We Need New Ways of Treating Depression

We Need New Ways of Treating Depression

As the 21st century was beginning, a South African psychiatrist named Derek Summerfield happened to be in Cambodia conducting some research on the psychological effects of unexploded land mines — at a time when chemical antidepressants were first being marketed in the country.

The local doctors didn’t know much about these drugs, so they asked Summerfield to explain them. When he finished, they explained that they didn’t need these new chemicals — because they already had antidepressants. Puzzled, Summerfield asked them to explain, expecting that they were going to tell him about some local herbal remedy. Instead, they told him about something quite different.

The doctors told Summerfield a story about a farmer they had treated. He worked in the water-logged rice fields, and one day he stepped on a land mine and his leg was blasted off. He was fitted with an artificial limb, and in time he went back to work. But it’s very painful to work when your artificial limb is underwater, and returning to the scene of his trauma must have made him highly anxious. The farmer became deeply depressed.

So the doctors and his neighbors sat with this man and talked through his life and his troubles. They realized that even with his new artificial limb, his old job — working in the paddies — was just too difficult, that he was constantly stressed and in physical pain, and that these things combined to make him want to just stop living. His interlocutors had an idea.

They suggested that he work as a dairy farmer, a job that would place less painful stress on his false leg and produce fewer disturbing memories. They believed he was perfectly capable of making the switch. So they bought him a cow. In the months and years that followed, his life changed. His depression, once profound, lifted. The Cambodian doctors told Summerfield: “You see, doctor, the cow was an analgesic, and antidepressant.”

In time, I came to believe that this little scene in Southeast Asia, which at first sounds just idiosyncratic, deeply “foreign,” in fact represents in a distilled form a shift in perspective that many of us need to make if we are going to make progress in tackling the epidemic of depression, anxiety, and despair spreading like a thick tar across our culture.

It’s not just about brain chemistry

For more than 30 years, we have collectively told one primary story about depression and anxiety. When I was a teenager and I went to my doctor and explained I felt distress was pouring out of me uncontrollably, like a foul smell, he told me a story.

The doctor said that depression is caused by the spontaneous lack of a chemical in the brain called serotonin, and I simply needed to take some drugs to get my serotonin levels up to a normal level. A few days before I wrote this piece, a young friend of one of my nephews, who was not much older than I was when I was first diagnosed, went to his doctor and asked for help with his depression. His doctor told him he had a problem with dopamine in his brain. In 20 years, all that has shifted is the name of the chemical.

I believed and preached versions of this story for more than a decade. But when I began to research the causes of depression and anxiety for my new book, Lost Connections, I was startled to find leading scientific organizations saying this approach was based on a misreading of the science. There are real biological factors that contribute to depression, but they are very far from being the whole story.

The World Health Organization, the leading medical body in the world, explained in 2011: “Mental health is produced socially: The presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual, solutions.” The United Nations’ special rapporteur on the right to health, Dr. Dainius Pūras — one of the leading experts in the world on mental health — explained last April that “the dominant biomedical narrative of depression” is based on “biased and selective use of research outcomes.”

“Regrettably, recent decades have been marked with excessive medicalization of mental health and the overuse of biomedical interventions, including in the treatment of depression and suicide prevention,” he said. While there is a role for medications, he added, we need to stop using them “to address issues which are closely related to social problems.”

I was initially bemused by statements like this: They were contrary to everything I had been told. So I spent three years interviewing the leading scientists in the world on these questions, to try to understand what is really going on in places where despair in our culture is worst, from Cleveland to Sao Paulo, and where the incidence of despair is lowest, including Amish communities. I traveled 40,000 miles and drilled into the deepest causes of our collective depression.

I learned there is broad agreement among scientists that there are three kinds of causes of depression and anxiety, and all three play out, to differing degrees, in all depressed and anxious people. The causes are: biological (like your genes), psychological (how you think about yourself), and social (the wider ways in which we live together). Very few people dispute this. But when it comes to communicating with the public, and offering help, psychological solutions have been increasingly neglected, and environmental solutions have been almost totally ignored.

The hotly contested studies of chemical antidepressants

Instead, we focus on the biology. We offer, and are offered, drugs as the first, and often last, recourse. This approach is only having modest results. When I took chemical antidepressants, after a brief burst of relief, I remained depressed, and I thought there was something wrong with me.I learned in my research that many researchers have examined the data on antidepressants and come to very different conclusions about their effectiveness. But it’s hard not to conclude, looking at the evidence as a whole, that they are at best a partial solution.

Depression is often measured by something called the Hamilton Depression Rating Scale, a 17-item test administered by clinicians, where a score of zero means you show no symptoms of the disorder and a score of 52 would indicate an absolutely debilitating episode.

The studies that most strongly support chemical antidepressants found that some 37 percent of people taking them experience a significant shift in their Hamilton scores amounting to a full remission in their symptoms. When therapy and other interventions were added in addition to or in place of these drugs — in treatment-resistant cases — remission rates went higher.

Yet other scholars, looking at the exact same data set, noticed that over the long term, fewer than 10 percent of the patients in the study — who were, incidentally, receiving more support than the average depressed American would receive from their doctor — experienced complete remission that lasted as long as a year. When I read this, I noticed to my surprise that it fit very closely with my own experience: I had a big initial boost, but eventually the depression came back. I thought I was weird for sinking back into depression despite taking these drugs, but it turns out I was quite normal.

Steve Ilardi, a professor of psychology at the University of Kansas, summarizes the research on chemical antidepressants this way, via email: “Only about 50 percent of depressed individuals experience an initial positive response to antidepressants (and only about 30 percent achieve full remission). Of all of those depressed individuals who take an antidepressant, only a small subset — estimated between 5 and 20 percent — will experience complete and enduring remission.” In other words: The drugs give some relief, and therefore have real value, but for a big majority, they aren’t enough.

Irving Kirsch, a professor of psychology who now teaches at Harvard Medical School, was initially a supporter of chemical antidepressants – but then he began to analyze this data, especially the data the drug companies had tried to keep hidden from the public. His research concluded that chemical antidepressants give you a boost, above the placebo effect, of 1.8 points on average on the Hamilton scale. This is less than a third of the boost that you get, by some estimates, from improving your sleep patterns.

(Kirsch points out that a study recently released in The Lancet, to much media coverage, confirmed what we already knew and everyone already agreed on: that chemical antidepressants have more effect than a placebo. The more important questions are: by how much, for how long?)

And even people less skeptical than Kirsch point to this inconvenient fact: Although antidepressant prescriptions have increased 500 percent since the 1980s, there has been no discernible decrease in society-wide depression rates. There’s clearly something very significant missing from the picture we have been offered.

After studying all this, I felt startled, and it took me time to fully absorb it. Kirsch regards the 1.8-point gain he finds as clinically meaningless and not justifying the benefits of these drugs. I found his studies persuasive, but I disagree a little with this takeaway. There are people I know for whom this small but real benefit outweighs the side effects, and for them, my advice is to carry on taking the drugs.

But it is clear, once you explore this science, that drugs are far from being enough. We have to be able to have a nuanced and honest discussion that acknowledges an indisputable fact: that for huge numbers of people, antidepressants only provide either no relief or a small and temporary amount, and we need to radically expand the menu of options to help those people.

Our focus on biology has led us to think of depression and anxiety as malfunctions in the individual’s brain or genes — a pathology that must be removed. But the scientists who study the social and psychological causes of these problems tend to see them differently. Far from being a malfunction, they see depression as partly or even largely a function, a necessary signal that our needs are not being met.

Everyone knows that human beings have innate physical needs — for food, water, shelter, clean air. There is equally clear evidence that human beings have innate psychological needs: to belong, to have meaning and purpose in our lives, to feel we are valued, to feel we have a secure future. Our culture is getting less good at meeting those underlying needs for a large number of people — and this is one of the key drivers of the current epidemic of despair.

I interviewed in great depth scientists who have conclusively demonstrated that many factors in our lives can cause depression (not just unhappiness: full depression). Loneliness, being forced to work in a job you find meaningless, facing a future of financial insecurity — these are all circumstances where an underlying psychological need is not being met.

The strange case of the “grief exception” — and its profound implications

The difficulty that some parts of psychiatry have had in responding to these insights can be seen in a debate that has been playing out since the 1970s. In that decade, the American Psychiatric Association decided, for the first time, to standardize how depression (specifically, “major depressive disorder”) was diagnosed across the United States. By committee, they settled on a list of nine symptoms — persistent low mood, for instance, and loss of interest or pleasure — and told doctors across the country that if patients showed more than five of these symptoms for more than a couple of weeks, they should be diagnosed as mentally ill.

But as these instructions were acted on across the country, some doctors reported a slightly awkward problem. Using these guidelines, every person who has lost a loved one — every grieving person — should be classed as mentally ill. The symptoms of depression and the symptoms of grief were identical.

Embarrassed, the psychiatric authorities came up with an awkward solution. They created something called “the grief exception.” They told doctors to keep using the checklist unless somebody the patient loved had recently died, in which case it didn’t count. But this led to a debate that they didn’t know how to respond to. Doctors were supposed to tell their patients that depression was a brain disease to be identified on a checklist — but now there was, uniquely, one life situation where that explanation didn’t hold.

Why, some doctors began to ask, should grief be the only situation in which deep despair is not a sign of a mental disorder that should be treated with drugs? What if you have lost your job? Your house? Your community? Once you entertain the idea that depression might be a reasonable response to some life circumstances — as Joanne Cacciatore, an associate professor in the school of social work at Arizona State University, told me — our theories about depression require “an entire system overhaul.”

Rather than do this, the psychiatric authorities simply got rid of the grief exception.

Now grieving people can be diagnosed as mentally ill at once. Cacciatore’s research has found that about a third percent of parents who lose a child are drugged with antidepressants or sedatives in the first 48 hours after the death.

Once you understand that psychological and social context is crucial to understanding depression, it suggests we should be responding to this crisis differently from how we now do. To those doctors in Cambodia, the concept of an “antidepressant” didn’t entail changing your brain chemistry, an idea alien to their culture. It was about the community empowering the depressed person to change his life.

All over the world, I interviewed a growing group of scientists and doctors who are trying to integrate these insights into their work. For them, anything that reduces depression should be regarded as an antidepressant.

To know what to fight, we need to think harder about causes of mental malaise. I was able to identify nine causes of depression and anxiety for which there is scientific evidence. Seven are forms of disconnection: from other people, from meaningful work, from meaningful values, from the natural world, from a safe and secure childhood, from status, and from a future that makes sense to you. Two are biological: your genes, and real brain changes.

(It is too crude to describe these as a “chemical imbalance,” the typical shorthand today; Marc Lewis, a neuroscientist at the University of Toronto, told me it makes more sense to think of them as “synaptic pruning” — your brain sheds synapses you don’t use, and if you are pushed into a pained response for too long, your brain can shed synapses, making it harder to navigate away from dark thoughts.)

These scientists were asking: What would antidepressants that dealt with these causes, rather than only their symptoms, look like?

“Social prescribing”: a new kind of treatment


In a poor part of East London in the 1990s, Dr. Sam Everington was experiencing something uncomfortable. Patients were coming to him with depression and anxiety. “When we went to medical school,” he told me, “everything was biomedical, so what you described as depression was [due to] neurotransmitters.” The solution, then, was drugs. But that didn’t seem to match the reality of what he was seeing.

If Everington sat and talked with his patients and really listened, he felt that their pain made sense — they were often profoundly lonely, or financially insecure. He wasn’t against chemical antidepressants. But he felt that they were not responding to the underlying reasons his patients were depressed in the first place. So he tried a different approach — and ended up pioneering a fresh approach to fighting depression.

A patient named Lisa Cunningham came to Everington’s surgery clinic one day. She’d been basically shut away in her home, crippled with depression and anxiety, for seven years. She was told by staffers at the clinic that they would continue prescribing drugs to her if she wanted, but they were also going to prescribe a group therapy session of sorts. There was a patch of land behind the clinic, backing onto a public park, that was just scrubland. Lisa joined a group of around 20 other depressed people, two times a week for a full afternoon, to turn it into something beautiful.

On her first day there, Lisa felt physically sick with anxiety. It was awkward to converse with the others. Still, for the first time in a long time, she had something to talk about that wasn’t how depressed and anxious she was.

As the weeks and months — and eventually years — passed, Everington’s patients taught themselves gardening. They put their fingers in the soil. They figured out how to make things grow. They started to talk about their problems. Lisa was outraged to learn that one of the other people in the group was sleeping on a public bus — so she started to pressure the local authorities to house him. She succeeded. It was the first thing she had done for somebody else in a long time.

As Lisa put it to me: As the garden began to bloom, the people in it began to bloom too. Everington’s project has been widely influential in England but not rigorously analyzed by statisticians, who tend to focus on drug-centered treatment. But a study in Norway of a similar program found it was more than twice as effective as chemical antidepressants — part of a modest but growing body of research suggesting approaches like this can yield striking results.

This fits with a much wider body of evidence about depression: We know that social contact reduces depression, we know that distraction from rumination (to which depressives are highly prone) has a similar effect, and there is some evidence that exposure to the natural world, and anything that increases exposure to sunlight, also has antidepressant effects.

Everington calls this approach “social prescribing,” and he believes it works because it deals with some (but not all) of the deeper social and environmental causes of depression.

Economic stress can lead to depression


A study last week showed that anti-depressants work better than placebos. But many people who take them remain depressed, or return to a depressed condition.

I searched out other radical experiments with different kinds of social and psychological antidepressants, often in unexpected places. (Some of these were not designed as antidepressants but ended up serving that purpose.) In the 1970s, the Canadian government embarked on an experiment in a rural town called Dauphin, in Manitoba. They told the population there: From now on, we are going to give you, in monthly installments, a guaranteed basic income. You don’t have to do anything for it — you’re getting this because you are a citizen of our country — and nothing you do can mean we will take this away from you. It added up to roughly $17,000 in today’s US dollars (if they had no income from other sources).

Many things happened as a result of this three-year experiment, but one of the most striking is a big fall in hospitalizations — 8.5 percent in three years, according to Evelyn Forget, a professor in the department of community health services at the University of Manitoba and the leading expert on this experiment. Visits for mental health reasons accounted for a significant part of that drop, Forget says, and visits to doctors for mental health reasons also decreased.

“It just removed the stress — or reduced the stress — that people dealt with in their everyday lives,” she says. There is evidence that if you have no control at work, you are significantly more likely to become depressed (and to die of a stress-related heart attack). A guaranteed income “makes you less of a hostage to the job you have, and some of the jobs that people work just in order to survive are terrible, demeaning jobs.”

The scientists I spoke with wanted to keep chemical antidepressants on the menu, but also to radically expand the options available to depressed and anxious people. Some interventions are things individuals can do by themselves. One is taking part in groups dedicated to rediscovering meaning in life (anything from a choir to a campaign group). Another is practicing a form of mindfulness called “loving-kindness meditation” (an ancient technique for overcoming envy in which you train yourself to feel joy not just for your friends but also for strangers and even for people you dislike).

But many of the most effective social antidepressants require us to come together to fight for big social changes that will reduce depression, like changing our workplaces to reduce the amount of control and humiliation that happens there.

As a 39-year-old gay man, I have seen how people can band together to fight for seemingly impossible goals — and win, radically reducing the amount of unhappiness gay people face. I have also seen how, in one sense, the struggle is the solution: The act of banding together, identifying that you are being mistreated, and fighting for something better restores dignity to people who felt they had been defeated.

Is there a type of depression utterly unconnected to life circumstances?

As I absorbed all this evidence over three years, a persistent question kept coming to me. Yes, there are these deep causes of depression, but what about people who have nothing to be unhappy about, yet still feel this deep despair descend on them?

There is a debate among scientists about whether there is something called “endogenous depression” — a form of despair that is triggered purely by biology. The most detailed research into this, by George Brown of the Institute of psychiatry at the University of London and his colleague Tirril Harris, in the 1970s, found that people diagnosed with this problem in fact had just as many life challenges as people whose depression was supposed to be a response to life events. (They had spent years studying how long-term stress can radically increase depression.)

This could mean that endogenous depression does not exist — or it could mean that scientists were not good at spotting the difference back then. The scientists I spoke to agreed on one thing: If the condition does exist, it affects a tiny minority of depressed and anxious people.

But I only really felt I made a breakthrough in my own thinking — in understanding the mystery of why some people seem to become depressed “for no good reason” — when, by coincidence, I started reading some feminist texts from the 1960s.

At that time, it was common for women to go to their doctors and say something like: “Doctor, there must be something wrong with my nerves. I have everything a woman could want. I have a husband who doesn’t beat me, two kids, a house, a car, a washing machine — but I still feel terrible.” Doctors would agree that they had a problem and would prescribe them drugs like Valium. (The locus of the problem only migrated from the “nerves” to the brain in the 1990s.)

Now if we could go back in time and talk to those women, we would say, “Yes, you have everything you could possibly want by the standards of the culture.” But the standards of the culture are simply wrong: You need much more than this.

In the same way, today, when people tell me they must be biologically broken because they have “everything they could want” yet they are still depressed, I say: Tell me what you have. They talk about having money, or status, or expensive consumer goods. But these are not what people need to have meaningful lives.

If I start to ask about the social and environmental factors of depression and anxiety I’ve mentioned, I have yet to find a depressed person for whom at least some are not playing out. Perhaps some of us are simply biologically broke, but the idea that a purely biological story describes the vast majority of depressed and anxious people is by now, it is fair to say, discredited.

The lesson the psychiatrist took back from Cambodia

After he had completed his work in Cambodia, and after he had heard the story about the farmer who was given a cow as an antidepressant, Summerfield returned to London, where he worked as a psychiatrist, and he realized something he had never quite seen so clearly before. He thought about when he had most helped his depressed and anxious patients. Most often, it occurred to him, it was when he helped them to get secure housing, or to fix their immigration status, or to find a job. “When I make a difference, it’s when I’m addressing their social situation, not what’s between their ears,” he told me.

Yet we have, as a society, built our responses to depression and anxiety almost entirely around changing brains, rather than changing lives. Every year we have done this, our depression and anxiety crisis has got worse. When, I began to wonder, will we learn the lesson that those Cambodian doctors understood intuitively, and that the World Health Organization has been trying to explain to us: Our pain makes sense.

Johann Hari’s latest book is Lost Connections: Uncovering the Real Causes of Depression — and the Unexpected Solutions.

This post originally appeared on Vox. This article is republished here with permission.

Source: https://getpocket.com/explore/item/we-need-new-ways-of-treating-depression

How an 18th-Century Philosopher Helped Solve My Midlife Crisis

How an 18th-Century Philosopher Helped Solve My Midlife Crisis

The Atlantic Visit Site

By Alison Gopnik September 15, 2015

10,523 saves

David Hume, the Buddha, and a search for the Eastern roots of the Western Enlightenment

In 2006, I was 50—and I was falling apart.

Until then, I had always known exactly who I was: an exceptionally fortunate and happy woman, full of irrational exuberance and everyday joy.

I knew who I was professionally. When I was 16, I’d discovered cognitive science and analytic philosophy, and knew at once that I wanted the tough-minded, rigorous, intellectual life they could offer me. I’d gotten my doctorate at 25 and had gone on to become a professor of psychology and philosophy at UC Berkeley.

I knew who I was personally, too. For one thing, I liked men. I was never pretty, but the heterosexual dance of attraction and flirtation had always been an important part of my life, a background thrum that brightened and sharpened all the rest. My closest friends and colleagues had all been men.

More than anything, though, I was a mother. I’d had a son at 23, and then two more in the years that followed. For me, raising children had been the most intellectually interesting and morally profound of experiences, and the happiest. I’d had a long marriage, with a good man who was as involved with our children as I was. Our youngest son was on his way to college.

I’d been able to combine these different roles, another piece of good fortune. My life’s work had been to demonstrate the scientific and philosophical importance of children, and I kept a playpen in my office long after my children had outgrown it. Children had been the center of my life and my work—the foundation of my identity.

And then, suddenly, I had no idea who I was at all.

My children had grown up, my marriage had unraveled, and I decided to leave. I moved out of the big, professorial home where I had raised my children, and rented a room in a crumbling old house. I was living alone for the first time, full of guilt and anxiety, hope and excitement.

I fell in love—with a woman, much to my surprise—and we talked about starting a new life together. And then my lover ended it.

Joy vanished. Grief took its place. I’d chosen my new room for its faded grandeur: black-oak beams and paneling, a sooty brick fireplace in lieu of central heating. But I hadn’t realized just how dark and cold the room would be during the rainy Northern California winter. I forced myself to eat the way I had once coaxed my children (“just three more bites”), but I still lost 20 pounds in two months. I measured each day by how many hours had gone by since the last crying jag (“There now, no meltdowns since 11 this morning”).

I couldn’t work. The dissolution of my own family made the very thought of children unbearable. I had won a multimillion-dollar grant to investigate computational models of children’s learning and had signed a contract to write a book on the philosophy of childhood, but I couldn’t pass a playground without tears, let alone design an experiment for 3-year-olds or write about the moral significance of parental love.

Everything that had defined me was gone. I was no longer a scientist or a philosopher or a wife or a mother or a lover.

My doctors prescribed Prozac, yoga, and meditation. I hated Prozac. I was terrible at yoga. But meditation seemed to help, and it was interesting, at least. In fact, researching meditation seemed to help as much as actually doing it. Where did it come from? Why did it work?

I had always been curious about Buddhism, although, as a committed atheist, I was suspicious of anything religious. And turning 50 and becoming bisexual and Buddhist did seem far too predictable—a sort of Berkeley bat mitzvah, a standard rite of passage for aging Jewish academic women in Northern California. But still, I began to read Buddhist philosophy.

In 1734, in scotland, a 23-year-old was falling apart.

As a teenager, he’d thought he had glimpsed a new way of thinking and living, and ever since, he’d been trying to work it out and convey it to others in a great book. The effort was literally driving him mad. His heart raced and his stomach churned. He couldn’t concentrate. Most of all, he just couldn’t get himself to write his book. His doctors diagnosed vapors, weak spirits, and “the Disease of the Learned.” Today, with different terminology but no more insight, we would say he was suffering from anxiety and depression. The doctors told him not to read so much and prescribed antihysteric pills, horseback riding, and claret—the Prozac, yoga, and meditation of their day.

The young man’s name was David Hume. Somehow, during the next three years, he managed not only to recover but also, remarkably, to write his book. Even more remarkably, it turned out to be one of the greatest books in the history of philosophy: A Treatise of Human Nature.

In his Treatise, Hume rejected the traditional religious and philosophical accounts of human nature. Instead, he took Newton as a model and announced a new science of the mind, based on observation and experiment. That new science led him to radical new conclusions. He argued that there was no soul, no coherent self, no “I.” “When I enter most intimately into what I call myself,” he wrote in the Treatise, “I always stumble on some particular perception or other, of heat or cold, light or shade, love or hatred, pain or pleasure. I never can catch myself at any time without a perception, and never can observe any thing but the perception.”

Hume had always been one of my heroes. I had known and loved his work since I was an undergraduate. In my own scientific papers I’d argued, like Hume, that the coherent self is an illusion. My research had convinced me that our selves are something we construct, not something we discover. I had found that when we are children, we don’t connect the “I” of the present to the “I” of the past and the future. We learn to be who we are.

Until Hume, philosophers had searched for metaphysical foundations supporting our ordinary experience, an omnipotent God or a transcendent reality outside our minds. But Hume undermined all that. When you really look hard at everything we think we know, he argued, the foundations crumble. Descartes at least had said you always know that you yourself exist (“I think, therefore I am”), but Hume rejected even that premise.

Photo by: Wikimedia

Hume articulates a thoroughgoing, vertiginous, existential kind of doubt. In the Treatise, he reports that when he first confronted those doubts himself he was terrified—“affrighted and confounded.” They made him feel like “some strange uncouth monster.” No wonder he turned to the doctors.

But here’s Hume’s really great idea: Ultimately, the metaphysical foundations don’t matter. Experience is enough all by itself. What do you lose when you give up God or “reality” or even “I”? The moon is still just as bright; you can still predict that a falling glass will break, and you can still act to catch it; you can still feel compassion for the suffering of others. Science and work and morality remain intact. Go back to your backgammon game after your skeptical crisis, Hume wrote, and it will be exactly the same game.

In fact, if you let yourself think this way, your life might actually get better. Give up the prospect of life after death, and you will finally really appreciate life before it. Give up metaphysics, and you can concentrate on physics. Give up the idea of your precious, unique, irreplaceable self, and you might actually be more sympathetic to other people.

How did Hume come up with these ideas, so profoundly at odds with the Western philosophy and religion of his day? What turned the neurotic Presbyterian teenager into the great founder of the European Enlightenment?

In my shabby room, as I read Buddhist philosophy, I began to notice something that others had noticed before me. Some of the ideas in Buddhist philosophy sounded a lot like what I had read in Hume’s Treatise. But this was crazy. Surely in the 1730s, few people in Europe knew about Buddhist philosophy.

Still, as I read, I kept finding parallels. The Buddha doubted the existence of an omnipotent, benevolent God. In his doctrine of “emptiness,” he suggested that we have no real evidence for the existence of the outside world. He said that our sense of self is an illusion, too. The Buddhist sage Nagasena elaborated on this idea. The self, he said, is like a chariot. A chariot has no transcendent essence; it’s just a collection of wheels and frame and handle. Similarly, the self has no transcendent essence; it’s just a collection of perceptions and emotions.

“I never can catch myself at any time without a perception.”

That sure sounded like Buddhist philosophy to me—except, of course, that Hume couldn’t have known anything about Buddhist philosophy.

Or could he have?

I settled into a new routine. Instead of going to therapy, I haunted the theology sections of used-book stores and spent the solitary evenings reading. I would sit in front of my grand fireplace, where a single sawdust log smoldered, wrapped in several duvets, and learn more about Buddhism.

I discovered that at least one person in Europe in the 1730s not only knew about Buddhism but had studied Buddhist philosophy for years. His name was Ippolito Desideri, and he had been a Jesuit missionary in Tibet. In 1728, just before Hume began the Treatise, Desideri finished his book, the most complete and accurate European account of Buddhist philosophy to be written until the 20th century. The catch was that it wasn’t published. No Catholic missionary could publish anything without the approval of the Vatican—and officials there had declared that Desideri’s book could not be printed. The manuscript disappeared into the Church’s archives.

I still couldn’t think or write about children, but maybe I could write an essay about Hume and Buddhism and include Desideri as a sort of close call—a missed connection.

I consulted Ernest Mossner’s classic biography of Hume. When Hume wrote the Treatise, he was living in a little French town called La Flèche, 160 miles southwest of Paris. Mossner said Hume went to La Flèche to “rusticate,” probably because it was cheap. But he also mentioned that La Flèche was home to the Jesuit Royal College.

So Hume lived near a French Jesuit college when he wrote the Treatise. This was an intriguing coincidence for my essay. But it didn’t really connect him to Desideri, of course, who had lived in Rome and Tibet.

When I searched the library databases at Berkeley, I found hundreds of books and thousands of articles I could read about David Hume, but only two about Ippolito Desideri: one article and a drastically abridged 1932 English translation of his manuscript. The article had appeared in Indica, an obscure journal published in Bombay, in 1986. I had to get it shipped down from the regional storage facility, where millions of books and articles in Berkeley’s collection languish unread. Ever since my love affair had ended, I had gone to bed each night dreading the next day. But now I found myself actually looking forward to tomorrow, when the article would arrive.

It mostly recapitulated what I had read before. But the author, an Italian named Luciano Petech, mentioned that he had edited a 1952 collection of missionary documents, I Missionari Italiani nel Tibet e nel Nepal, and that it included some Desideri manuscripts. And, in passing, he provided me with an interesting new detail. “In January 1727,” Petech wrote, “he left India, once more on a French ship, and arrived in Paris.”

Desideri had come back to Rome through France—one more intriguing coincidence.

The abridged Desideri translation could be read only in the Rare Book Room, so I headed there the next day. It was a beautiful book with red capital letters and romantic tipped-in photographs of majestic Buddhas and tranquil Himalayan valleys. I began to read eagerly.

I had been obsessively, ruminatively, fruitlessly trying to figure out who I was and what I would do without work or love or children to care for. It was like formulating an argument when the premises refuse to yield the conclusion, or analyzing a data set that makes no sense. But if I couldn’t figure myself out, I decided, I could at least try to figure out Desideri, and so I lost myself in his book, and his life.

It’s a remarkable story. In his 20s, Desideri conceived his own grand project—to convert the Indies to Catholicism—and in 1716 he became one of the first Europeans to go to Lhasa, and the first to stay. He was passionate, emotional, and easily exasperated. He was also curious, brave, and unbelievably tenacious. In an early letter written on his way to Tibet, he says he feels as if he is being torn apart on the rack. “It pleases his divine majesty to draw my whole heart away with sweet and amorous violence to where the perdition of souls is great,” he wrote, “and at the same time with fastest bonds are my feet bound and drawn elsewhere.” He kept up that intense pitch in everything he did.

Desideri sailed from Rome to India in 1712. In 1714 he began walking from Delhi across the Himalayas to Lhasa—a trek that lasted 18 months. He slept on the ground, in the snow, and struggled with snow blindness and frostbite. At one point he made his way over a rushing river by clinging precariously to a bridge made of two vine ropes. To get through the Ladakh desert, he joined the caravan of a Tartar princess and argued about theology with her each night in her tent.

When he finally arrived in Lhasa, the king and the lamas welcomed him enthusiastically, and their enthusiasm didn’t wane when he announced that he was a lama himself and intended to convert them all to Catholicism. In that case, the king suggested, it would be a good idea for him to study Buddhism. If he really understood Buddhism and he could still convince the Tibetans that Catholicism was better, then of course they would convert.

Desideri accepted the challenge. He spent the next five years in the Buddhist monasteries tucked away in the mountains around Lhasa. The monasteries were among the largest academic institutions in the world at the time. Desideri embarked on their 12-year-long curriculum in theology and philosophy. He composed a series of Christian tracts in Tibetan verse, which he presented to the king. They were beautifully written on the scrolls used by the great Tibetan libraries, with elegant lettering and carved wooden cases.

But his project was rudely interrupted by war. An army from a nearby kingdom invaded, laid waste to Lhasa, murdered the king—and then was itself defeated by a Chinese army. Desideri retreated to an even more remote monastery. He worked on his Christian tracts and mastered the basic texts of Buddhism. He also translated the work of the great Buddhist philosopher Tsongkhapa into Italian.

In his book, Desideri describes Tibetan Buddhism in great and accurate detail, especially in one volume titled “Of the False and Peculiar Religion Observed in Tibet.” He explains emptiness, karma, reincarnation, and meditation, and he talks about the Buddhist denial of the self.

It’s hard to imagine how Desideri kept any sense at all of who he was. He spent all his time reading, writing, and thinking about another religion, in another language. (Thupten Jinpa, the current Dalai Lama’s translator, told me that Desideri’s Tibetan manuscripts are even more perceptive than the Italian ones, and are written in particularly beautiful Tibetan, too.) As I read his book, I could feel him fighting to retain his missionary convictions as he immersed himself in the practices of “the false and peculiar religion” and became deeply attached to its practitioners.

Desideri overcame Himalayan blizzards, mountain torrents, and war. But bureaucratic infighting got him in the end. Rival missionaries, the Capuchins, were struggling bitterly with the Jesuits over evangelical turf, and they claimed Tibet for themselves. Michelangelo Tamburini, the head of the Jesuits, ordered Desideri to return to Europe immediately, until the territory dispute was settled. The letter took two years to reach Tibet, but once it arrived, in 1721, Desideri had no choice. He had to leave.

Michelangelo Tamburini Photo by: Wikimedia

He spent the next 11 years writing and rewriting his book and appealing desperately to the Vatican to let him return to Tibet. It had clearly become the only place where he really felt that he was himself. In 1732 the authorities finally ruled—in favor of the Capuchins. His book would not be published and he could never return. He died four months later.

Almost at the end of Desideri’s book, I came across a sentence that brought me up short. “I passed through La Flèche,” he wrote, “and on September the fourth arrived in the city of Le Mans.”

La Flèche? Where Hume had lived? I let out an astonished cry. The librarians, accustomed to Rare Book Room epiphanies, smiled instead of shushing me.

I headed to a café, wolfed down a sandwich (I was suddenly hungry again), and took stock of this new discovery. Could there be a connection after all?

The English Desideri was abridged. Could I find out more in the Italian book of missionary documents that Petech had described in his article? The seven volumes of the 1952 I Missionari Italiani nel Tibet e nel Nepal, never translated or reprinted, arrived from the storage facility the next day.

I called my brother Blake, an art historian who knows Italian (and French, German, Latin, and Anglo-Saxon), and got him to translate for me. Blake had been my mainstay through my darkest days, and I think he was immeasurably relieved that this time my late-night emergency phone call was about an obscure manuscript instead of a broken heart.

With Blake’s help, I made out a longer version of the passage about France. “On the 31st (August) around noon,” Desideri wrote, “I arrived at our Royal College at La Flèche. There I received the particular attention of the rector, the procurator, Père Tolu and several other of the reverend fathers. On the 4th I left La Flèche.”

So Desideri not only had been to La Flèche but had also talked with the Jesuits at the Royal College at some length. Reading Petech with Blake, I realized that the Jesuits at La Flèche might even have had a copy of Desideri’s manuscript. Petech described the history of Desideri’s manuscript in detail. He explained that Desideri had actually written multiple manuscripts about his travels. He wrote the first while he was sailing from India to France, and evidence suggests that he had this manuscript with him as he made his way from France to Rome in 1727. When he got back to Rome, he revised his text considerably, and six months later he produced a new manuscript. In this version, Desideri writes, “When I returned through France and Italy to Tuscany and Rome, I was strongly urged by many men of letters, by gentlemen and by important personages, to write down in proper order all I had told them at different times.” The reason? The religion of Tibet was “so entirely different from any other,” he wrote, that it “deserves to be known in order to be contested.”

So it was possible that Desideri had sent the Royal College at La Flèche a copy of this revised manuscript; the Jesuits regularly circulated such unpublished reports among themselves.

But Desideri visited in 1727. David Hume arrived at La Flèche eight years later, in 1735. Could anyone there have told Hume about Desideri? I couldn’t find any trace of Père Tolu, the Jesuit who had been especially interested in Desideri.

Maybe Hume’s letters contained a clue? I sat on my narrow sofa bed, listening to the rain fall, and made my way through his voluminous correspondence. To be immersed in Desideri’s world was fascinating but exhausting. To be immersed in Hume’s world was sheer pleasure. Hume writes better than any other great philosopher and, unlike many great philosophers, he is funny, humane, fair, and wise. He charmed the sophisticated Parisian ladies of the grand salons, though he was stout, awkward, and absentminded and spoke French with an execrable Scots accent. They called him “le bon David”—the good David.

Hume always described his time at La Flèche with great fondness. In the one letter of his that survives from his time there, he says he is engaged in constant study. La Flèche’s library was exceptional—reading books was a far better way to learn, he notes, than listening to professors. As for reaping all the advantages of both travel and study, he writes, “there is no place more proper than La Flèche … The People are extremely civil and sociable and besides the good company in the Town, there is a college of a hundred Jesuits.”

A later letter shows that Hume talked with at least one of those Jesuits at some length. He recalls walking in the cloister of the Royal College, his head “full of the topics of my Treatise,” with a Jesuit “of some parts and learning.” The Jesuit was describing a miracle, and this inspired Hume to come up with one of his cleverest skeptical arguments. A real miracle, he said, is by definition highly improbable, which means that deception or delusion is always a more likely—and therefore better—explanation. The Jesuit understood this reasoning (he was “very much gravelled,” Hume wrote) but said that it simply couldn’t be right, because if it were, you would have to reject not just the miracle in question but all the Gospels. “Which observation,” Hume the skeptic noted drily, “I thought it proper to treat as a sufficient answer.”

Who was this Jesuit “of some parts and learning?” Could he have been one of the fathers who had met Desideri eight years earlier? And whoever he was, what else did he and Hume talk about?

When you’re young, you want things: work, love, children. When you reach middle age, you want to want things. When you’re depressed, you no longer want anything. Desire, hope, the future itself—all seem to vanish, as they had for me. But now I at least wanted to know whether Hume could have heard about Desideri. It was a sign that my future might return.

I had thought I would spend that future alone; I was realistic about the prospects of a 50-year-old female professor. But then I had a romantic adventure or two.

They were adventures with both women and men. In my period of crisis I had discovered that I could have deep, sustaining friendships with women, as well as romance. I had been wrong about that part of my identity, too.

I was still fragile. A one-line e-mail from my ex-lover enveloped me in black depression once more. But the adventures were invigorating.

One of them happened in Montreal. I had grown up there, and went back to give a lecture at my old university. One evening I walked up St. Lawrence Boulevard in a swirling snowstorm toward a rendezvous. Suddenly, my 16-year-old self appeared, in a memory as vivid as a hallucination, striding through the snow in her hippie vintage fur coat, saying eagerly, as she often did, “I wonder what will happen next?”

Something was going to happen next, even if it wasn’t the new life I had longed for.

I got back to work. In 2007, I began the Moore Distinguished Visiting Fellowship at the California Institute of Technology, in Pasadena, glad to get away from my dark, cold room and melancholy memories. The school gave me a big sunny apartment looking out at the San Gabriel Mountains. I found myself able to write about children again, and I started my next book, The Philosophical Baby. But I kept working on the Hume project, too.

My philosophical detective story had driven me to find out more about the Royal College at La Flèche. If my atheism made me suspicious of the Buddhists, I was even more suspicious of the Jesuits. After all, at least in the traditional telling, the whole point of the Enlightenment had been to dispel the malign influence of the Catholic Church.

The Berkeley library had only one book about the college at La Flèche: Un Collège de Jésuites aux XVIIe et XVIIIe Siècles, 1,200 pages in four fat volumes with marbled covers, printed in 1889. I had waded through them before I left for Caltech, and had started to get a picture of the place. And then, fortuitously, my neighbor down the hall at Caltech turned out to be the historian of science Mordechai Feingold, one of the world’s leading experts on the 17th- and 18th-century Jesuits and their contributions to science.

For a long time, the conventional wisdom was that the Jesuits were retrograde enforcers of orthodoxy. But Feingold taught me that in the 17th century, the Jesuits were actually on the cutting edge of intellectual and scientific life. They were devoted to Catholic theology, of course, and the Catholic authorities strictly controlled which ideas were permitted and which were forbidden. But the Jesuit fathers at the Royal College knew a great deal about mathematics and science and contemporary philosophy—even heretical philosophy.

Hume had said that Descartes, Nicolas Malebranche, and Pierre Bayle inspired the Treatise. Descartes, I learned, graduated from the Royal College, and Malebranche’s most dedicated students had taught there, although the most-fervent Malebranchistes were eventually dismissed. Books by Descartes, Malebranche, and Bayle were in the college library—although they were on the Index, the Vatican’s list of forbidden books. (Hume’s Treatise would join them later.)

La Flèche was also startlingly global. In the 1700s, alumni and teachers from the Royal College could be found in Paraguay, Martinique, the Dominican Republic, and Canada, and they were ubiquitous in India and China. In fact, the sleepy little town in France was one of the very few places in Europe where there were scholars who knew about both contemporary philosophy and Asian religion.

The Jesuits documented everything, Feingold told me. If I wanted to know who had talked with Hume at La Flèche, I could go to Rome to find out.

Toward the end of my Caltech stay, I gave a talk at one of those TED-like conferences where successful people from different fields gather to inspire the young and impress one another. A large, striking, white-haired man in the audience nodded and laughed in an especially enthusiastic way during my talk. He turned out to be Alvy Ray Smith, a co-founder of Pixar.

Unlike me, Alvy had leapt into new lives many times. He had started out as a Southern Baptist boy in small-town New Mexico, and then had plunged into the wildest reaches of San Francisco’s counterculture. Later, he impulsively abandoned his job as a computer-science professor at NYU and took off again for California, because he felt “something good would happen.” Something did: Xerox PARC, where he helped invent the first color computer graphics, and then Lucasfilm, where he helped invent the first computer-generated movies. He leapt into entrepreneurship and created Pixar—and then left Pixar, to found a new company, which he sold to Microsoft. He retired on the proceeds. Now he lived in Seattle, where he collected art, proved mathematical theorems, and did historical research for fun.

His favorite motto came from Alan Kay, another computer pioneer: “The best way to predict the future is to invent it.” The conference went on for two days, and by the end of it, after a few long conversations but without so much as a kiss, he took another leap and decided that his next life would be with me. If I was a bit slow to realize it, that was okay. He was used to the fact that it took other people a while to catch up to his visions of the future, especially poky academics.

When my time at Caltech was up, I returned to my old beloved Berkeley house; my ex-husband had moved to Boston, and I had bought out his half. Alvy came to visit one weekend, and we began talking on the phone every night. I had decided to follow Feingold’s advice and go to the Jesuit archives in Rome, and I asked Alvy, rather tentatively, whether he would like to come along. It was an unusual venue for a date, but he found the prospect far more romantic than sitting in the sun by the Trevi Fountain. It seemed a good omen.

The archives are not easy to find—they are, appropriately, tucked away behind a corner of St. Peter’s Basilica. Finding the actual records was not so easy either. But on our very last day there, we discovered the entries in the Jesuit catalogs that listed everyone who lived at the Royal College in 1726, 1734, and 1737: some 100 teachers, students, and servants in all. Twelve Jesuit fathers had been at La Flèche when Desideri visited and were still there when Hume arrived. So Hume had lots of opportunities to learn about Desideri.

One name stood out: P. Charles François Dolu, a missionary in the Indies. This had to be the Père Tolu I had been looking for; the “Tolu” in Petech’s book was a transcription error. Dolu not only had been particularly interested in Desideri; he was also there for all of Hume’s stay. And he had spent time in the East. Could he be the missing link?

When I got back to California, I found nothing at all about Dolu in the Berkeley library catalogs. But Google Books had just been born, so I searched for Dolu Jesuit in all the world’s libraries. Alvy kept track of what we found, in an impressively thorough and complex spreadsheet.

We discovered that in the 1730s not one but two Europeans had experienced Buddhism firsthand, and both of them had been at the Royal College. Desideri was the first, and the second was Dolu. He had been part of another fascinating voyage to the East: the French embassy to Buddhist Siam.

In the 1680s, King Narai of Siam became interested in Christianity, and even more interested in European science, especially astronomy. Louis XIV dispatched two embassies to Siam, in 1685 and 1687, including a strong contingent of Jesuit scientists. Dolu was part of the 1687 group.

One of the other ambassadors was another extraordinary 17th-century figure: the abbé de Choisy. The abbé was an open and famous transvestite who gave the ladies of the French court fashion tips. He wrote a very popular and entertaining account of his trip to Siam. Hume had it in his library, along with de Choisy’s scandalous autobiography, The Memoirs of the Abbé de Choisy Who Dressed as a Woman. The abbé’s sexual fluidity was a good example of the adventurous, boundary-crossing spirit of the 17th century, which often leaves the 21st looking staid by comparison.

The Jesuits in the 1687 embassy, including Dolu, stayed in Siam for a year and spent a great deal of time with the talapoins—the European word for the Siamese Buddhist monks. Three of them even lived in the Buddhist monastery and followed its rules.

Like Desideri’s mission, the Siamese embassy ended in bloodshed and chaos. In 1688 the local courtiers and priests revolted against the liberal king and his arrogant foreign advisers. They assassinated King Narai, the new bridge between the two cultures crumbled, and the Jesuits fled for their lives. Several of them died. Dolu and a few others escaped to Pondicherry, in India, where they set up a Jesuit church.

In 1723, after his extraordinarily eventful and exotic career, Dolu retired to peaceful La Flèche for the rest of his long life. He was 80 when Hume arrived, the last surviving member of the embassies, and a relic of the great age of Jesuit science.

I had to piece together a picture of Dolu from contradictory fragments, mostly from his time in India. To Protestant English writers, he was a typical Catholic zealot. On the other hand, Catholic Capuchin writers, Desideri’s adversaries, attacked Dolu and his fellow Jesuits for their sympathy toward Hinduism. Dolu joined two other priests to break down the doors of a Hindu temple and destroy lamps and torches. But with Jean-Venance Bouchet, the head of the Indian mission, he also designed Catholic ceremonies that integrated Hindu traditions, and the Vatican disapproved. In fact, Bouchet became a noted scholar of Hinduism and adopted Hindu dress, ascetic practices, and even vegetarianism.

I also caught glimpses of Dolu the scientist. “There was never a more polite and generous man, nor one more learned about the natural world,” reported a periodical of the time. The Jesuits brought state-of-the-art 12-foot-long telescopes to Siam and then to Pondicherry, and they made important astronomical discoveries. I saw an engraving of King Narai of Siam gazing through one of the telescopes at a lunar eclipse.

Dolu had a sense of humor, too, and wrote satirical squibs and plays. An aristocratic intellectual named Saint-Fonds wrote to a friend that as an amusement, back in France, he had invited Dolu to lunch with Robert Challes, an intensely anti-Jesuit writer—indeed, an atheist—who had also traveled in Siam and India. Saint-Fonds hoped, he said, to enjoy the furious storm of controversy that would surely result. But instead, “I found myself in the midst of the gentlest breezes,” he wrote. “P. Dolu, the name of the missionary, under a wild beard, is a Jesuit per omnes casus, that is to say, polite and politic, and he understands witty repartee better than a man of the world.”

Dolu was an evangelical Catholic, and Hume was a skeptical Protestant, but they had a lot in common—endless curiosity, a love of science and conversation, and, most of all, a sense of humor. Dolu was intelligent, knowledgeable, gregarious, and witty, and certainly “of some parts and learning.” He was just the sort of man Hume would have liked.

And I discovered something else. Hume had said that Pierre Bayle’s Historical and Critical Dictionary was an important influence on the Treatise—particularly the entry on Spinoza. So I looked up that entry in the dictionary, which is a brilliant, encyclopedic, 6 million–word mess of footnotes, footnotes to footnotes, references, and cross-references. One of the footnotes in the Spinoza entry was about “oriental philosophers” who, like Spinoza, denied the existence of God and argued for “emptiness.” And it cross-referenced another entry about the monks of Siam, as described by the Jesuit ambassadors. Hume must have been reading about Buddhism, and Dolu’s journey, in the very building where Dolu lived.

What had I learned?

I’d learned that Hume could indeed have known about Buddhist philosophy. In fact, he had written the Treatise in one of the few places in Europe where that knowledge was available. Dolu himself had had firsthand experience of Siamese Buddhism, and had talked at some length with Desideri, who knew about Tibetan Buddhism. It’s even possible that the Jesuits at the Royal College had a copy of Desideri’s manuscript.

Of course, it’s impossible to know for sure what Hume learned at the Royal College, or whether any of it influenced the Treatise. Philosophers like Descartes, Malebranche, and Bayle had already put Hume on the skeptical path. But simply hearing about the Buddhist argument against the self could have nudged him further in that direction. Buddhist ideas might have percolated in his mind and influenced his thoughts, even if he didn’t track their source. After all, contemporary philosophers have been known to borrow ideas without remembering exactly where they came from.

I published an article about Hume, Buddhism, and the Jesuits, long on footnotes and short on romance, in an academic journal. As I was doing my research, many unfailingly helpful historians told me that my quirky personal project reflected a much broader trend. Historians have begun to think about the Enlightenment in a newly global way. Those creaky wooden ships carried ideas across the boundaries of continents, languages, and religions just as the Internet does now (although they were a lot slower and perhaps even more perilous). As part of this new global intellectual history, new bibliographies and biographies and translations of Desideri have started to appear, and new links between Eastern and Western philosophy keep emerging.

It’s easy to think of the Enlightenment as the exclusive invention of a few iconoclastic European philosophers. But in a broader sense, the spirit of the Enlightenment, the spirit that both Hume and the Buddha articulated, pervades the story I’ve been telling. The drive to convert and conquer the “false and peculiar” in the name of some metaphysical absolute was certainly there, in the West and in the East. It still is. But the characters in this story were even more strongly driven by the simple desire to know, and the simple thirst for experience. They wanted to know what had happened before and what would happen next, what was on the other shore of the ocean, the other side of the mountain, the other face of the religious or philosophical—or even sexual—divide.

This story may help explain Hume’s ideas. It unquestionably exemplifies them. All of the characters started out with clear, and clashing, identities—the passionate Italian missionary and the urbane French priest, the Tibetan king and lamas, the Siamese king and monks, the skeptical young Scot.

But I learned that they were all much more complicated, unpredictable, and fluid than they appeared at first, even to themselves. Both Hume and the Buddha would have nodded sagely at that thought. Although Dolu and Desideri went to Siam and Tibet to bring the wisdom of Europe to the Buddhists, they also brought back the wisdom of the Buddhists to Europe. Siam and Tibet changed them more than they changed Siam and Tibet. And his two years at La Flèche undoubtedly changed David Hume.

Hume and the Jesuits and Siam and Tibet changed me as well. I’d always thought Hume was right about the self. But now, for the first time, I felt that he was right.

In 2010, Alvy and I got married—the future reinvented. Once again, I was an exceptionally fortunate and happy woman, full of irrational exuberance and everyday joy. But that’s not all I was. I’d discovered that I could love women as well as men, history as well as science, and that I could make my way through sadness and solitude, not just happiness. Like Dolu and Desideri, the gender-bending abbé and the Siamese astronomer-king, and, most of all, like Hume himself, I had found my salvation in the sheer endless curiosity of the human mind—and the sheer endless variety of human experience.

This post originally appeared on The Atlantic. This article is republished here with permission.

Source: https://getpocket.com/explore/item/how-an-18th-century-philosopher-helped-solve-my-midlife-crisis

Beurre Salé

A container of Societe France caramels au beurre sale

The savory treat from Brittany

For the health-conscious, salt and butter are very high on the list of dietary no-no’s, although in recent years butter’s reputation has slightly improved (while margarine has become less well-thought of). And as Mark Kurlansky detailed in his fascinating book Salt: A World History, salt has played an important role in human society and is even necessary (in a certain amount) to the healthy functioning of our bodies.

But just because we crave something doesn’t mean it’s healthy to have it in copious quantities, no matter how tempting it seems. Years ago, I ran across a blog post by professional chef and author David Lebovitz that made me aware of the tastiest combination of this “evil” duo: creamy butter laced and studded with large crystals of salt. This tempting concoction was beurre salé (literally, “salted butter”), a regional specialty from the Brittany region of France, and the sight of it made me want to eat copious quantities of it, health concerns notwithstanding.

Worth Its Salt

So what makes this salted butter different from the kind you can buy at the local supermarket? For one thing, it’s made with Brittany sea salt, some of the finest produced anywhere. Brittany is located in the northwest corner of France (south of Normandy) and its lengthy ocean coastline is a perfect place for cultivating salt. Its most famous type of salt, fleur de sel, comes from the town of Guérande (which was historically part of Brittany, but is now part of the Pays de Loire region), and is world-renowned for its texture and flavor.

Having such ready access to salt, Breton cuisine developed to take advantage of this situation. Whereas in most other regions of France there are dozens, if not hundreds, of types of cheese specific to that region, there is not even a word for cheese in the Breton language. There are a few cheeses to be found in the region, but less-processed dairy products (butter and cream) are much more prevalent in the Breton cuisine. The reason is that before the advent of refrigeration, making milk into cheese was more effective against spoilage than making butter—that is, unless you had plenty of salt.

Sel Preservation

Salt has historically been used as a preservative; that is a large part of why it has been so coveted throughout human history. In the case of butter, this was especially so, since butter has a tendency to quickly go rancid when it is exposed to air. Refrigeration has taken care of this problem for modern butter-eaters (and the invention of a water-sealed butter dish helped too), but it was a serious problem for our ancestors. According to Margaret Visser’s delightful book Much Depends on Dinner (which includes individual chapters on butter and salt), butter that has been oxidized (exposed to the air) can cause “diarrhoea, poor growth, loss of hair, skin lesions, anorexia, emaciation and intestinal haemorrhages.”

Mixing butter with salt, or storing it in brine, was a way to prevent butter from going rancid, and was commonly done before the days of refrigeration. Indeed, a record from 1305 CE noted that one pound of salt was added to every ten pounds of butter or cheese. To remove some of the salt, people had to rinse the butter by kneading water into it, and then squeezing it out again along with some of the salt.

Butter Batters

No longer a necessity, beurre salé is today a gourmet treat; it is used in many traditional Breton dishes, and is coveted for its delicious effect on everything from fine chocolates to buttery cakes. It may seem counterintuitive, but salt can be as important as sugar in many dessert recipes, and lends an interesting counterpoint to the sweetness.

Traditional Breton desserts made using beurre salé include: gâteaux Breton, a type of poundcake made with flour, butter, sugar, and eggs; palets Bretons, small buttery cakes; and caramel au beurre salé, which can refer to individual candies (salted caramels) or the process of caramelizing sugar and salted butter while baking a dessert, such as Kouign Amann. Amann is the Breton word for butter, and this cake is made with plenty of it, along with yeast, sugar, flour, and water.

Salty Language

Since the time I wrote the first version of this article in 2006, salted caramel (inspired by caramel au beurre salé) has become much more popular in North America; it seems everywhere you look these days the salted caramel flavor is popping up, from popcorn and hot chocolate, to cookies and coffee drinks. And since this article was first written, I have personally tried beurre salé in its birthplace, on several trips to Brittany, and have loved every bite, whether slathered on a baguette or baked in a Kouign Amann. And while living in Paris in the late 2000s, I also had the pleasure of meeting and befriending David Lebovitz and Margaret Visser, both originally cited in this article. It was an unexpected delight, much like finding crystals of briny sea salt in the midst of delicious and creamy butter.

Note: This is an updated version of an article that originally appeared on Interesting Thing of the Day on July 31, 2006.

Image credit: Photozou.jp [CC BY]

Go to Source
Author: Morgen Jahnke

Library Shelfie Day

A man looking at a library shelf

It’s one thing to like libraries, or even to say you like libraries. Today’s observation demands proof: pix or it didn’t happen. Starting in 2014, the New York Public Library declared the fourth Wednesday in January to be Library Shelfie Day. So let’s break this down: a shelfie is like a selfie, except it’s in front of a shelf. A library shelfie is a shelfie taken in a library. So grab your smartphone and head on over to the nearest library today to participate. While you’re at it, pick up a few good books!

Image credit: Pixabay

Go to Source
Author: Joe Kissell

How often do paternity tests show infidelity?

While some families begin with parents getting married and planning to have children, some occur unexpectedly between unmarried couples. In some cases, it may not be clear who the father is. This could be at question even when parents are married. When paternity is at issue, parents can take certain steps to not only get an answer but also options when the results are in.

How often do paternity tests show infidelity? It is been told that roughly 10 percent of all assumed biological children are actually the result of infidelity. Although this statement has survived decades, the fact of the matter is that this assertion is actually a myth. In fact, many of the men questioning paternity are not the ones who believe infidelity took place. It is often the man’s new partner suggesting the testing to help them avoid child support obligations.

Current data suggests that 3 out of every four men questioning paternity are the biological father. Despite these figures, men are often convinced that their child may not be theirs. The reason for this is the prevalence of non-paternity over the decades and even centuries. Although men may still stress their concerns that a child may not be theirs, the reality is that more times than not, a DNA test will prove that the child is theirs.

Whether you are seeking to establish paternity to collect child support, initiate a relationship with a child or to prove that your are not the father, it is important to understand how the process works and how it can benefit you. It can be a complex and emotional process, making it essential to take steps to protect your rights.

Go to Source
Author: On behalf of Katie L. Lewis of Katie L. Lewis, P.C. Family Law

Family Mediation Day 2: What about the children?

Family breakdown is never easy and often it is extremely stressful and painful for everyone involved, parents and children. Everyone needs help and guidance, from friends, counsellors, therapists and lawyers.

Mediation can help enormously, providing a real viable alternative to court proceedings which can often exasperate the inevitable consequences of family breakdown: fear, anger, betrayal, worry and anxiety about the future but most of all anxiety about how the children will cope.

Court proceedings and endless correspondence between solicitors can do nothing to help with those very common and very understandable emotions. Mediation can.

Mediation is ideally and uniquely equipped to be able to help parents focus on the needs of their children and to involve the children.

Specially trained Mediators can see the children in confidence and speak to them about how they feel, what they would like their parents to do and how they see the future.  Those views can then be fed back to the parents if the children agree.

In this way, the parents can make informed decisions about the future knowing and taking into account what their children have said.

This is in addition to all the other benefits of family mediation:

  • It is quicker
  • It is cheaper

As part of Family Mediation Week, and the initiative of the Family Mediators Association (FMA), there is a wealth of very helpful material available including:

Meet our mediators

Here at Stowe Family Law we strongly support the use of mediation when managing a relationship breakdown, and are pleased to have the following mediators in our team:

National Family Mediation Week 21- 25th January 2019, Click here to find out everything you need to know about Family Mediation and how it can help.

Graham Coy

22 January 2019

The post Family Mediation Day 2: What about the children? appeared first on Stowe Family Law.

Go to Source
Author: Graham Coy

Stowe tips: What is a special guardianship order?

Hannah Ross, Solicitor from the Stowe office in Leeds joins us on the blog today to look at special guardianship orders? What are they? Why would you need one? And, how do you get one?

Special guardianship orders were introduced in 2005 and are governed by the Children Act 1989. They are often described as a mix of a child arrangement order and an order for adoption.

Why should I choose a special guardianship order?

A special guardianship order application is suitable in circumstances whereby the child has been living with you for a period of time or they have been placed into your care by way of care proceedings.

The order remains in place until the child has reached the age of 18 and although you share parental responsibility with the parents, you are able to make almost all decisions about the child without the parent’s approval.

If the child was already subject to local authority involvement prior to the application for a special guardianship order being made then you may be entitled to additional support from them, this can include a special guardian allowance.

A child arrangements order is very similar, however parental responsibility is shared with the parents and therefore decisions regarding the child will require their agreement. In addition to this, there would be no additional support provided to you by the local authority.

How do I start the process?

Before taking steps towards making an application to Court for a special guardianship order the Local Authority must be given three months’ notice of the intention to apply.

This gives the Local Authority the time to undertake a thorough and detailed assessment of the applicants which goes into detail about the housing arrangements, financial circumstances and the ability to care for the child. If the special guardianship assessment is negative, then the prospects of successfully obtaining a special guardianship order are significantly reduced.

If successful, a special guardianship order application is made to the local Family Court, this can be done within existing proceedings or as its own standalone application. There is often a requirement for the court to grant permission for the application to be made

Who can apply for a special guardianship order?

The law sets out clearly who is entitled to apply for a special guardianship order and they are as follows:

  • Any guardian of the child
  • Any individual who is named in a child arrangement order as a person who the child is to live with
  • A local authority foster parent with whom the child has lived for a period of at least one year immediately preceding the application
  • A relative with whom the child has lived for a period of at least one year immediately preceding the application

What will the court consider?

The court, as always will take into consideration what is in the best interests of the child using a welfare checklist which is prevalent in the decision-making process and considers the following:

  • The ascertainable wishes and feelings of the child concerned
  • The child’s physical, emotional and educational needs
  • The likely effect on the child if circumstances changed as a result of the court’s decision
  • The child’s age, sex, background and any other characteristics which will be relevant to the court’s decision
  • Any harm the child has suffered or maybe at risk of suffering
  • The capability of the child’s parents (or any other person the courts find relevant) at meeting the child’s needs
  • The powers available to the court in the given proceedings

A special guardianship order is a useful tool in ensuring that a child is given a permanent and secure home without losing the crucial link to their birth parents.

The law around special guardianship orders, however, can be complex and difficult to navigate and legal advice is strongly advised.

The post Stowe tips: What is a special guardianship order? appeared first on Stowe Family Law.

Go to Source
Author: Hannah Ross

The limits of the court’s power

I’ve quite often written here about the consequences of failing to comply with the wishes of the court. I’ve also quite often written about how judges get things right, unlike so many parties to family proceedings. However, judges do not always get things right (in my defence, I have never suggested that they do), and a recent case is a prime example of this.

Whilst it may not be a family law case, Hughes Jarvis Ltd v Searle & Another is I think certainly of interest to anyone involved in family court proceedings. It concerns the common situation in which the court adjourns a case before a witness has completed giving their evidence. In such a situation the witness is often given a warning by the judge not to discuss their evidence with anyone else during the adjournment. The reason for this warning was explained by Lord Justice Patten, who gave the leading judgment in Hughes Jarvis:

“The purpose of the warning is to protect the witness from any attempt by a third party to influence their evidence and also to ensure that, so far as possible, the evidence which the witness gives is his or her own best recollection unassisted by any other person. Compliance with the warning both protects the witness and the effectiveness of the trial process.”

Obviously, this can apply equally to a witness giving evidence in a family case.

So what went wrong in the Hughes Jarvis case?

The witness, Mr Jarvis, was giving his evidence on the first day of the hearing, when the case was adjourned for the day. The judge gave him the warning, but it came to light the next day that Mr Jarvis had sent a number of emails to his solicitors and his counsel. His counsel told the court that she had not read the emails and had simply replied by email saying that he must not communicate with her whilst under cross-examination. However, it later transpired that he had also spoken overnight to a third party, as a result of which he changed his evidence.

The judge responded by stopping the hearing. She remanded Mr Jarvis in custody overnight and the next morning committed him to prison for 14 days (suspended for three months) for contempt. The case (which was a claim by Mr Jarvis’s company) was struck out. Mr Jarvis appealed, to the Court of Appeal.

The Court of Appeal allowed the appeal.

Lord Justice Patten said that when a witness failed to comply with such a warning from a judge, it was necessary for the judge to make an assessment of the damage which that had caused. Here, the emails had not been responded to, and there was therefore no damage caused by them, as the judge recognised. As to the contact with the third party, the change of evidence did not mean that the evidence was untrue, or that none of Mr Jarvis’s evidence could be relied upon. If anything it had helped the defendant (the other party).

As to the committal, Lord Justice Patten said that the judge had no jurisdiction to deal with the alleged contempt, except as a breach of an order of the County Court. Here, no such order had been made.

And as to the striking out of the claim, Lord Justice Patten found that this was an unjustified overreaction. He said that the situation faced by the judge, whilst undesirable, was in fact manageable had the judge allowed herself and the parties time to investigate the facts and to make a more informed assessment of the damage which the conversation with the third party had caused.

Giving a judgment concurring with Lord Justice Patten, Lord Justice Leggatt said that the judge’s response to what Mr Jarvis had done “could well serve as a case study in how not to deal with such a situation”, and described the judge’s action in remanding Mr Jarvis in custody overnight as “a misuse of judicial power”.

The committal order was set aside and the claim was reinstated, to be heard by a different judge.

You can read the full Court of Appeal judgment here.

The post The limits of the court’s power appeared first on Stowe Family Law.

Go to Source
Author: John Bolch


Bottles of Fernet-Branca

Italy’s mystery liqueur

While some companies are completely transparent about the ingredients in their products, hoping to snag customers looking for the healthiest option, in some cases the secret of a product’s makeup is not only closely guarded, but promoted as a key part of its allure. Mysteries can be a great advertising gimmick.

The proprietors of Antoine’s restaurant in New Orleans were clearly operating from this idea when they created their famous recipe for Oysters Rockefeller; although it has been widely speculated upon, this recipe has remained a secret since it was first developed in 1899. Having sampled Oysters Rockefeller at Antoine’s, I would say that I greatly enjoyed their taste, but I got more enjoyment out of trying to guess the elements of the recipe.

This same type of marketing is at work in the promotion of Dr Pepper soda. The only information given by the manufacturer is that it contains 23 flavors; it’s up to customers to draw their own conclusions about what those flavors are. Ditto for Coca Cola’s secret recipe and the “11 herbs and spices” in Kentucky Fried Chicken. In a similar vein, the makers of one of Italy’s best-known liqueurs, Fernet-Branca, prefer to keep the composition of their product top secret, but rumors about what it may contain are certainly tantalizing.

Saffron So Good

Fernet-Branca is a type of bitters, a spirit made from different herbs, plants, and roots that supposedly aids digestion and stimulates the appetite. Other types of bitters include Campari, Angostura bitters, and orange bitters. While the complete list of 40 herbs and spices that go into Fernet-Branca has never been made public, some of its ingredients are common knowledge, and include myrrh, chamomile, cardamom, aloe, and saffron, as well as its base component of grape alcohol.

Saffron in particular seems to be an important ingredient; this rare spice, harvested from the saffron crocus flower, is the world’s most expensive spice by weight. According to an article about Fernet-Branca that appeared in a San Francisco newspaper, the company that produces Fernet-Branca, Fratelli Branca, is the largest consumer of saffron in the world, claiming 75% of worldwide output.

As far as the other ingredients are concerned, there is wide speculation about what these may be. A few of the rumored mystery elements include: rhubarb, cinchona bark from South America (known for its anti-malarial properties), gentian root (a powerful medicinal herb), wormwood (used in absinthe), bay leaves, sage, peppermint oil, and the ginger-like spices galanga and zedoary.

Medicinal Compound

With all these medicinal ingredients, it is not surprising that Fernet-Branca was first developed as a health elixir. The creator of the formula, Bernardino Branca, was a self-taught apothecary in Milan, who first offered Fernet-Branca to the public in 1845. Marketing his product as a tonic to cure many kinds of illness, Branca even persuaded the director of a local hospital of its curative benefits.

Even today, Fernet-Branca is known for its ability to calm upset stomachs and soothe hangover misery. If earlier marketing pitches for the spirit are to be believed, it can also cure cholera and ease menstrual cramp pain. The health-enhancing nature of Fernet-Branca proved handy during Prohibition in the United States. Since it was considered a medicinal product, pharmacies could import and sell Fernet-Branca without interference from the government.

Where Everybody Knows Its Name

Although Fernet-Branca is made by an Italian company, Italy is not the largest consumer of this liqueur. In fact, there are two other places in the world known for their prodigious consumption of the bitter quaff. These two places are San Francisco, California, and the country of Argentina.

San Francisco is the biggest consumer of Fernet-Branca in the United States, and has the highest per capita consumption of it in the world. Its popularity in the city may be partially attributed to San Francisco’s large Italian-American community, centered around the commercial district of North Beach. Whatever the reason, San Franciscans drink Fernet-Branca in large quantities, usually followed by a chaser of ginger ale.

Argentina also has a large Italian population and a similar thirst for Fernet-Branca. There is even a popular song that celebrates the joys of “Fernet Con Coca,” or Fernet mixed with cola, the usual way it is prepared in Argentina. In fact, the only other distillery of Fernet-Branca located outside Milan is in Argentina.

Above and beyond its regional popularity, Fernet-Branca has made a mark on pop culture as well. When mention of Fernet-Branca comes up, fans of Christopher Nolan’s film The Dark Knight Rises will no doubt be put in mind of Alfred’s memorable references to the drink in the film. On the literary side, James Hamilton-Paterson’s novel Cooking with Fernet Branca, a humorous look at life in Tuscany, was long- listed for the prestigious Booker Prize.

A Matter of Taste

After living in San Francisco for quite some time and feeling ashamed that I had never enjoyed this quintessential San Francisco experience, years ago I tried my first shot of Fernet-Branca. Unsure of what to expect, and slightly put off by the strong pine scent I registered, I closed my eyes and gulped it down.

The intense menthol-like sensation caused me to cough, and I didn’t enjoy the bitter aftertaste the drink created, but soon after finishing it, I began to feel a bit better. I can’t say whether or not I gained any health benefits from drinking the Fernet-Branca, but the next time I experience an upset stomach I will have to try another shot of it, for purely medicinal purposes of course.

Note: This is an updated version of an article that originally appeared on Interesting Thing of the Day on October 16, 2006.

Image credit: Jesús Dehesa [CC BY-ND 2.0], via Flickr

Go to Source
Author: Morgen Jahnke