adding kara to aham means that we experience a limit on our feeling of existence. our Clottery to the past and present contexts in which it was born may be scary at first, but in so doing, we can experience a broader emotional life. self-talk impacts how we see and feel about ourselves in ways we barely notice, much less register. we call ourselves stupid, or a Clot, what becomes of that? the same weaponizing of language that we use against others who hurt or offend us. we really think those words will have a different effect against ourselves? not. we need to become more thoughtful, careful, and gentle with what we say to ourselves. I see #@! on a printed article, as I often do in dialogue bubbles in comics or graphic novels when one character uses an epithet, I choose to read it as a substitute for the word Clot. all, a Clot is what I tell myself not to be. would be natural to assume she was in despair from having a terminal diagnosis. Mary turned to me, I could tell there was so much more. She told me of her marriage, and how they had quickly become a family of four. She explained how she quickly fell into a state of undiagnosed postpartum depression, self-prescribing alcohol to cope with her impaired state. It was this solace that would ultimately take her family from her and give her the cancer that would end her life. Her bottle of treatment shampoo had been unceremoniously dropped into her room, along with plastic-wrapped instructions. In her debilitated state, she simply lacked the strength to wash her hair full of lice. In her isolated condition, no family was coming to help her, either. She was too ashamed to tell them she was dying, sickened by the very thing that drove them apart.

So I sat with Mary in silence, as I ran the sudsy warm water through her thinned red hair, helping her wash away some of the pain. These mutations allow bacteria to create new defensive mechanisms against antibiotic assault. Some of these mutations are natural, either random or in response to the antibiotic attack from other bacteria. But many are also a result of excessive exposure to antibiotics discovered by scientists and produced by pharmaceutical companies. How could bacteria that had never seen any human activity, and predated humans by millions of years, have the same resistance patterns that doctors witnessed in hospitals? Barton and Wright dug in even more. They wanted to be absolutely sure of their results. They chose to compare a cave bacterium that had been isolated from any and all human activity with a cousin bacteria on the surface of the Earth with all of its exposures to human and animal activity. team chose a particular bacteria from the cave called Paenibacillus sp. and compared it to surface bacteria from the same family, Paenibacillus lautus ATCC 43898. To their surprise, LC231 was resistant to most clinically useful antibiotics. This reward, in turn, moves the gauge up, thereby encouraging more behavior of a similar adaptive type. This self- monitoring system is based on various neurological and perceptual processes in the brain called modules. When seen this way, the evolution of self-esteem also helps its proponents understand important behavioral and social problems with self- control. For instance, one person's self- esteem may become stuck on low, which tends to make life more difficult for him or her personally or interpersonally. Another's self- esteem may become unreasonably high, which might result in a lack of self- control that causes disruption for those around him or her. And yet someone else's sociometer may swing back and forth like a broken gauge, which is even more problematic. Some of these possibilities, of course, can occur in relatively mild ways, such as those that happen on a bad day. Others may develop into one of the more problematic types of self- esteem described in article 1.

A relative few may even manifest themselves in the types of mental disorders associated with low or defensive self- esteem, such as depression, narcissism, and bipolar disorder, respectively, in the three instances just described. These limits can come to define us. We become identified with these roles. We can come to believe that we are a lawyer, a teacher, a mother, and forget that we are, in truth, limitless consciousness, playing a role. This is not to diminish the importance of fulfilling these roles skillfully and beautifully. However, the identification with the role, whatever it is, can become narrow and turn into a feeling that we are small, weak and lacking in confidence. The key is to be conscious, awake and aware. Manas weaves all this identification quite naturally. If we are unaware of it, we will unconsciously believe these transitory ideas and feel that we are limited and small. This simply isn't the case. This is why we need the proper foundations of timeless wisdom and knowledge to remind us of who we really are, and the transformative power of practice, to restore the natural functions of this powerful and fine inner instrument of mind and heart. ) The English language contains plenty of words that can stand in for Clot (admittedly offensive to many people, including my parents. ) I could've use the word jerk, but for the behavioral dynamic I'm addressing in this article, I wanted a word with oomph. Now that we've got it, though, I want to dial things down. To be gentler to ourselves, let's come up with alternative terms that coincide with our recovery. Coming up with your own expletive is part of the creative process. You can put your substitute in your head whenever you feel like someone is acting like a Clot. Though the point of your #@! % may be to thoughtfully lessen the degree of provocation likely triggered by an expletive like Clot, (it also lessens the offensiveness to my mom and her church friends) any word can refer to the kind of person who, shall we say, does not play well with others. Since Clot is what we call an expletive, I'll use the word impletive to refer to the bleeped-out version you may prefer.

friends have suggested other names (the #@! Mary's situation ignited an internal struggle that to this day I still grapple with. There is an elusive balance between compassion for an illness and the practical understanding of life choices that may lead to that illness. Compassion is one of the staunchest virtues of any medical mission statement, although this virtue is impossible to instill in others and challenging to hold on to oneself through the tests of time. Treating an infinite number of patients with self-inflicted illness such as addictions and obesity has the potential for eroding one's sense of compassion. How can I care for someone if they simply do not care enough to care for themselves? It is easy to fall into this thought process. is the very thing that makes us human and separates us from the rest of the animal kingdom. We treat our sick, aid our infirm, and help those who have made mistakes. To err is to be human, and to be American is to help our fellow man, or woman. The mission of a physician is to engage with patients in the pursuit of a healthy life, all the while maintaining an emotional bond with the people who trust us with their lives. Out of the forty antibiotics they tested, the bacteria was resistant to twenty-six. 9 But there was more. When the team investigated the mechanisms of resistance, they found that several of the mechanisms by which LC231 was showing resistance were familiar and well documented in other bacteria, but there were at least three new mechanisms of resistance that had never been reported before. The team had shown, definitively, that the bacterial-resistance mechanism was very old and predated human activity or the marvels of modern medicine. It had little to do with the overuse or abuse of antibiotics by humans. The bacteria in the cave had developed their own defense against an antibiotic attack, and these bacteria had been remarkable at conserving this defense machinery for millions of years. The story was big--and a potential boon to those who had been arguing that human activity does not affect nature. Some in the industries and drug manufacturers grabbed hold of these findings to argue that if bacteria have been producing their own resistance mechanisms, and had been doing this well before any antibiotics were made, there was no need to stop using antibiotics in, say, agriculture and food production. What difference did it make if, globally, three times more antibiotics were used in livestock than were given out to people in clinics and hospitals?

Clearly the bacteria were doing what they had been doing for millions of years, independent of human behavior. To deal with that ultimate fact, human culture is said to develop and offer what may be called a sacred canopy (Berger, 1967. ) Originally, these belief systems were religious in nature. However, over time people developed various philosophies, social causes, or political ideologies that serve the same purpose: They offer a reason to live beyond a mere desire to survive by providing a clear moral guide or behavioral pathway for living a good, which is to say meaningful, life. Religion, of course, even promises immortality, which, if true, conquers death by transcending it altogether, providing that one faithfully follows its prescribed beliefs and practices whatever they may be. This development, in turn, increases his or her experience of angst, which may be manifested in many ways, including anxiety, guilt, and depression, all of which may be associated with low or defensive self- esteem as discussed in article 1. Interestingly, the research studies supporting this approach indicate that when people are confronted by stimuli concerning death, those with low self- esteem are more likely to be affected in a negative way. In short, control theories of self-esteem view it as an important emotional signal that helps us govern both individual and social behavior to make it more organized, coherent, and purposeful. A third type of theory also accounts for the importance of self- esteem in regulating behavior but differs from the other two in one important fashion. Instead of focusing on maintaining the self or society as the others do, this view emphasizes the role self- esteem plays in human growth and development, especially in regard to the process of self- actualization. Rather than protecting the self or controlling behavior, this approach focuses on how self- esteem is connected to happiness and well- being through the process of self- expansion. The story of The Monkey and the Bamboo Pole illustrates how we can deal with Manas, or the monkey mind we all have. Once there was a man who desired to spend his time in deep meditation and prayer. He wanted to realize the universal truth of himself. He was a farmer and householder, so he had many responsibilities and tasks to perform every day. This took up most of his time, and he knew that ignoring them was not the way to peace and fulfillment either. One day a monkey turned up on his doorstep. The monkey was a tricky character who could appear very attractive in one moment, but like a monster in the next. made an offer to the farmer: here to help you.