to the real outcomes of the young people who went through Chris’s program. Chris has been out of the program for at least three years, and so far we have received no follow-up asking us how he is faring. While he was in the program, we were aware of no statistics on the outcomes of the previous ten years. Like the little boy who saw that the emperor had no clothes, we were told to believe in the miracle that was happening.
Readers of this blog will know that Chris was not getting better during the time he spent in his program. My pleas to individualize his treatment, to begin by at least acknowledging that that the drugs weren’t helping him, fell on deaf ears. I felt the program was off-base in getting at the real problems of psychosis. The program believed in the second generation antipsychotics, particularly clozapine. I have my own reasons for believing in a financial incentive as the reason the program particularly pushed clozapine, even though it was, by then, a generic drug.
Here is an extract from the Evelyn Pringle article.
An August 2008 article, by Charles Schmidt in Discover Magazine, highlighted the PIER program with a byline that stated: “A new mix of therapy and medication may stave off psychosis among teens at risk.”
Schmidt discussed the case of Camila (not her real name), who entered the program in September 2001, when she was 14. “Camila and her family stuck with PIER for the four-year treatment program, which ended formally in 2005, and still keep in touch with counselors there,” he reports.
However, “Camila’s health still hinges on antipsychotic medication,” Schmidt says. “In the summer of 2007 she went off the drugs for a spell and her strange feelings returned.”
He notes that her reliance on antipsychotics raises issues. “On the one hand, it shows that the threat of psychosis hasn’t really been removed, it’s just been held in check.”
“What we hope is that the benefits of treatment will be lifelong,” McFarlane says in the article. “We don’t have any empirical evidence to support that yet, but what we’ve seen is that young people who still haven’t converted to psychosis after about three years of our treatment don’t seem to be at much risk.”
While he suggests that over time, some patients may be able to go off medications, McFarlane acknowledges that PIER hasn’t developed a plan for managing that process, Schmidt reports.
“As to when or if they can go off medication, that’s hard to say,” he told Schmidt. “I think many of our patients don’t feel a need to stop; they certainly don’t feel oppressed by it. At a certain point it becomes a personal choice.”
A fortune can be made from these life-long antipsychotic customers.
The downside of progress
Today’s New York Times article is about how advances in medical innovation, such as pacemakers, mean that many of us will become progress’s casualties, or, as the author writes about her parents, “At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims.”
Normally, I don’t like to introduce such a somber note into my blog, but I think the article shows the similarities between access (or lack of) to full information for both psychiatric treatment and other medical treatment. If you have full disclosure, you may decide to take a different course. At some point, I,too, decided that psychiatric medications were making a difficult situation worse.
Below is a condensed selection of paragraphs from the article.
. . . My father’s medical conservatism, I have since learned, is not unusual. According to an analysis by the Dartmouth Atlas medical-research group, patients are far more likely than their doctors to reject aggressive treatments when fully informed of pros, cons and alternatives — information, one study suggests, that nearly half of patients say they don’t get. And although many doctors assume that people want to extend their lives, many do not. In a 1997 study in The Journal of the American Geriatrics Society, 30 percent of seriously ill people surveyed in a hospital said they would “rather die” than live permanently in a nursing home. In a 2008 study in The Journal of the American College of Cardiology, 28 percent of patients with advanced heart failure said they would trade one day of excellent health for another two years in their current state. . .
. . . And so my father’s electronically managed heart — now requiring frequent monitoring, paid by Medicare — became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals. The profit margins that manufacturers earn on cardiac devices is close to 30 percent. Cardiac procedures and diagnostics generate about 20 percent of hospital revenues and 30 percent of profits. . .
. . . In the summer of 2006, he fell in the driveway and suffered a brain hemorrhage. Not long afterward, he spent a full weekend compulsively brushing and rebrushing his teeth. “The Jeff I married . . . is no longer the same person,” my mother wrote in the journal a social worker had suggested she keep. “My life is in ruins. This is horrible, and I have lasted for five years.” His pacemaker kept on ticking. . .
. . . Not long afterward, my mother declined additional medical tests and refused to put my father on a new anti-dementia drug and a blood thinner with troublesome side effects. “I take responsibility for whatever,” she wrote in her journal that summer. “Enough of all this overkill! It’s killing me! Talk about quality of life — what about mine?” . . .
. . . On a Tuesday afternoon, with my mother at his side, my father stopped breathing. A hospice nurse hung a blue light on the outside of his hospital door. Inside his chest, his pacemaker was still quietly pulsing. . .
. . . A year later, I took my mother to meet a heart surgeon in a windowless treatment room at Brigham and Women’s Hospital in Boston. She was 84, with two leaking heart valves. Her cardiologist had recommended open-heart surgery, and I was hoping to find a less invasive approach. When the surgeon asked us why we were there, my mother said, “To ask questions.” She was no longer a trusting and deferential patient. Like me, she no longer saw doctors — perhaps with the exception of Fales — as healers or her fiduciaries. They were now skilled technicians with their own agendas. But I couldn’t help feeling that something precious — our old faith in a doctor’s calling, perhaps, or in a healing that is more than a financial transaction or a reflexive fixing of broken parts — had been lost.
Extraordinary rendition
“By pursuing clinical trials in foreign countries with lower standards and where F.D.A. lacks oversight, the industry is seeking the path of least resistance toward lower costs and higher profits to the detriment of public health.”
Full New York Times article found here
Just keep hammering home the message
From Beyond Meds
Think of those who are still subject to the care of mental health professionals. They are by definition subject to care, if my experience is to be taken seriously, and I for one do take it seriously, that considers them inherently less than equal. I remember when I was a clinician too. Some of these people who are prejudiced are well-meaning. But well-meaning and acting without prejudice are unfortunately not mutually exclusive. I don’t know how one extracts this insidious form of prejudice. They don’t see it in themselves…how do we help them see?
My solution is probably simplistic, but here goes. Just keep hammering home the message, politely, respectfully, but leave no one in any doubt as to why the attitude is objectionable. If you lose control, you will give “them” more ammunition to use against you and others like you. You will only haved confirmed their prejudice. Join forces with others and vary your media. Picket, write letters to the editor. Write letters in response to letters to the editor. Do book reviews. Remember the gay pride movement? Notice how respectful everybody is these days to homosexuals compared to what it used to be. Homosexuality was considered a mental illness, too, until the movement forced psychiatry to drop it from the DSM.
A big yawn
I was talking with Chris last night before dinner and he kept breaking into big yawns from his comfortable position in the easy chair. His whole face contorted, he opened his mouth wide and he sucked in air. In other words, a typical yawn. He yawned three or four times, enough to make me wonder if I was boring him. Why is this so interesting? Well, for one, a yawner he is not.
Apparently, people with a diagnosis of schizophrenia do not yawn. Based on my knowing Chris, by golly that’s right. I had never seen Chris yawn. Maybe he did as a baby. If so, I’ve forgotten, but for sure I never saw him yawn as a child, teen and adult. A few weeks after Chris underwent the assemblage point therapy, I caught him yawning. Haven’t seen much since. Chris has told me repeatedly recently that his life lacks fun. It appears that he is beginning to be uncomfortable in his role of stay-at-home guy with little fun in his life.
Here’s a partial explanation for what’s going on, from the Bulletin of the Menninger Clinic. I don’t necessarily agree with the final paragraph’s hypothesis about chronicity.
YAWNING
A homeostatic reflex and its psychological significance
Heinz E. Lehmann, Professor of Psychiatry, McGill University
Clinical Observations : It is an old clinical observation (Russell 1891; Geigel 1908) that persons suffering from an acute physical illness never yawn as long as their condition is serious. Nurses have learned to recognize the return of yawning as a sign of patients’ convalescence, particularly in those patients who have infectious diseases. The literature, however, reports few observations regarding yawning in psychotic patients, although Hauptmann (1920) made mention of its possible significance.
Some time ago I was struck by the conspicuous scarcity of yawning among mental patients. I informally recorded the incidence of people yawning in public gatherings, on buses, in restaurants, at scientific meetings, and on mental hospital wards. These observations confirmed my impression that yawning among the mentally ill is unusually rare. There were two exceptions: patients receiving large doses of sedatives and those diagnosed as suffering from organic brain syndrome. Of course, the absence of yawning in patients with psychoses associated with constant psychomotor excitement or increased nervous tension was not surprising since excitement or emotional tension usually excludes the occurrence of yawning in normal individuals. However, the majority of patients I observed were quiet, inactive, indifferent persons suffering from schizophrenia. Their failure to yawn requires an explanation.
One of the most consistent physiological findings about patients with schizophrenia is defective homeostasis. The schizophrenic patient’s ability to adjust to changes in the internal milieu is impaired. Slight reductions of the schizophrenic subject’s brain metabolism would, therefore, provoke a homeostatic response less easily than in a normal person. Yawning might not be elicited unless the yawning provoking stimulus assumes an unusual strength such as that provided by hypoglycemia or by barbiturates.
As I have mentioned, the principal psychological agent to produce yawning-boredom-is an affect characterized by an extraverted attitude, a searching tendency toward reality. The schizophrenic subject’s typical withdrawal from reality and his affective blunting make it almost impossible for him to be truly bored; his passivity, indifference, and daydreaming must not be confused with boredom. In addition, the schizophrenic individual can hardly be expected to imitate unconsciously the yawning of another person since he is not likely to transfer sufficient interest to other persons in his surroundings. Therefore, when a schizophrenic patient yawns as a result of boredom or unconmous imitation, it shows that the patient’s contact with reality is not entirely lost and that he is making an effort to maintain it. In fact, when any psychiatric patient yawns, it is a signal that he is in an accessible mood, regardless of his general mental state or diagnosis.
Of course, yawning is by no means completely absent in schizophrenic patients. Its incidence, however, appears to be much lower in schizophrenia than in normal mental conditions or in other mental diseases. The occurrence of yawning in early schizophrenia may be evaluated as a favorable sign; however, it seems to be of ominous significance in chronic schizophrenia. One may theorize that yawning in the acute schizophrenic patient is the reflection of a fairly intact homeostatic system and possibly the expression of the patient’s efforts to retain his contact with reality. In the chronic stages of the disease, yawning may be indicative of structural brain changes and the formation of a new, permanent, and pathological relationship to the outside world, characterized by complacency and the complete loss of the inner stress and tension that should accompany even partial insight.
Another constellation
Ian and I underwent a Family Constellation on Thursday morning with Dr. Stern, just the three of us, no Chris involved. The premise of this Constellation was Chris’s early childhood and in utero period, what Ian and I were like at that stage, our feelings surrounding the pregnancy, etc. Dr. Stern already had “the dirt” on us since I had provided her early on with a family tree on both Ian’s and my sides of the family. She knows where all our skeletons are hanging.
For those not familiar with our Family Constellation Work, you can read about what it is and a Constellation that we did earlier, here and here.
Before we began the Constellation, we discussed the fact that I actually heard the pregnancy happen (yes, it was a “ping” sound) but after that I felt nothing more from Chris for ten months. It was like he froze. We discussed how Ian and I felt like we weren’t ready for parenthood. It took us a few weeks to welcome the idea, not without prior feelings of apprehension. Chris didn’t seem to want to be born, given the fact he was twenty-seven days past due (born in early January instead of early December) and frozen almost the entire time. We discussed Chris being as good as gold in childhood, never wanting to draw attention to himself, never stepping out of line to risk incurring our anger. There are other things that we discussed that had a bearing on the Family Constellation, which I feel are a bit too private to post.
Then it gets complicated, complicated in ways that emotional bonds in families are complicated. Dr. Stern took over and Ian and I drew straws as to who would place the shoes on the floor. I was the one and I quickly, without thinking, dropped the papers with the shoe outlines of Ian, me and baby Chris on the floor in the middle of the room. Ian noticed that I had put Chris on the other side of me, as if I was shielding him from his father. I was, in the sense that I often felt that Ian’s concern with safety issues was getting in the way of healthy childhood exploration. I noticed that the gap between Ian’s and my place on the floor was rather large. Ian’s shoes were pointed out, away from us. This intuitively made sense because Ian was focused on his career during the early years. Successfully married people grow together over the years. At the beginning,you are still finding your way.
Dr. Stern stepped into everybody’s shoes and expressed the emotions that she picked up from her own intuition, knowledge of our family, and the way in which the shoes were placed on the floor. She remarked that she couldn’t see Chris from Ian’s position on the floor. When she stepped into my shoes, she also noticed that she couldn’t see Chris behind her. When she stepped into Chris’s shoes, she felt that nobody saw her/him. Chris was blocked from seeing the world ahead of him. Why was this? she asked.
If you are interested in a Family Constellation and willing to suspend disbelief, this therapy is for you. Ian and I were intent on Dr. Stern’s message and joined in the speculation. It became apparent from the Constellation that we were protecting Chris, but from what? Dr. Stern then had an “idea” and shuffled through the file of our long dead family members and produced the shoes of my father’s older brother, who died, unnamed,in 1908, having lived from Dec. 9th to Dec. 11th. What was Chris’s due date, again? Dr. Stern asked. December 10th, I answered. I placed my great uncle’s tiny prints on the floor in front of me. That struck me as the more logical place to have put Chris. That was my quick intuitive response, and the unconscious mind knows best. Here was the dead baby looming large in front of us, in direct sight of me, Ian, and Chris. Yet, I never gave this unnamed baby a thought when I was growing up.
Dr. Stern then had another idea. She hauled out Ian’s father’s older brother, who died in 1926 around the age of four of leukemia. Ian’s father carried the identical name of his brother, as if he was the replacement for the dead brother. Ian placed the dead great uncle behind him.
Dr. Stern, through her acting out this particular Constellation, was hinting that early childhood separation of first born sons was a shadow that loomed over both sides of the family. Ian and I unconsciously passed a fear of early separation to Chris. In essence, Chris assumed the victims’ roles and assumed their spectral presence, perhaps staying close to home to fulfill our unmet needs. I reminded Dr. Stern that Chris has had a ghostly quality to him from childhood. He was pale and unobtrusive. He can (and still does) somewhat miraculously appear in a room, as if he had materialized out of thin air.
Dr. Stern then moved Chris’s footprints to the front and off to the side, where he could see his father, mother and great, great uncles. She stood in his shoes and looked at the Constellation for a long time, then slowly shook herself, noticing that her left arm was beginning to feel less heavy and mechanical. The left side of the body, she said, represents the mother. Her right arm (the father’s side) slowly started returning to life again. I feel quite good, I feel like I can make a new beginning, she announced. I am not very down-to-earth, though, she continued. I am lighter than that. If I do something with my life, what would it be? Ian and I waited patiently for her answer. She appeared perplexed. It wouldn’t be a businessman or a gardener, she felt sure about that. That is too earthbound for me. No, I am, more like a . . . . Well, I can’t quite put what I want to say in words, but it is almost like being a stewardess in an airplane, having a light touch in asking the passengers how I can be of help.
Family Constellation therapy doesn’t assume that there is one defining event that shapes families’ intergenerational emotional lives. There are many events that have a transgenerational impact. It is clear to me the goal of every Family Constellation session is to bring unity to the family members, both dead and alive. Dr. Stern didn’t leave us wondering. She closed the session on a note of hope. She literally stood in Chris’s shoes and said “I am going to be okay.” Ian and I will then go away relieved, with a burden lifted. We will not be passing on our worries to Chris, because these worries have been lifted. Chris, himself, will sense this.
We are following Dr. Dietrich Klinghardt’s advice. After a Family Constellation you walk away from it, you do not analyze it, and you wait for the magic to happen
Connecting the dots in consciousness and schizophrenia
The therapeutic treatment of serious mental health issues like schizophrenia will converge in future around consciousness.
Eric Allen Bell
I asked Deepak, “Why is there suffering in the world” and he answered..”All suffering comes from the hallucination of separateness”.
Hallucinogens
Scientists are taking a new look at hallucinogens, which became taboo among regulators after enthusiasts like Timothy Leary promoted them in the 1960s with the slogan “Turn on, tune in, drop out.” Now, using rigorous protocols and safeguards, scientists have won permission to study once again the drugs’ potential for treating mental problems and illuminating the nature of consciousness.
Lucid dreaming
People who focus single-mindedly on a task during the day, be it a computer game or playing a musical instrument, are more likely to experience lucid dreams, says Jayne Gackenbach at Grant MacEwan University in Edmonton, Canada.
These experiments in lucid dreaming, few though they currently are, may have wide-reaching implications in clinical situations, particularly in the study of mental illness. “When you’re a schizophrenic, you’re in primary consciousness really,” Voss claims. “What you’re lacking is reflective awareness; you cannot distinguish between reality and your hallucinations.” On this basis, Voss wonders whether it might be possible to stimulate the necessary regions in schizophrenic patients to help them achieve greater lucidity in their waking life. The work might even suggest ways for healthy people to enjoy lucid dreams. “Wouldn’t it be nice if you could get somebody in REM sleep to become a lucid dreamer just by stimulating his brain?” says Voss. “No one’s tried this before.”
The Satori system
This privately developed technology is being used by the US military in veterans centers and in Iraq and Afghanistan. It is becoming widely available in US spas and the developers are partnering with Mental Health America to distribute 250,000 MP3 complimentary downloads to U.S. servicemen (emphasis, my own)
The Satori system uses alpha, theta and delta frequencies to induce relaxation by lowering brainwaves, lowering serotonin levels and bringing the body into a REM-like state.
Chris Forbes on sound (color) therapy
A very interesting thing happened, which accelerated the time it took to achieve “zen” with the color therapy. Beginning with red (opposites), all the tension left me and I entered into a different space, a space that was not defined by my body but rather was defined by my “rational” mind, the part of me which had preferences and opinions. My mind was liberated, and while I did not enter into free fantasy or “lucid dreaming”, I was questioning things I took for granted, and how I defined most things against my body. At green and blue I was released completely from the present and concentrated on my memories, and I became aware of the life flowing in my limbs and the changes, I could see how my legs had become stronger but less flexible since I started treating the body like a machine.
Writer’s block
Saturday morning I attended a writers’ workshop on publishing and marketing. The discussion revolved around the latest technologies like Twitter, self-publishing on demand and a machine that chunks your manuscript out as a bound book. (There are twenty-eight of these machines around the world at an installation cost of $100,000 each.) I found out that you can get a ten minute e-mail so that you can send a one-off message and not be bothered with your mailbox filling up with spam afterwards.
Speaking of which, on Friday I was targeted by one of those e-mail scams using the familiar name a sophisticated man I know here who claims he was robbed in London and desperately needed money to get back home. Knowing that this was a fraudulent abuse of his good name, I sent a message back. Yes, yes, would like to help, what can I do? A day later, my “friend” is still broke and in London. Nobody has bailed him out yet. The new e-mail suggests that I wire the money to him through Western Union and send an e-mail as I set out for the office. I immediately wrote back and said that I tried to go, but the office was closed when I got there and that I hoped he had sorted himself out. His reply arrived the next day. “Alright no prob. I’ll have to reschedule my flight and as soon as it is done, kindly get back to me with the Western Union transfer details. I owe you alot!”
Technology . . . making our lives easier and less complicated.
Attending the writing group is to give me the push I need to get my book finished. This baby has been five years in the making. It’s time to give birth. I don’t want to give up the daily blogging, so I am going to have to find a way to get this done short of taking a leave of absence from my day job. The reason I have not given up is because I feel it is important to put out a positive perspective for once on schizophrenia. A positive perspective coming from a mother I hope will carry some clout. It would be excellent timing because it would coincide with the growing disillusionment with the biochemical romance that Robert Whitaker’s new book, Anatomy of an Epidemic, has demonstrated.
In the meantime, I have the added burden of struggling with the technology and the promotion. Self-publish or hound hundreds of agents to no avail? Twitter my accomplishments? I’m still dubious about Twitter. I fear that I am in a Twittering myself loop most of the time.