MEDICINE AND ANTI-AGING

In an old Sunday Times magazine,(https://www.nytimes.com/2010/01/17/magazine/17antiaging-t.html) Tom Dunkel wrote about a man and his doctor working together to slow or reverse the aging process and about other organizations promoting similar treatments.  He also included rebuttal from other doctors who reject this as "quackery".  Other more recent articles describe other approaches: (https://www.nytimes.com/2022/07/19/business/aging-protein-elevian.html)  (https://www.nytimes.com/2023/06/08/health/taurine-supplements-aging.html)

In the context of current healthcare debates, the cost  of  elder healthcare looms large, so reducing elder disability could be helpful.  The body changes and deteriorates with age,  which can be interpreted three ways:  1) the changes are programmed into the species to eliminate those who have reproduced to make room for the next generation.  2) the changes are failures of human design which impacts  current human longevity.  or 3) "Aging" is a disease like any other and needs investigations to cure or prevent it.   The first view means aging is part of the normal evolutionary cycle that humans should do nothing to interfere with.  The second and third views support  finding ways to arrest or prevent aging by stopping or reversing the biological factors that contribute to it.  While Dr Comite is quoted in the article as distinguishing between "optimal health during life" and preventing death,  the latter is the stronger motivation for engaging in these studies.  It is interesting that this article concentrates on examples of males trying to prevent aging, and the hormonal changes women naturally experience are not discussed.  Male aging seems to be a reality that men strive to hide.  Should men do this? Certainly some of the treatments are simply placebos,  but there is clear evidence that hormone supplements have impact on the body.   But are they  effective in preventing "aging" or promote "optimal health" without undesirable side effects?   Nature seems to reduce certain hormones with age to prevent certain effects,  while worsening others.  Which consequences are preferred?

Should people have the right to choose?  And should medicine be free to research the potential consequences and develop "antidotes" to prevent them?   In short, should our scientific community explore ways to prevent the changes of aging and "optimize health" for as long as possible in the population?  This is not simply a scientific question, despite the impression given by Dunkel in the article.  It is a moral issue illustrated by the following example:  if a plant is discovered in the Amazon tomorrow which conveys eternal (or prolonged) life should it be developed and distributed to everyone at whatever cost?  If there are really vampires in the world somewhere,  should we allow ourselves to be bitten so that we can enjoy eternal life (albeit in this case only in the dark)? By framing the question this way, " optimal health" becomes "escaping death",  and the finite-ness that gives meaning to human life is gone.   The moral answer for most of us,  even with our fear of death,  would be "no.  This is not a good thing to do."  But where is the line between the two,  when does "optimizing health" become "trying to live forever".   When does improving life become attempting to prevent death which ultimately changes the meaning of life?  The urge for immortality is seen in other scientific quests:  creating a computer "upload" of the mind, so the person's "mind" lives forever.  We humans have an intense desire to prevent the loss of our "self", so that it continues eternally.

ON READING AND LITERACY

 On the occasion of the NYT examining the current controversy over books (https://www.nytimes.com/2023/06/21/books/review/book-bans-humanities-ai.html) it might be useful to give some thought to reading as an activity.    Scott begins: "Everyone loves reading. In principle, anyway. Nobody is against it, right? Surely, in the midst of our many quarrels, we can agree that people should learn to read, should learn to enjoy it and should do a lot of it." This passage reflects the attitude of an educated, literate, urban intelligence, not the opinion of everyone, nor every American.  Literacy in America has evolved.  Though estimated at 80% of male adults in 1776,  this did not include slaves, or women whose rate was not documented.  Estimates claim 80% of adults by 1870 (though again women are not included), but only 20% of blacks were deemed literate in that survey.  This is reported to reach close to 100% by 1980's though it is unlikely that the estimates are correct.  Reading skills were emphasized in basic education during this period, but it is not an inherent human skill.

The evolution of speech is impossible to document precisely, but its presence is pervasive across human societies. (https://www.sciencedirect.com/science/article/abs/pii/S1364661300014947) Estimates suggest it developed 50 to 100 thousand years ago, but this does not include reading! The ability to combine auditory signals and visual signals requires brain pathways that are not instinctual and estimates suggest that the ability to write and read languages is roughly 6,000 to 10,000 years old, a relatively new capacity!  (Perhaps auditory speech and visual symbols, petroglyphs, etc were combined and selected images linked to concepts (in pictographic languages) or sounds (phonetic ones).  Some ancient scripts persist into contemporary forms as in Chinese, Egyptian to greek, etc; others do not have a known correspondence, as in Mayan.  The importance of written language is the ability to maintain and record records of actions, and transmit information and history across generations without relying on memory-mimetic skills.  The importance of this change is discussed in detail by Abram (THE SPELL OF THE SENSUOUS).  

Culture is transmitted orally as well as in written form, but great importance attaches to the written as in religious documents.  The "bible" is a canonization of previous manuscripts, as is the "Koran".  Once established as definitive, each becomes the basis for the culture of that religion; this decision was made by a group of "experts" around 2000 years ago for "bible", and 1500 years ago for the "Koran".   A similar role is assigned to texts in other cultures.  These written texts were not universally available to "readers" in these cultures on a personal basis,  only as scarce hand written documents, shared by many users.  Moveable type printing developed in 1455 with Gutenberg's printing of the bible.  Only in the last two centuries has the writing and printing of books of skills, biography, and literature (fantasy) been readily available.  So Scott's assumptions about the universality and importance of reading reflect very recent developments in human history.

Coming from an academic, intellectual background, the importance of literacy and reading are paramount.  And so recent issues raise serious concerns. The teaching of reading in the US has deteriorated.  Students do not read as well as previous generations. This is ascribed variously to poor teaching, teaching non-phonetic methods(in a language that is inconsistently phonetic!), and the expansion of audio-visual sources of information.  Each of these may play a role,  but their significance is masked by a broader issue.  Contemporary culture has a wide range of available sources of auditory-visual information.  And students are able to create this information with or without words to share with others.  The dominance the physical-object-book generating a visual-verbal experience is diminishing.  Almost everywhere in the country,  you can overhear a conversation, often among women, about how their grandchildren are not reading enough, and spending too much time on "social media".  Many of these same women were in the generation that was transformed by radio, movies, and television; but they do not recognize the impact of those media as clearly.  McLuhan did, the cultural prophet who stated that "the medium is the message", or at least influences it.

The paradox of this de-emphasis on reading is the recent focus on restricting what books are retained by libraries and read by young people.   Just when the general youth culture is more focused on audio-visual experience,  parents and politicians are concerned, obsessed really,  about the "danger" of reading this or that book.  The typical concern of the 50s-70s was about the child/teen reading books with passages describing sexual activities in explicit language.(as in https://www.latimes.com/california/story/2023-06-21/huntington-beach-will-seek-to-stop-children-from-accessing-library-books-deemed-obscene-or-pornographic)  This is rarely a current concern.  Instead,  the focus is on normative content.  What feelings about oneself and one's gender are appropriate to share with others?  What feelings, attitudes, and historical information are appropriate to share which do not conform to traditional cultural norms about the country?  Elders and politicians are emphasizing the role of written communication in transmitting history, at the time when youth are ignoring it most of the time. These two aren't a coincidence.  It seems that the erosion of emphasis on written communication for a decade or so has weakened the importance of normative history in the society,  and now those who viewed that history as their history,  are shocked that others now claim a different history for the United States.  Which books are allowed becomes the basis for certifying what is the "real history".  The goal is "a campaign to win the hearts and minds of America's youth", and the supposed future history of the country.  In a time when different news media report "the facts" of an event in incompatible terms,  and a candidate and followers claim they did not lose an election despite the calculations,  defining which books "tell the true story" and are allowed, and which do not, and are prohibited, takes on a new urgency.

The sad truth is that books or written texts do not have this intrinsic validity.  Just as there are many variations of religious texts, and even several variations of the "bible" and its translations, there are many books and papers that claim to document the "truth" of the country, and its origins and current norms.  Fighting for a particular version of this "truth" and eliminating the voice of others is a necessary step in political control.  And attacking political norms is a basic technique to undermine the establishment.   Books have been swept into the political maelstrom because their writing and authors have been. Fighting for your version of the culture and the reality of a society only assures that another person will challenge this and try to oppose your views.  This is, of course, not about books, or reading, but power politics at a time when cultural norms are in transition.

Is California different? California doubles down on inclusive education as red states ban books in classrooms          Is this the future? 

https://www.latimes.com/california/story/2023-06-21/california-doubles-down-on-diverse-lessons-in-schools-as-book-bans-happen-across-u-s

FIXING THE INTERNET 3 Misinformation

The 2020 election and aftermath have intensified the conflicts over biased information.  People are concerned that distorted or false information have a negative impact on the integrity of the society itself  There are congressional hearings,  and innumerable articles in print media and online media,  and recently a documentary  SOCIAL DILEMMA, that review the situation.  (The film, a mixture of interview, narrative, and dramatization,  illustrates how easy it is to confuse the three!) It presents a dramatized family whose teen struggles with "internet addiction",  and imaginary characters representing the AI inside search engines.  There are focused interviews from previous employees of Google and other internet companies,  including Jarrod Lanier, who has written a book WHO OWNS THE FUTURE?  about this.   The interviewees as insiders make several important points, which clarify the problem and define it in a different way:  The model of the social media companies is selling you/users/your information to advertisers. Personal information is the commodity.  Facebook/Instagram collects this directly,  Google collects it by search activities, Twitter collects it by tweets and re-tweets.  The goal of all of these companies is increasing your screen time to get more of you to sell.  The more time you spend selecting on screen,  the more information about you they acquire.  Algorithms are designed to identify what is important to you, the user, and sell it.

The goal of advertisers is to sell their product to likely buyers as carefully as possible in selected users/groups.  The internet companies try to define groups with maximum value to advertisers using AI algorithms.  The core model is making money by selling user information and targeting ad/info to defined users.  This is a financial model, and cannot be reversed except by changing the financial incentives or penalties.  Lanier has proposed along with others,  that users/us share in the revenue of the use of information about ourselves.  This is one solution to the incentive model,  but hard to ensure the companies would do it equitably,  and it doesn't address several other issues.  California has instituted an "opt out" control by users,  which must be user initiated.  

When translated into the political arena, another kind of marketing emerges.  Russians, Chinese, and other information sources do not “hack” Facebook.  They pay to be advertisers hiding their identity,  or they create “bot” sites to spread information, as fake "personal sources".  Facebook and other site algorithms identify user preferences for these sources and feed users, and user/groups, the data users select.  Instead of targeted advertising for products or businesses,  they market/ target political influence.  This is not fundamentally different from other political advertising on television at election time,  but social media algorithm methods are more efficient at targeting viewers.  (This is a mixed benefit, since they do not always target "swing voters".)  The idea of “editorial control” concept borrowed from newspaper/TV media makes no sense because the management of distribution of this data by algorithm is precisely controlled.  Users select what they wish by clicking, and get what they want and more of the same.  THAT is the problem.  If users do not select certain media,  the AI quickly diminishes its presentation.  When users continue to select it,  it is expanded.  This is how the system is designed and the user plays a basic role in the outcome.  This is widely misunderstood in congress.  Introducing government control authorizes whatever group is in power to totally control the distribution of information of a very powerful medium.  This is the Liberal answer that reflects the persistence of the belief that the editorial control in newspapers and network TV "protected" viewers from "wrong information". Conservatives object to control fearing that their sources would be the first to be suppressed.  Both sides favor restricting expression of information, because the selective choice of information reinforces the other side's bias!

The problem for society is a secondary effect of the process. Targeting information and advertising to users means that subgroups self select to get more information supporting their views, differentiating themselves from other users/groups.  The algorithm  inherently separates information delivery by the selection of individuals, producing a division in "consensus reality".  Previous media, including newspapers and network TV, aggregated the public into a small number of large subgroups by editorial policy.  This is more fragmented in social media (and talk radio and blogs), and less obviously under anyone's control.

The French are attempting to address this by educating the user,  especially children and teens, to understand the selection process and protect themselves by critically evaluating messages. (https://www.nytimes.com/2018/12/13/technology/france-internet-literacy-school.html) The US has resisted this because exploiting children and teens economically has been pervasive for two generations.  Any effort to educate consumers to resist the promotional distortion of advertising undermines the economic premise of social media.  And some studies suggest that rational thinking does not reduce the divide.(https://www.nytimes.com/2019/01/19/opinion/sunday/fake-news.html) Other factors play an important role in two recent books (The Misinformation Age How False Beliefs Spread, By Cailin O’Connor and James Owen Weatherall; Down to Earth Politics in the New Climatic Regime By Bruno Latour).  A study about the public opinion of the Trump tax cuts casts doubt on the publics' inability to understand the issues. (https://www.newyorker.com/news/our-columnists/fighting-fake-news-is-not-the-solution)  The user does have power to control the process.  My own strategy has been to use FACEBOOK, but  limit my feed by deleting ads and information that are not desirable.  This results in a highly focused, satisfactory experience for me, with limited marketing value, which makes me a user of little value to FACEBOOK.  During the last election, I got almost no political ads or promotions except re-posts by friends.   The user can interact with the algorithm to shape the experience,  that is how the algorithm is designed.  But the user must do this mindfully and intentionally to block undesired information.  This process does not address the biasing of information,  it just lets the user select his or her preferred bias.

This answers one issue of the internet: who controls what information I can receive?  But it does not answer what veracity that information carries?  Is it true or false?  This will be addressed in another musing of OBIRON.

WHATS THE MATTER WITH MEN?

Richard V. Reeves, a British American scholar of inequality and social mobility, and a self-described “conscientious objector in the culture wars,” would like to skip past the moralizing and analyze men in the state that he finds them: beset by bewildering changes that they cannot adapt to. His latest book, “Of Boys and Men: Why the Modern Male Is Struggling, Why It Matters, and What to Do About It” argues that the rapid liberation of women and the labor-market shift toward brains and away from brawn have left men bereft of what the sociologist David Morgan calls “ontological security.” (https://www.newyorker.com/magazine/2023/01/30/whats-the-matter-with-men)  This analysis seems to forget many other features of "male insecurity" that have been documented in the past.  An example is the book DELIVERANCE (also made into a movie of the same name) in which a group of "urban" men go on a canoeing trip in the "wild" where each is trying to prove his manliness to the other.  The story culminates in outsiders committing homosexual rape on some of the group until one manages to kill the attacker with a crossbow (the true weapon of archaic manhood!).  Reeves doesn't emphasize homosexuality as a threat to modern males, perhaps because of the changing culture, but his British heritage includes strict laws prohibiting the behavior,  which persists anyway (perhaps learned by isolation in same sex boarding schools).   Homosexuality is an ambivalent dilemma of males seeking to define their "masculinity" in the absence of available women.  The transition from the 50s, which made short military haircuts the sign of masculinity, to the 60s when "independent males" let their hair grow long "like women" is highlighted in the movie EASY RIDER when the motorcycle guys with long hair and their buddy get attacked while camping out.

Earnest Hemingway provides a most interesting story of 20th century "manliness".  Most of his writing describes activities in the outdoors and military adventures.  He participated in a few as a journalist,  though biographies suggest that his involvement was more limited than the writing suggests.  He was famous for challenging others to fist fights in bars, etc, and wrote a book about the masculine courage of bullfighters.  But his mother dressed him as a girl until mid childhood,  his relationship to his father, who emphasized hunting and fishing, was conflicted, and the father eventually committed suicide.  Hemingway had difficulty maintaining relationships with women,  and was partly supported by his wives until his writing became successful.  FOR WHOM THE BELL TOLLS is a masterpiece of masculine wartime adventure,  but after writing it,  Hemingway's later years were mostly dissipated in fun adventures, before his own suicide. His books suggest a standard of masculinity he could not fulfill, as in "The short happy life of Francis Macomber".

In contrast,  a long history of successful powerful men not involved in specific "masculine activities" occurs in many cultures.  Leadership, cultural sophistication, financial acumen, and other skills result in successful men who are political figures, traders, etc.  The European/British tradition of martial "lords" remains a fantasy of that culture,  while the majority of their descendants have assimilated into bourgeois society and its roles.  In other words,  "macho males" have been transforming into more socially complex individuals for hundreds of years.  Why the sudden concern about the current changes?

Some of this is probably an American phenomenon.  We are a new country and culture,  whose settlement required significant physical capabilities.  The last state was incorporated in 1959, less than a century ago.  Much of the settlement of the western states still requires physically active jobs,  though less than in the last century.  The country is transitioning from a settlers' culture to an urban culture, to a mega-urban culture in some areas.  The role for men is changing and some men have more aptitude for the changes.  This leaves some men confused about how to fit into the society,  and changes the work tasks but does not "threaten masculinity".  Reeve's view that there are particular skills (hunting, exploration, etc) that are more significantly male is a typically upperclass British, not wrong, but culturally narrow.

Some of this may also be a result of #METOO culture.  The assumption that a woman without an escort is fair game for sexual advances is not a universal human cultural assumption.  It is not even a universal American cultural assumption.  The cultural value that respects the personal physical space of a woman continues to be present in much of America, including legal standards.  The increasing role of women outside the home in the workplace may contribute to an increase in attempts at exploitation.  But many instances of women exploited by famous or powerful men do not occur in the immediate workplace,  and suggest that these are characteristics of specific men, with specific attitudes about women, and should not be generalized to changes in all men.  And not being able to exploit women does not threaten "masculinity" any more than it threatens a woman's ability to be sexually attractive to others.

The more significant change in gender role is the expanding option of LGBT+, the possibility of choosing one's gender role in disregard of your genetic/anatomical basis.  These changes reject the notion of any absolute gender determination, and offer the option that the individual chooses their social-gender-presentation, and disregards the reproductive aspect.  This does not just threaten "masculinity" it challenges the definition of gender as a predetermined genetic-anatomical feature,  and substitutes social presentation as an alternative.  

Many features of modern society are in transition.  The role of men, women, and their gender identities are all being reassessed.  It is a mistake to make this a sign of problems in "masculinity"  though some men may experience it in that way.  And some women may experience a de-valuation of emphasizing "femininity" as well.  It is a characteristic of elders to sometimes see changes as problems,  and a characteristic of younger members of society to not anticipate  potential dangers in the changes.

WEALTH INEQUALITY

Sometimes a long explanation of a topic is unnecessary.  Adequate documentation of the issue already exists.  It is only necessary to organize it into a review document.

Forbes documents the expansion of the income inequality during the pandemic, as "operation warp speed":  https://www.forbes.com/sites/randalllane/2021/04/06/operation-wealth-speed-what-a-record-number-of-new-self-made-billionaires-says-about-capitalism/

How is it possible that during a period of economic contraction, executive compensation increased?  Don't the boards of for profit companies read the newspapers? https://www.newyorker.com/news/daily-comment/inequality-has-soared-during-the-pandemic-and-so-has-ceo-compensation    

And by the way, the stimulus during the pandemic was mostly absorbed by large banks. https://www.newyorker.com/news/our-columnists/wall-streets-pandemic-bonanza

Even the in-between middle classes have done worse overall: https://www.vox.com/the-goods/22673605/upper-middle-class-meritocracy-matthew-stewart

We are talking about billionaires now.  https://www.nytimes.com/2022/04/07/magazine/billionaires.html

And this is not just about buying big houses or yachts.  Very rich people think they should tell everyone else what to do and buy up control of things.  https://www.nytimes.com/2021/11/02/opinion/tax-elon-musk-billionaire.html 

Is Thiel a stimulus or a destructive element? https://www.nytimes.com/2021/09/21/books/review/the-contrarian-peter-thiel-max-chafkin.html

And it matters how the money was made. The Sacklers accelerated a vast expansion of addiction in the US. And personally walked away with little penalty:  https://www.nytimes.com/2021/09/11/opinion/purdue-sacklers-opioids-oxycontin-settlement.html

Politicians depend too much on the very rich for campaign financing:  https://www.newyorker.com/news/our-columnists/how-not-to-tax-billionaires

And the very wealthy have arranged the rules to benefit them: https://www.propublica.org/article/the-secret-irs-files-trove-of-never-before-seen-records-reveal-how-the-wealthiest-avoid-income-tax

This is not just about the US,  though it shows that the determination of Britain to stay British is an illusion: https://www.newyorker.com/magazine/2022/03/28/how-putins-oligarchs-bought-london

Perhaps the most toxic feature is the way in which money is being made by not rebuilding the infrastructure,  not improving schools,  and making crippling interest off students.  The rich are getting richer by damaging the future of both the material world,  and our children: https://www.nytimes.com/2021/08/27/opinion/school-debt-economy.html

What to do about this?  Should we create sanctions on the wealthy in the US, the way they  are (supposed to be) sanctioned in Russia due to the Ukraine invasion? https://www.newyorker.com/news/daily-comment/turning-the-focus-on-americas-oligarchs

Politically that will never happen.  The Trump presidency showed the inability of the current political system to challenge the status quo.  The extreme Right protestors and the Black Lives Matter protestors share a common problem: they are getting sucked dry by the system.  Fighting each other keeps both sides from looking at the economic issue.

Is the answer just to have better Facebook contact between rich and poor? https://www.nytimes.com/interactive/2022/08/01/upshot/rich-poor-friendships.html

This seems a truly naive and limited answer.

Should we create a large group of organizations to address the needs of the poor and homeless?  Who will decide how the money is spent? https://www.nytimes.com/2021/10/03/nyregion/jack-brown-homeless-nyc-core-services.html

Can the solution come by legal actions against those exploiting others for housing? https://www.newyorker.com/business/currency/a-promising-court-victory-for-mobile-home-residents

Pikety tells the interviewer that the US is "primed" for redistribution of wealth.  https://www.nytimes.com/interactive/2022/04/03/magazine/thomas-piketty-interview.html

But how will this happen?

OUR ENVIRONMENTAL FUTURE

 I have been posting on the environment and climate change on my Facebook site(Ron Milestone) almost daily for the last year. Although the day to day posts cover a range of topics, the basic issues are not complicated or confusing (though they may be difficult to solve!).
1) How do we rein in the use of fossil fuels and other carbon production to slow the climate changes already occurring? How do we do this without totally disrupting the economic balance of separate countries?  The relationship of humans to energy use is a vital concern.  A defined amount of energy arrives at the earth each day as sunlight.  This is converted into various phenomena and may be converted to other forms (solar power, wind turbines).  Residual heat from processes within the earth provides an additional source of energy.  And plants have stored energy in their structures over eons, and continue to do so.  Energy is stored in every molecule and methods of releasing this have been developed (nuclear) but their safety has historically been poorly engineered.  Energy is needed for daily activities and for transportation from place to place.  It is easier to use alternative energy sources converted to electricity for daily activities, and more difficult to use them for transportation.   The reserve of fossil fuels is depleting.  A decision must be made to slow their use and preserve their availability to make the transition to future power needs less drastic.
2) How do we adjust to the climate changes occurring and likely to continue in this century without catastrophic political events? This includes managing the changing distribution of water, intensification of weather events, fires, and the relation of people to the events.  Climate change is already underway.  How rapidly it will occur, and all of its ramifications are not understood.  Some of the effects are clear already.  Major political decisions will be needed to adjust to these changes.  Wars in regions of Africa and the middle east indicate the consequences for failure to make peaceful decisions.
3) How do we reduce the distribution of toxic polluting substances, and clear ones already distributed, to avoid human and animal damage? This includes ending the use of the oceans as toilets.  The manufacture of new materials and electronic devices is associated with the creation of pollution not cycled back to natural substances rapidly.  A similar issue occurs in nuclear production of energy.  The only solution to this problem is the reduction of use of these substances.  This goes in the face of the economic evolution of human consumption and will be difficult to accomplish!
4) How do we balance the distribution of humans to other plant and animal species to retain suitable biological diversity? This must involve changes in human demography, and changes in how humans exploit other species.  Every place where humans sequester land to grow crops  or animals for human consumption creates an opportunity for wild animals to exploit this food supply.  This interferes with human food production, and diverts animals from "natural" food source activities.  Opportunistic animal species also invade human cities and dwellings creating unintended "shared spaces".  THERE IS NO WAY TO COMPLETELY ISOLATE HUMANS AND OTHER SPECIES.  A constant attention to the ecology of sharing is needed,  along with creating "natural spaces" that retain animal species away from human concerns.  This is a decision about use of land, which also involves major economic and political considerations.
Solving these problems without creating chaos requires careful decisions about choices and balancing different goals. The current political process in the US is not capable of this level of careful decision making. Perhaps more mature countries will lead the process.

THE MEANING OF "FAILURE TO LAUNCH"

The term "failure to launch" (in humans) is applied to young adults who do not successfully enter roles in society.  There is an article describing this "syndrome" in Scientific American (https://www.scientificamerican.com/article/failure-to-launch-syndrome/).  And a study has been initiated at Yale department of Psychiatry, enrolling "patients" to evaluate interventions. (https://www.spacetreatment.net/forum-1/professional-forum/new-failure-to-launch-treatment-study-at-yale-child-study-center     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504878/).  Parent training has been recommended (https://pubmed.ncbi.nlm.nih.gov/36047938/).  ( https://www.medscape.com/viewarticle/991190?ecd=mkm_ret_230506_mscpmrk_psych_anxiety&uac=75012BG&impID=5403082#vp_1) And there is a special outdoor program for men (https://fortestrong.com/landing/?gad=1).  

This is not entirely an AMERICAN phenomenon.  The Japanese "lost generation" refers to young men who could not enter the employment cycle during the downturn of Japan's economy in the mid 90s-2000's.  They often retreated to their rooms and were eventually described as the Hikikomori (https://en.wikipedia.org/wiki/Hikikomori).  They have a serious impact on the pension system of elderly in Japan.   Similar trends are observed in the EU,  and these issues occur despite the changing demographic profile which is producing fewer young persons, while expanding the elderly survival.  

Nor is it an entirely NEW phenomenon.  Kenneth Keniston wrote about it in THE UNCOMMITTED: ALIENATED YOUTH IN AMERICAN SOCIETY.  Entering society is the last "aspect" of adolescent development  usually through entry into employment.  (The adolescent developmental stage includes five transitions that impact social adaptation: The physiologic changes of adolescence combine rapid somatic growth with the changes of puberty associated with a general increase in emotional intensity. The cognitive changes associated with abstract thinking. Personal gender identity is different from physical puberty and builds on childhood experiences of sexual identification, normal and abusive childhood sexuality, and other pre-adolescent issues. Social development is the transition from dependence on family for emotional and physical support of childhood to using the peer group in adolescence. Adolescents may have difficulty separating from the family and ambivalent autonomy. Social identity is the task of becoming a productive member of society.  SEE NEUROMIND: A CONTEMPORARY APPROACH TO MENTAL HEALTH Ch 6) Interfering with the development of one's role in the larger society can result from many different processes.  Severe physical incapacity,  cognitive disability, head trauma, emotional trauma/PTSD, and mental health disturbances may all result in failure to achieve family autonomy.  But none of these factors explain the sudden increase in the number of failures, either in Japan or the US.

It is only possible to understand and address the "failure to launch" when considering it as an indication of social and economic problems that impact the individual.  Two specific features must be considered in the US: 1) The role of youth in American society in the last twenty plus years is primarily the role of consumer.  All media, social and non-social aimed at American youth are designed to direct the motivation to be consumers.  The goal to enhance the desire to acquire goods and services that stimulate the economy does not emphasize the skills needed to be productive.  Even traditional roles like athletic success have been transformed into their importance for economic impact.  and  2) The failure to enhance the funding and development of the education for productive skills.  All the evidence suggests that public education is declining in its ability to produce students with effective skills needed in the general society.  This is due in part to the disappearance of training in non-academic skills in high schools, etc.  and also the declining quality of learning primary skills (the 3 Rs).  It is also a consequence of the failure to develop teachers and curricula for the new digital skills needed in modern society.  Everyone, liberal and conservative, agrees on these changes,  but they do not agree on the solutions, and so none have occurred.  Instead  conflicts about social values and the historical accuracy of information distracts the energy from teaching productivity.

At the same time that the education process has been less successful in preparing students for work skills,  several changes in the work environment have made entry less desirable or more difficult.  Companies frequently complain about the lack of commitment of young workers and their self centered expectations.  But no consideration is made of the companies' failure to assure lifelong employment to workers.  Why should young workers be committed to companies that are not committed to them?  The lucky ones take entry jobs and then "climb the ladder" of opportunities across companies who hire workers away from other companies to avoid the costs of training.  The unlucky ones do not find good entry opportunities, and become quickly disillusioned.  Complicating this is the failure of contemporary education to train students in the digital technical skills needed to perform the basic operations of modern corporations efficiently.  Most older teachers do not have these skills.  Most older leaders in corporations do not have these skills.  The ability to advance in tech companies depends on highly specialized skills.  The desire to enter or advance in less appealing and poorer compensating jobs has little motivation for young people who see the social emphasis on technology and the digital world.  Making "failure to launch" a mental health issue leads to suitable outcomes in selected persons,  but makes the individuals the problem in all cases,  without addressing the social factors.

IT IS IMPOSSIBLE TO ADDRESS THE VARIOUS ISSUES IN FAILURE TO LAUNCH WITHOUT INCORPORATING THE ROLE OF EDUCATION AND SOCIAL REWARD IN THE CONSIDERATION.