Some situations are particularly challenging. These include high-stakes, high-emotion conversations, like when patients talk about miracles or when they request hastened death. In the case of miracles, it is because they understand how bad things are that miracles are invoked. In the case of requests for hastened death, the request is brought on by suffering or fear of suffering. In both cases, the first thing is to do is take a breath and then explore, rather than react from a place of emotion. Another challenge is when responding to emotion isn’t enough. This can occur when a patient really does want information, when patients are coping through intellectualizing, when the emotion is too overwhelming, or when the level of emotion (and sometimes physical agitation) is elevated to the point of feeling or being unsafe. Each of these requires a tailored response like giving information, nonconfrontation, or containment before being able to move forward. Finally, in situations when our own emotions become elevated, it is important to allow ourselves to feel while being mindful we remain of service to the patient, and that we get support from trusted team members and colleagues.

Denial means rejecting the best knowledge we have about the state of the world. In its extreme (but not rare) manifestations, denial means that no amount of evidence or argument can change that rejection. The main forms of denial dealt with here concern climate change, Holocaust, election results, and pandemic. Chapter 6 examines the sources of denial in both the psychology of identity and in the political economy, which involves powerful interests such as fossil fuel corporations organizing denial, before moving on to the range of communicative responses to denial. The discussion here begins with the more obvious (and likely ineffective) responses of presenting the facts and promoting objectivity. More promising deliberative approaches involve communication and rhetoric that might reach denial via discursive bridges, and sometimes even draw deniers into deliberative interactions. If that fails, denial might be diverted or kept out of places in deliberative systems where it can do the most damage.

It is necessary to maintain healthy and productive responses to the stresses and declines associated with aging. A key factor is the choice of attitude. It is critical to see opportunities for growth in aging – they are there to be had. Aging is accompanied by declines in the speed of learning, working memory, and memory capacity. These declines are not caused by disease and are nearly universal. Devoting memory resources to what is important, and ignoring things that are not important is an excellent strategy. The best way to avoid negative emotions caused by events and experiences in the past is to be actively involved in the present moment and planning for the future. Meditation is a valuable method to practice letting go and enhancing your awareness of the opportunities that are available now. Aging also presents an opportunity to demonstrate self-compassion. Frequently, persons express compassion to others throughout their lives with loving devotion and selfless actions, without realizing that that are worthy of compassion themselves. Psychological reserve can be enhanced by attention to the development of self-compassion and appreciation of what give your life meaning.

The Saudi-led intervention in Yemen is a valuable case study in the coercive use of air power. Saudi Arabia’s bombing campaign demonstrates the danger of employing a punishment approach against a subnational actor in a multi-sided internal conflict. Strategies of collective punishment, blockade, and decapitation have all malfunctioned against a stubborn and resilient Houthi adversary. The early audit from Yemen endorses a denial strategy, supports the growing orthodoxy that air attack is most effectively applied in support of ground forces, and offers insight on the relative utility of interdiction and close air support for that purpose. The Saudi-led coalition’s performance also underscores how difficult it is to achieve positive objectives with proxy warfare, regardless of air support. This chapter dissects the campaign, assesses its effectiveness, and draws lessons about air power’s ability to influence the outcome of similar complex civil war scenarios elsewhere.

Against weaker states and nonstate actors, powerful air forces working with competent proxy ground forces have been militarily effective in almost all cases, but their political effectiveness has varied by ambition and target. Air power was most likely to be politically effective in denial strategies against weak states but least effective when attempting to coerce nonstate actors by punishment. Air power was far more effective in breaking armies and toppling regimes than restoring political order in the aftermath of regime change. Some but not all of the strategies of the age of primacy will survive the transition to an age of great power rivalry. The persistence of small wars against nonstate actors will leave space for refinement of advisory models, close air support, and counter-network targeting. But missions that were feasible in an era of unchallenged air supremacy – CAS and persistent ISR – may become extinct against enemies possessing resilient IADS and long-range strike capabilities of their own.

Chapter 6 deals with the legal and political forces determining the visibility of Israeli state violence against young Palestinians. First, it examines three ways in which Israel subjects Palestinians to its gaze or pressures them to internalize it: putting up threatening posters with photographs of Palestinian youth or their parents; taking pictures of unsuspected Palestinian youth; and soldiers filming their abuse of young Palestinians. Second, this chapter lays bare a range of Israeli practices and discursive techniques operating to conceal, downplay, and legitimize violence against young Palestinians: the prevention of such violence from being witnessed in real time; the destruction of incriminating evidence; restrictions on publishing unflattering information; the failure to record interrogations; torture methods that leave no physical marks; legally sanctioned secrecy; the impunity of alleged perpetrators; and their depiction as merely a few rotten apples. Finally, the chapter offers a rethinking of evidence. Israel and its human rights critics tend to privilege video footage and state agents’ testimonies, thereby validating both Israel’s dismissal of uncorroborated Palestinian allegations and its “rotten apples” narrative. It is argued that alternative types of evidence foreground the representation at work and can thus highlight the invisibility shrouding both state violence and young witnesses.

Plausible deniability is a common feature of political discourse that allows speakers to avoid taking responsibility for a controversial utterance by invoking possible counter-interpretations. To engage in plausible deniability, Trump invokes seemingly reasonable evidence to contest or refute that he meant what he said, foregrounding only select elements of the meaning-making process while downplaying others. Trump’s use of plausible deniability allows him to rally his base while feigning innocence when confronted about controversial remarks. Although common to politics, Trumpian discourse pushes this language game to the limits of credulity through frequent acts of strategic denying that arouse both supporters and critics. This chapter analyzes the way Trump and his allies engage in plausible deniability through the examination of several high-profile cases, introducing the linguistic concept of “implicature” to shed light on the discursive moves and interpretive processes that underlie attempts to invoke plausible deniability. Key to deconstructing each of these examples is an anthropological understanding of the interactional context in which political remarks are spoken and understood.

The topic of marijuana addiction is emotionally charged. The two aspects of addiction—withdrawal symptoms unique to marijuana and alterations in the brain’s reward mechanism common to all addictive drugs—must be approached separately. THC’s stimulation of CB1 receptors causes a homeostatic reduction of receptor density, called downregulation. When THC stimulation wanes, the resultant relative lack of receptors leads to a transient deficiency of endocannabinoid activity. Hirnoven found a 20% reduction in endocannabinoid receptors in the cortex of individuals regularly using marijuana requiring 4 weeks of abstinence to be reversed. The effects of cannabinoid deficiency outlined by Budney include withdrawal symptoms of restlessness, anxiety, insomnia, boredom and irritability. Relapse to marijuana use often occurs to abort withdrawal symptoms. The influx of dopamine in the reward center (nucleus accumbens) caused by excessive cannabinoid stimulation is the sine qua non for addiction and leads to a neurologically based increase in the salience of marijuana. Modification of reward mechanisms increases the motivation to use marijuana to the point that cognitive rationality is clouded and denial is produced.

Most people who use marijuana enjoy the experience and are going about their lives effectively. But there are others who crash and burn, or at least smolder, especially those in early adolescence. The largest community focused on concern for a loved one’s harmful involvement with alcohol and other drugs is found in Al-Anon Family Groups, which focus on maintaining understanding of the drug-induced neurologically-based salience of marijuana for their loved one and feeling compassion for their addiction. Al-Anon embodies the principle that we are powerless to force an addict to think differently, though we can educate ourselves about addiction, encourage them toward health, present factual information and reflect reality for them. We can learn nonjudgmental ways to respond to their denial, myths and rationalizations. Parental authority also stems from parental integrity – living a life that embodies what you hope children will learn. When adolescents refuse to stop using marijuana despite their parents’ firm insistence, a process of contracting for privileges and consequences can be useful.

In 1972, a localised rebellion against the Tutsi-dominated state triggered a ‘selective’ genocide against the Hutu population. This chapter considers the actions and representations of the rebellion, then examines the phases of genocidal repression: massacres in the areas affected by the rebellion, the elimination of prominent politicians, and the decentralised arrest and disappearance of key individuals across the countryside. It explores the processes of legal triage that authorised the murder of civilians through the categorisation of suspicious classes of local intellectuals, teachers, priests and successful traders. It devotes special attention to the role of the youth league in the local repression, partly captured by the control of information and the bureaucratisation of violence. It then considers the different faces of truth in violence: total state denial, the use of frank truth as hopeless protest, the lingering possibilities of loyalty to official truth, and the construction of new truths in the aftermath. The chapter ends with the popular renditions of a postcolonial order, in the nature of violent authority and ethnic community, as being revealed through violence.