As a teenager in anguish, with a rapidly growing vocabulary, I came up with a concept I called Deleterious Cognition [1].   It was a destructive thinking process, starting with a few verifiable facts, that led to dangerous inaction, or actions contrary to your best interests, all based on empirical knowledge that can’t be refuted. 

I was hard pressed to define deleterious cognition, or even give any convincing examples of it, until the other day, a half century after I began to understand the role deleterious cognition has played in my life, and, increasingly, in millions of lives.  I spoke it out loud to Sekhnet and realized: EUREKA!  I’ve got my perfect example of deleterious cognition.

I’m a fairly old man now and I need various medical treatments, sooner rather than later.  I have cataracts that are now clearly affecting my vision, a painful bone on bone severely bowed left knee joint that needs to be replaced, several other things I need to see to.  Procrastination is natural in the face of scary things, particularly when they come in bunches, but here’s where deleterious cognition comes in.

As I try to navigate Medicare (the poison pill-laden gold standard for health care here in the truly exceptional US of A) I am stopped in my tracks, over and over, by lack of basic information, by ambiguities in the written guide book they send Medicare recipients, contradictions that, if not caught, can cost the unwary their life savings. 

You’d think they’d have a warning in bold for all the codgers fearfully poring over the new terms every year, in a country where most people don’t have $400 on hand in the event of an emergency: 

WATCH THIS SHIT HERE, YOU HAVE A SHORT WINDOW OF TIME TO DO THIS OR IT MAY COST YOU, OUT OF POCKET, $50,000 or more FOR YOUR MEDICARE COVERED CANCER TREATMENT.   CALL THIS 24/7 HELPLINE IF YOU HAVE ANY QUESTIONS, YOU QUERULOUS COOTS.  ALSO, BEWARE OF CONSTANTLY ADVERTISED LOW COST  “MEDICARE ADVANTAGE PLANS” THAT APPEAR TO OFFER GREAT BENEFITS BUT CAN LEAVE YOU HOLDING ENORMOUS HOSPITAL BILLS.

Instead we have only the normal guardrail of the “Free Market” — caveat emptor, buyer beware, you fucking chump. 

Here’s where deleterious cognition comes in.  Frustrated by the poor design, and grotesque porousness of America’s health care “safety net” for senior citizens, I become too angry to read on, make notes, call various numbers over and over to try to solve an immediate and pressing problem.  So an actual objective set of facts, something I know, along with millions of others on a program booby trapped in favor of for-profit companies that live on the blood of anyone with any disease or health condition, becomes deleterious cognition when knowledge of the aggravating pitfalls stops you in your tracks.

Your mind will tell you, as you are caught in this deleterious thought cycle, that you are perfectly within your rights to be angry about a program designed to preserve mercenary corporate profits, at the expense of some of our most vulnerable citizens.  If an answer to a basic question cannot be found in the booklet they send out to “help” you, or by a visit to a website or a quick phone call … you know, fuck it and the fucking fucks who designed the goddamned program.   Deleterious cognition is a breakdown of rationality that the sufferer can present a perfectly rational argument for.

In a cooler moment you will freely concede that, once you find someone to explain what can’t be found in the guide book they send you, the program does allow you to protect yourself against tsunami-sized medical bills.   It’s very far from perfect, true, but, in fairness to Medicare, 80% of a million dollar hospital bill paid by public insurance leaves you only a $200,000 share to pay, which you can avoid by choosing the right “supplemental” plan from the alphabet soup of randomly lettered government mandated but privately administered programs, and pay the extra premium every month, to a private insurance company, to protect your life savings from health care predation once you pay $4,000-$5,000 every year out of pocket.

Deleterious cognition is the stream of aggravating thoughts that prevents you from avoiding danger you can also see coming.

If someone blames you for all conflict, insists you never talk about how the conflict hurts you, gets angry when you try to make peace, you can brood for a long time about what more you can do until you recognize a pattern and stumble on a sensible real-world explanation.  Inability to accept any responsibility, inability to empathize, inability to compromise, apologize, recognize another person’s right to their feelings are the hallmarks of a common, and very intractable, emotional frailty know as narcissism.  The need to be right, to feel just and perfect, in this type, outweighs all other considerations, because the agony of utter humiliation is their only alternative to feeling right, and just, and perfect at all times.

If a dear friend demonstrates these things to you, and your best efforts to show friendship are brushed away as they gaslight you, blame you and assault your reputation among common acquaintances, you can confirm this diagnosis for yourself.

The question remains: is seeing the insoluble stalemate clearly for what it is — your friends suffer a difficult to cure and debilitating emotional condition and will never meet you halfway about anything  — deleterious cognition, or salubrious cognition?  

It is not really a question.  If people who claim to love you also insist you shut up about anything that makes them feel less than perfect … well, is there really a question there?

[1]   

Deleterious:  1]  Having a harmful effect; injurious.    2] Hurtful; noxious; destructive; pernicious 3]  harmful often in a subtle or unexpected way (as for example deleterious effects, deleterious to health).

Cognition refers to “the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses”.Wikipedia