Stickman Readers' Submissions August 30th, 2006

On Love And Being “Clinically Sick”

Like Korski, my background is also largely as an academic. In my case, as a scientifically oriented clinical psychologist. I have taught abnormal psychology at all levels at several major universities and I have even served at times as Director of a training program in clinical psychology at a major, internationally recognized university. My own research focused largely on cognitive approaches to psychopathology. As a psychological researcher, I too give homage to evolutionary theory. Much of our make-up and how we learn and survive is the result of our ability to adapt to and learn from environmental demands. I will add, however, that I do not pay homage to Freud or Freudian theory. In modern psychology, such work is of only historical interest.

While I agree strongly with Korski that there are biological correlates (e.g., changes in neurotransmitter levels or neurochemical activity in certain brain regions) with love, or lust, or any other state, I do not agree that such changes reflect being clinically “sick” or in fact clinically anything at all. Everything we do is reflected within the electrochemistry of our brains. Everything but death, that is, and even then, at the outset it does indeed represent a change, albeit to none.

He Clinic Bangkok

The types of changes that one sees in brain activity with strong emotional states associated with elevated arousal are not as yet all that specific given the level of measurement that we are at present capable of. But Korski is correct that to the extent that we can measure such changes, “love” or “lust” will tend to be reflected in activation of neurotransmitter systems that is not unlike what might be seen with arousing and addictive drugs like cocaine or in problem gamblers when they are exposed to gambling-related stimuli. Although we could quibble, the biological underpinnings of arousal across numerous situations from your first BG experience to parachuting are not all that different. Evolution gave us systems to adapt to changing environmental demands, so it is no surprise that similar systems are in play across a wide range of situations that require similar adaptations on our part.

Where I disagree, and do so strongly, is with the notion that you can infer (at present) either clinical “illness” on the basis of such activity in the brain or that you can infer such biological underpinnings as playing a causal role in so-called clinical illnesses when they are present. We would like to do so at times, but even in what we all agree to be more biologically-based disorders (e.g., schizophrenia, bipolar disorder, or autism), the hunt is still on and will be for some time.

Early attempts at developing diagnostic systems for clinical disorders in psychiatry and psychology tried hard to extend the medical model of illness to problems in living. The hope was that a diagnosis, by such thinking, would tell you the cause, the treatment, and the likely prognosis for so-called mental or emotional problems just as it does for a biological infection. Perhaps it may some day, but it does not yet. For now it helps more in conducting research that does indeed help us in better understanding which treatments work best for which presenting problems than it does for telling us what caused those problems in the first place.

CBD bangkok

To those of you who would say I quibble with Korski, please note. I am less concerned by what he says than by what he does not. Before you breath a sigh of relief and conclude that yes, indeed, the expert says “I am not sick” please note, my points about the underpinnings are to some extent mere quibbles, but my primary purpose in writing this droll piece is not to disagree so much with what he said, but to note what he left out.

In order to be able to be classified as a clinical disorder, the difficulties that a person experiences must be associated with either subjective distress, interfere with a person's ability to function (i.e., social, educational, vocational, etc.), or both. Only then does one go about deciding whether or not a specific diagnostic categorization is appropriate. This is the underlying basis for modern diagnostics in clinical psychology and psychiatry – subjective distress, functional impairment, or both.

Being in love or in lust, therefore, is not sufficient for applying concepts like clinical disorder, “sickness” or “illness.” I seriously doubt that orgasm, white water rafting, parachuting, or those last few moments that the horse you bet on speeds to the finish line are very different in the dopaminergic centers of the brain to which Korski refers. They all “get us off” as, apparently, does Thailand or the very act of landing at Don Muang for most of us. Indeed, even with the new airport, the response will be similar, albeit with a bit of justifiable fear for the first few brave souls who try to land there (sorry, could not resist that one).

I lived and worked in Thailand for several years, all of it in positions where I interacted with large numbers of Farang. I have cooked western food for them from a food stall and a breakfast bar, and I helped to establish and run a western café and a serviced apartment building. If I have not experienced it there, I have heard it over beer many times and read it on Stick repeatedly. I know, all too well, from whence I speak. All too well (see my earlier “Slow Learner” submissions for my abbreviated tale). I have heard it all. Sometimes it seems the only thing that changes beyond the common things is the teller, not the tale of woe.

wonderland clinic

And herein lies the rub – I do think love and lust in Thailand are somewhat different in several ways. Please bear with my while I elaborate.

Did you read between the lines above? I once was an established, respected, and upwardly rising academic psychologist with an impressive publication and citation count and a resume that would impress you. Yet I have had a food stall and breakfast bar in Thailand? I rented you an apartment? What?????

I have been in love many times. I have lived with five women and been married to three. I have had more girlfriends than I care to count. I hold no regrets, but NEVER, NEVER, NEVER did my life get so turned around until I set foot in Thailand one fateful day. And I am not alone. It is not just the rice in Thailand that can be sticky, it is the whole damned place and its people.

In the West, love, like life, can be happy or sad. Yet nowhere else have I ever seen so many people who I respect fall apart. Never have I seen so much subjective distress or interference with the ability to function back home, or over there. Indeed, it is the conversion of so many from “being back home” to “being over there” that strikes me as extraordinary in the extreme. Everyone packs their bags to travel, but it seems to me that only in Thailand have so many men packed their lives, myself included.

While there is as of yet no “I am moving to Thailand” disorder listed in the diagnostic manual, I have seen and been among the many cases over there where the basic criteria of subjective distress and interference with the ability to function are unquestionably met, and often exceeded in a way I can almost only capture in words by calling them “Thai.” When the tourism authority declared “Amazing Thailand” in one of their annual campaigns, we all laughed. Not because we thought they were wrong, but because we thought they were all too right.

I think there are several reasons for this and, yes, the biology of love and lust are among them. But so too are the impacts of “interest” and “arousal” on our underlying biology. It is not just love and lust, it is the interest in a new culture, fascination with the exotic (and erotic) Thailand, and the arousal of being in Bangkok (or Phuket, Chiang Mai, etc.) where you live like Kings, debauched or not, in places that actually seem to breathe.

It is not just the easy accessibility to the exotic little ladies of Thailand and their wondrous ways. Sure, that is a big part of it and Korski can certainly talk to the evolutionary implications of that better than I (where else can you be a lion among the young and fertile pride, strutting among so many alternatives?). But this is only one part.

A second part, as noted, is the shear exotic nature of the place. Add the Thai twists that are ever present, where every time you think you have it figured out the ending changes, and interest is at its peak. We may experience many things in Thailand, but boredom is rarely one of them. For these reasons we can be addicted to Thailand, even if we are not addicted to the Thai.

And this brings us to the third, that it is not just the country or its ladies, it is the people you encounter there in general. Humans are social animals. There is little doubt of that. We evolved to live in groups. We are not the rogue lion or bull elephant that affiliates only to mate; we live in and need to be among the group. And Thailand is very special in that way. The Thai are open and warm, they smile and they laugh. They travel in packs and once we are accepted, they invite us along.

It is not just the Thai, though. It is the expats and other visitors, faced with a strange people in a strange land, we open up to each other and we bond. I can make meet, have fun, and bond with more Westerners in Bangkok in a week while in Thailand than I could do in years in the West. I have met the most fascinating people, generally interesting for positive reasons, but interesting even when not. I have gone to war with the mafia and been stranded on an island with no money or personal identification (yes, robbery is a problem there as elsewhere). I have lived and told tales in Thailand. Where else do we find the life experiences in the developed world that suffice to fill the coffers of a site like Stick’s?

And the ladies… Ah, it is not just the allure of the lovely Thai lasses. Frankly, I am addicted to Asian women; I care not where they come from in my addiction. Line them up, tell them to keep their mouths shut, and I could fall in love with the lot before I know where it is they were born and raised. No, to me at least, it need not be (and is not my preference) that she hail from Buriram. Only those eyes, that lustrous hair, the ready smile and the skin like silk. At first glance, those are all I need. But there is more to this than that.

It is not just the girls, their “asianness” or Thailand itself, it is more than that. It is a few peccadilloes inherent in their culture. Chief among these, in my opinion, is that the Thai are so immersed in their own culture and so, in my opinion, unwilling or unable to compromise. We all know these aspects of the Thai. The “Thai way”, the difficulties they have adapting elsewhere (for years, Thai men working away from home were of great interest due to their high rate or inexplicable sudden death). The Thai are not like the Chinese, they do not pick up and pack and move on and adapt so well.

But they know sanuk. Their culture is permeated by its imperative. Life must be fun and so they try to make it, at least on the surface. And that sucks us in. Oh yes it does.

The inability to compromise, or seeming cultural theme of being unwilling to do so unless absolutely required, then serves to trap us further. When you become involved with the Thai, or a Thai, all of a sudden it becomes an issue of why you should consider moving and living there. Sometimes you can date a girl for quite a few months and only really know how she feels when she starts telling you about how she could never leave Thailand, but if you were to stay, then…

Of course, if you stay, you must learn the Thai way. It is the Thai way or the highway, mate. And that is the trap. Love and lust in Thailand are not just about love and lust, they become about being Thai. Life is all so black and white. We are pushed, prodded, or leap willingly in with both feet and eyes closed, into thinking that we must choose between the biochemical jolts we experience in Thailand and the rest of life as we know it. There are no shades of grey – there is Thailand or no Thailand. Life, love, and happiness or home. Or so we are led to believe.

And so we come back, and back, and back, and maybe even move. For some who have real and appropriate businesses, skills, or resources it is even a smart move. A good one. The best. But for most it is indeed a form of insanity. We pack it all up, race across and set fire to the bridge behind us. When we burn that bridge, alas, it is not the enemy we keep from following us, it is we who are now trapped of our own accord. The way home is no longer easy and sometimes not even clear. <GREAT analogy, thisStick>

TIT. This is Thailand. The Thailand I knew and love. It is as if it is not Thailand, love it or leave it, but Thailand or that great balcony plunge. It is Thailand as addiction, not as destination. It is Thailand, need I say more?

But if I can impart one bit of wisdom to you, my fellow Stickmanites, let it be this. The shades of life are not painted with black and white, they span the rainbow. There is a life outside of Thailand and the simple act of living there is not the key to happiness. There is more to life than Thailand. Once you stop thinking that is true, you may have a problem. If you shake in the morning, then perhaps you drink too much. If calls of “airport, airport…” send shivers up your spine, then perhaps your life at home is lacking.

Life is not black and white. Returning home does not require that you find and move in with a 50 year-old cow, as some here seem to imply. It is not black and white. All white women are not bad and all Asian women are not Thai. Life is a balance, and if you do not achieve it, then the balcony railing may seem far too much like friend than foe.

I trashed my life for Thailand. Mind you, I enjoyed the hell out of trashing it, but for me Thailand became addiction, not destination. It was a place I willingly and repeatedly flew into, but never really left in my heart. It has taken me ten years to get over my first trip. TEN YEARS. All because when I was down and divorcing the sirens called. My friends said “Thailand…Thailand…you will like it there…go, and heal your broken heart…” And like the addict, I popped it under my skin only to end up mainlining Thai culture for the next ten years of my life.

Do I love it? Yes, no doubt. But is it life? No, it is Thailand. A wonderful place to visit and perhaps to live. But, not the only place and not the only life.

So, now as I write to you from New York City I have finished my travels for this year’s leave. And, for the first time, they did not include Thailand. I am going cold turkey, trying to up-regulate those old dopamine receptors. And you know what? I had just as much fun in my old Sydney stomping ground with my friends and fellow travelers in Bondi Beach this year as I ever had in Thailand. And there is a beautiful jet lagged Chinese lady sleeping in the other room. She is my wife and part of my new old life. She has the eyes, the smile, the skin and one big brain (M.D., Ph.D.) and all those things Asian I so love. But she lacks one thing Thai, she can compromise, she can live anywhere in the world and be happy if we work as a team and have our love. Life is not perfect, but it does exist outside of Thailand and it is going smoother here, at home, where my job skills count, then it ever did for me in Thailand.

Of course, I cheated. That made it easier. I live in an Asian neighborhood. I sought out Asian friends and I found a pretty Asian lady. Asia is still in my heart, Thailand in my memories. I still watch the pretty little Asian things walk by me on my way to work. I still cannot read the signs. But I can live outside of Thailand and truly say I am happy.

Are you sick? Or are you stuck? To the extent you are stuck, then you may have caught a bit too much of Thailand.

Chok dee maak,

Slow Learner

Stickman's thoughts:

A very enjoyable read indeed.

nana plaza