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Big Think Interview With Lindsey Graham
Lindsey Graham is a Republican U.S. Senator from South Carolina. A lawyer with a degree from the University of South Carolina in Columbia, Graham served as an active-duty Air Force lawyer for over six years. In 1994, Graham was elected to the United States House of Representatives from South Carolina's 3rd congressional district. In 2002, upon Senator Strom Thurmond's retirement, Graham was elected to the U.S. Senate.
Since 1995, Graham has continued to serve his country in the U.S. Air Force Reserves and is one of only two U.S. Senators currently serving in the Guard or Reserves. He is a colonel and is assigned as a Senior Instructor at the Air Force JAG School.
Graham serves on six committees in the Senate: Aging, Armed Services, Homeland Security and Governmental Affairs, Judiciary, Budget, and Veterans Affairs.
Question: Do you believe that government is “broken?"
Lindsey Graham: You know, democracy is difficult to begin with and the fact that you can’t find quick solutions to hard problems is not necessarily a bad thing. What would be a bad thing is if the institutions failed to the point they cannot find any solution to a problem over time. Politics is like term papers. You usually get serious right before the term paper is due. That’s the downside of democracy: without friction, there is really no consensus.
Question: How would you describe your political ideology?
Lindsey Graham: I’m a conservative, but I think I’m a practical guy. Ronald Reagan was one of the great conservatives of modern times and he pursued strong national defense, he was a big believer in lower taxes... but he’s able to find a solution to social security insolvency by working with Tip O’Neill. So the Reagan model of conservatism that can move the country forward is probably where I’m at.
I like the idea that Ronald Reagan stood up to the Soviet Union without flinching, that he pursued a very business-friendly agenda in the Congress, but at the same time, he could sit down with his colleagues on the other side and, in a friendly way, move the ball forward on big issues like social security. So I wish this Congress coming in to being next January would look at what Ronald Reagan and Tip O’Neill did on social security is a way to maybe find a breakthrough on that topic.
Question: How would you solve the problems facing our nation?
Lindsey Graham: Three things I would do if I were king, one, I’d be benevolent, but firm, and I don’t expect to be king. But I would like the country to look at entitlement reform in a serious way. Now, what do I mean by that? When I look at America, I don’t see an under-taxed nation, I see a nation struggling to create jobs in a global economy that’s changed forever and we’re over-promising as a nation. We made promises to future generations we can’t keep.
So what would I do if I could? I would sit Republicans and Democrats down and fix social security, because that is eminently doable. I would change the age of retirement. We’re living longer, that’s the good news. The bad new is these entitlement programs haven’t had the age adjusted. So I would move the age somewhere in the 69 range, slowly over time, for people under 55. I would not affect people on social security or near retirement.
I would also ask people of my income level to take less in benefits, because the promises we’ve made to future generations of Americans are unsustainable. We’ve got 3 workers for every social security retiree today; in 20 years we’ll have 2. When I was born in ’55, we had 16 for every retiree. So we’re having less people and more retirees living longer. So I would adjust the age and I would recalculate benefits for people in my income level.
The second thing I would do for the country is I would create a legal infrastructure that would allow our country to be at war, but within our values. The CIA no longer interrogates terror suspects. I’m not for waterboarding, but I’m also not for taking the CIA out of the interrogation business. The Army Field Manual is the only document we have now to interrogate enemy combatants, people suspected of terrorism. Somewhere between the Army Field Manual, which is published online, and water boarding, which I think is a bad way to interrogate people, we should find a middle ground, allow the CIA to do enhanced interrogations within our values, but not tell the enemy what’s coming their way.
I would make sure that Khalid Sheikh Mohammed, the mastermind of 9/11 is tried in military commissions. He’s been held under the law of war for six or seven years, I think it’s a mistake to put him in civilian court. We’re at war, we’re fighting a war, not a crime.
Which leads me to energy policy. We use more Mideast oil today, we’re dependent on Mideast oil today, than we were before 9/11. That’s a national security nightmare. So what I’d like to do, is the third thing, is to become energy independent, create jobs in low carbon technologies, like wind, solar, and nuclear, and the third thing is clean up the air. If my generation of political leaders could break our dependency on foreign oil, create a low-carbon economy that would allow America to develop technology and create new jobs for future generations, and pass on to the future generations cleaner air, that would be a pretty good use of my time.
Question: Why are many environmentalists loath to accept nuclear energy?
Lindsey Graham: Well, I think there’s a mindset from the Chernobyl accident that, you know, nuclear power is verboten. Quite frankly, 80% of the power in France comes from the nuclear industry, surely we can be as bold as the French. There’s a waste disposal problem; the French have a reprocessing system. Secretary Chu, whom I admire greatly in this administration, believes that in the next 10 or 15 years new technology will develop better than reprocessing. So what I’m willing, work with administration to provide a jump start of building nuclear power plants, loan guarantees that will back these plants up, reform the regulatory process, like they do in France, so that we can, you know, really get on with developing power.
I understand environmental concerns, but every technology has some downside. I think nuclear power has proven over time to be a safe, reliable form of power. And the good news: it doesn’t emit CO2. The other good news is, it creates a lot of high tech jobs that we need.
And a lot of environmentalists are changing their position. The environmental community, I’ve tried to work on a comprehensive energy bill with Senator Lieberman and Kerry, was pretty practical, quite frankly.
Question: How should we reform immigration policy?
Lindsey Graham: In 2007, we tried comprehensive immigration reform. I, along with Senator Kennedy, McCain, Kyl, Senator Menendez and others, put together a comprehensive bill that focused on border security, a temporary worker program so our employers could access labor from overseas in a win/win fashion. We had an employer verification system, making it harder to hire illegal immigrants and we did what I thought a rational thing with the 12 million illegal immigrants. We'd allow them to raise their hands, to identify themselves, and if they’d committed no crime other than breaking our immigration laws, they were given a legal status, and they could earn their way to citizenship only after getting behind those who are doing it right. So to come out of the shadows, you would be a biometrically identified, you would be required to learn our language, pay a fine for the crime you committed, get in the back of the line to become a citizen, and it would take from 8 to 13 years in that process to get to citizenship, if that was your goal.
So, I think that is a workable solution that needs to be refined. What’s happened from 2007 to now is the border is less secure and the violence in Mexico is getting out of control. So you have to look at 2010, 2011 immigration politics through the Arizona eyes. The people in Arizona feel under siege, they passed a statute that’s controversial, but other states are taking up similar statutes. So the tide is turned to where the American people are focusing on securing our borders, which I think is a good thing. But I think most Americans 2 to 1, still believe that you have to rational and logical when it comes to the 12 million.
On our southern border, life is not so good. If I lived in a southern hemisphere nation that had no hopes, I’d be enticed to come to America. And quite frankly, we’re going to need immigrants. We’re a declining population, as I said before. Japan has been very xenophobic; they don’t have a workforce. We’re going to need immigrants as far as the eye can see, I just want them to become legal and do it in a win/win way.
Question: Why should we revisit the 14th Amendment?
Lindsey Graham: In 1866, they never envisioned the world in which we live in today, where we have a flood of illegal immigrants coming, mainly from our southern border.
The 14th Amendment has been interpreted three times by our Supreme Court to say that if you were born in the United States, even if you were here in illegal status or your parents were here in illegal status, you’re automatically entitled to citizenship. There are a lot of people who come to this country for the very purpose of having a child. Some break our law by coming across the border in our border states, to go to American hospitals to have a child, so that child will become a citizen, having an anchor to the country. There are other people, rich people mainly, from the Mideast and Asia, who come to America on tourist visas for the purpose of having a child in an American resort with a hospital to gain citizenship. I think those two ways of conferring citizenship really undermine the value of citizenship.
So I think that’s not an unreasonable request in a prospective fashion, to change the 14th amendment by allowing the Congress to set rules on citizenship.
And what I would say is if you’re a student studying here and you have a child, they’re automatically a citizen. If you’re a temporary worker and you have a child, you’re automatically a citizen. In other words, if you’re adding value to our country, if you have a good connection with America, then your child will be conferred citizenship. You would not be given citizenship under my proposal if you’re just visiting the country as a tourist, and you would not be given citizenship if you broke our law and had a child here in illegal status. To me, that makes sense. And I think that’s a logical way to move forward.
The American people are looking for solutions to prevent the third wave of illegal immigration. Ronald Reagan gave amnesty to 3 million, now we have 12. What I have to do to sell this in South Carolina is to prove to the people in my state we’re not going to have a third wave of illegal immigration 20 years from now. That’s why we need to look at the 14th amendment.
Question: Are you open to reconsidering other parts of the Constitution?
Lindsey Graham: I’m always open to making sure the Constitution makes sense in the time we live. I’d like to add the balanced budget amendment to the Constitution. I’m convinced that Republicans and Democrats are not going to do the hard things to balance our budget, saying no to different groups unless a Constitutional requirement to balance the budget, like most states have. So yes, I think the constitution is a sacred document in many ways, but it’s a governing document.
Recorded December 1, 2010
Interviewed by Alicia Menendez
A conversation with the U.S. Senator.
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A report from the New York Times raises questions over how the teletherapy startup Talkspace handles user data.
- In the report, several former employees said that "individual users' anonymized conversations were routinely reviewed and mined for insights."
- Talkspace denied using user data for marketing purposes, though it acknowledged that it looks at client transcripts to improve its services.
- It's still unclear whether teletherapy is as effective as traditional therapy.
Talkspace.com<p>Former employees also questioned the legitimacy of certain interventions by the company into client-therapist interactions. For example, after one therapist sent a client a link to an online anxiety worksheet, a company representative instructed her to try to keep clients inside the app.</p><p style="margin-left: 20px;">"I was like, 'How do you know I did that?'" Karissa Brennan, a therapist who worked with Talkspace from 2015 to 2017, told the Times. "They said it was private, but it wasn't."</p><p>Other former employees said the company would pay special attention to its "enterprise partner" clients, who worked at companies like Google. One therapist said Talkspace contacted her for taking too long to respond to Google clients.</p><p>Talkspace responded to the Times with a Medium <a href="https://medium.com/@founders_22883/talkspace-founders-respond-to-a-new-york-times-article-78d6f5c45c59" target="_blank">post</a>, which claimed the Times report contained false and "uninformed assertions."</p><p style="margin-left: 20px;">"Talkspace is a HIPAA/HITECH and SOC2 approved platform, audited annually by external vendors, and has deployed additional technologies to keep its data safe, exceeding all existing regulatory requirements," the post states.</p>
HIPAA concerns<p>However, if the claims in the Times report are true, Talkspace may have violated the <a href="https://www.hhs.gov/sites/default/files//hipaa-privacy-rule-and-sharing-info-related-to-mental-health.pdf" target="_blank">Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule</a>, which prohibits providers from disclosing patients' medical data for marketing purposes, unless the patient gives <a href="https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html" target="_blank">authorization</a>.</p><p style="margin-left: 20px;">"If it is true that Talkspace used information from private therapy sessions for marketing purposes, that is a clear violation of trust with their customers," Hayley Tsukayama, Legislative Activist from the Electronic Frontier Foundation, told <a href="https://www.salon.com/2020/08/10/therapy-app-talkspace-allegedly-data-mined-patients-conversations-with-therapists/" target="_blank">Salon</a>. "All companies should be very clear with their customers about how they use personal information, make sure that they don't use information in ways that consumers don't expect, and give them the opportunity to withdraw consent for those purposes on an ongoing basis. Talkspace trades on its trustworthiness and mentions privacy frequently in its ad campaigns. Its actions should be in line with its promises."</p><p>(It's also worth noting that Talkspace recently threatened legal action against a security researcher who wrote a blog post outlining the potential discovery of a bug that allowed him to get a year's subscription for free. A report from <a href="https://techcrunch.com/2020/03/09/talkspace-cease-desist/" target="_blank" rel="dofollow">TechCrunch</a> notes that Talkspace rejected the findings, and that the company does not offer a way for researchers to submit potential security bugs.) </p><p>Beyond privacy concerns, the report also raises questions about the efficacy of teletherapy, especially within a corporate model.</p><p style="margin-left: 20px;">"The app-ification of mental health care has real problems," Hannah Zeavin, a lecturer at the University of California and author of an upcoming book on teletherapy, told the <a href="https://www.nytimes.com/2020/08/07/technology/talkspace.html" target="_blank" rel="noopener noreferrer dofollow">Times</a>. "These are corporate platforms first. And they offer therapy second."</p><p>The main problem with judging the efficacy of teletherapy is the lack of solid research — it's too new to comprehensively compare it with in-person therapy. Still, some <a href="https://www.theraplatform.com/blog/284/is-telemental-health-effective-how-does-it-measure-up" target="_blank" rel="noopener noreferrer dofollow">studies</a> suggest it could be useful for at-risk populations, or for people in the wake of a disaster.</p>
'It's just not therapy'<p>But others remain skeptical.</p><p style="margin-left: 20px;">"Maybe [teletherapy] products and services are helpful to certain people," <a href="https://www.nytimes.com/2020/08/07/technology/talkspace.html" target="_blank">said</a> Linda Michaels, a founder of the Psychotherapy Action Network, a therapists advocacy group. "But it's just not therapy."</p><p>Proper therapy or not, it's worth considering how platforms like Talkspace use — and possibly even depend on — user data. In a 2019 <a href="https://www.nytimes.com/2019/10/02/opinion/health-care-data-privacy.html" target="_blank" rel="dofollow">opinion piece published in the Times</a>, Talkspace co-founder Oren Frank wrote:</p><p style="margin-left: 20px;">"The vast amount of information each of us possesses is far too important to be left under the control of just a few entities — private or public. We can think of our health care data as a contribution to the public good and equalize its availability to scientists and researchers across disciplines, like open source code. From there, imagine better predictive models that will in turn allow better and earlier diagnoses, and eventually better treatments.</p><p style="margin-left: 20px;">Your health care data could help people who are, at least in some medical aspects, very similar to you. It might even save their lives. The right thing to do with your data is not to guard it, but to share it."</p><p>Would you?</p>
A new Harvard study finds that the language you use affects patient outcome.
- A study at Harvard's McLean Hospital claims that using the language of chemical imbalances worsens patient outcomes.
- Though psychiatry has largely abandoned DSM categories, professor Joseph E Davis writes that the field continues to strive for a "brain-based diagnostic system."
- Chemical explanations of mental health appear to benefit pharmaceutical companies far more than patients.
Challenging the Chemical Imbalance Theory of Mental Disorders: Robert Whitaker, Journalist<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="41699c8c2cb2aee9271a36646e0bee7d"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/-8BDC7i8Yyw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>This is a far cry from Howard Rusk's 1947 NY Times editorial calling for mental healt</p><p>h disorders to be treated similarly to physical disease (such as diabetes and cancer). This mindset—not attributable to Rusk alone; he was merely relaying the psychiatric currency of the time—has dominated the field for decades: mental anguish is a genetic and/or chemical-deficiency disorder that must be treated pharmacologically.</p><p>Even as psychiatry untethered from DSM categories, the field still used chemistry to validate its existence. Psychotherapy, arguably the most efficient means for managing much of our anxiety and depression, is time- and labor-intensive. Counseling requires an empathetic and wizened ear to guide the patient to do the work. Ingesting a pill to do that work for you is more seductive, and easier. As Davis writes, even though the industry abandoned the DSM, it continues to strive for a "brain-based diagnostic system." </p><p>That language has infiltrated public consciousness. The team at McLean surveyed 279 patients seeking acute treatment for depression. As they note, the causes of psychological distress have constantly shifted over the millennia: humoral imbalance in the ancient world; spiritual possession in medieval times; early childhood experiences around the time of Freud; maladaptive thought patterns dominant in the latter half of last century. While the team found that psychosocial explanations remain popular, biogenetic explanations (such as the chemical imbalance theory) are becoming more prominent. </p><p>Interestingly, the 80 people Davis interviewed for his book predominantly relied on biogenetic explanations. Instead of doctors diagnosing patients, as you might expect, they increasingly serve to confirm what patients come in suspecting. Patients arrive at medical offices confident in their self-diagnoses. They believe a pill is the best course of treatment, largely because they saw an advertisement or listened to a friend. Doctors too often oblige without further curiosity as to the reasons for their distress. </p>
Image: Illustration Forest / Shutterstock<p>While medicalizing mental health softens the stigma of depression—if a disorder is inheritable, it was never really your fault—it also disempowers the patient. The team at McLean writes,</p><p style="margin-left: 20px;">"More recent studies indicate that participants who are told that their depression is caused by a chemical imbalance or genetic abnormality expect to have depression for a longer period, report more depressive symptoms, and feel they have less control over their negative emotions."</p><p>Davis points out the language used by direct-to-consumer advertising prevalent in America. Doctors, media, and advertising agencies converge around common messages, such as everyday blues is a "real medical condition," everyone is susceptible to clinical depression, and drugs correct underlying somatic conditions that you never consciously control. He continues,</p><p style="margin-left: 20px;">"Your inner life and evaluative stance are of marginal, if any, relevance; counseling or psychotherapy aimed at self-insight would serve little purpose." </p><p>The McLean team discovered a similar phenomenon: patients expect little from psychotherapy and a lot from pills. When depression is treated as the result of an internal and immutable essence instead of environmental conditions, behavioral changes are not expected to make much difference. Chemistry rules the popular imagination.</p>
Why Depression Isn't Just a Chemical Imbalance<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fbc027c9358dad4a6d9e2704fc9ddb04"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/GAC9ODvSxh0?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Many years ago, my best friend tried to quit smoking. He asked for help. While I'm no addiction expert, I offered what I knew from my fitness toolkit: breathing exercises and cardiovascular training, methods for strengthening his body and mind that could, I hoped, inspire him to take better care of himself in general. He replied, "No, I meant something like a pill."</p><p>A few years later, he quit for good. After failing the cold turkey method a number of times, it finally stuck. Maybe it was watching his children grow up—the reason my parents quit when I was young. This method is not easy, however. It challenges you; it forces you to confront your demons; it drastically affects your brain chemistry. Yet, in the long run, it sometimes works. </p><p>Sometimes pills work, too. But often they do not. The journalist Robert Whitaker, author of "Anatomy of an Epidemic," discussed the clinical trial process <a href="https://bigthink.com/mind-brain/antidepressants-dangers" target="_self">during our recent conversation</a>. While the FDA process appears thorough from the outside, pharmaceutical companies only need to prove that a drug works better than placebo, not that it works for the most amount of people. He continues, </p><p style="margin-left: 20px;">"Let's say you have a drug that provides a relief of symptoms in 20 percent of people. In placebo, it's 10 percent. How many people in that study do not benefit from the drug? Nine out of 10. How many people are exposed to the adverse effects of the drug? 100 percent."</p><p>Even though some pharmacological interventions show little efficacy, and even though Xanax, an addictive and destructive benzodiazepine that only showed <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/" target="_blank">short-term (four weeks) efficacy</a> in clinical trials, is being prescribed for many months and years, doctors continue to use the language of clinical neuroscience to describe mental health issues. If chemistry is the problem, people will turn to chemistry for the solution. </p><p>Perhaps we should, as psychiatrist Dean Schuyler <a href="https://bigthink.com/surprising-science/antidepressant-effects" target="_self">writes</a> in a 1974 book, recognize that most depressive episodes "will run their course and terminate with virtually complete recovery without specific intervention." The problem is that idea isn't profitable. As long as the gatekeepers continue to use the language of chemical imbalances to describe what for many is just an episodic case of the "blahs," we'll continue creating more problems than we solve.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
Viewing art that doesn't look like anything makes your brain take extra steps to try and get it.
- A new study finds that viewing modern art causes real cognitive changes in the viewer.
- Abstract art causes the viewer to place more psychological distance between themselves and the art than with more typical works.
- Exactly how this works is not yet known.