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These ponderings attempt to let themselves be appropriated by the event. (Beiträge zur Philosophie (Vom Ereignis), Martin Heidegger, 1936–38/1989)
Thursday, August 20, 2026
Xi Jinping’s Taiwan Dashboard (Gregory J. Moore, 2025)
https://media.defense.gov/2025/Apr/29/2003700710/-1/-1/1/FEATURE%20-%20MOORE%20DISCLAIMER.PDF
Abstract
Xi Jinping’s calculus on Taiwan is not guided by mere opportunism but by a structured assessment of strategic, political, and military realities—his metaphorical “dashboard.” This article dissects 13 key indicators shaping Beijing’s decision on whether and when to invade Taiwan, alongside four enduring factors reinforcing China’s long- term objective to acquire Taiwan. The analysis finds that 11 of the 13 indicators favor near- term action, suggesting a closing window of opportunity that could drive Xi toward a military solution sooner rather than later. While China’s military readiness remains a consideration, the dynamics of US commitments, Taiwan’s shifting identity, and China’s economic and demographic pressures weigh heavily on the timeline. Coupled with Xi’s personal ambitions and his directive to the PLA to be ready for action by 2027, the balance tilts toward military escalation. Ignoring these hard truths invites peril; understanding them is imperative for policymakers navigating what may be the most volatile flashpoint in US foreign policy in the coming few years.
習近平攻台 13 + 1
「習近平攻台 13 + 1」 指的是美國國際關係學者莫凱歌(Gregory J. Moore)近期提出的台海局勢評估理論。他將習近平評估是否對台動武的條件比喻為一面「儀表板」,其中包含 13 項關鍵指標,而目前全球局勢的演變又催生了第 「+1」項新變數,使得北京在 2027 年 8 月前 犯台的風險顯著升高。 [1, 2]
- 台灣內部趨勢(紅燈):台灣民眾的自我身分認同持續遠離中國,認同自己是台灣人的比例攀升;且民進黨持續執政,政治社會氛圍讓北京感到愈拖延愈不利。 [1]
- 中國人口結構(紅燈):中國面臨嚴重的人口減少與高齡化,長期而言將壓縮適齡作戰人口的規模,增加維持高強度軍力的難度。 [1]
- 半導體供應鏈(紅燈):全球正逐步將高端晶片與半導體供應鏈移出台灣(分散風險),北京若想利用半導體作為制衡國際的籌碼,時間正不斷流失。 [1]
- 習近平個人野心(紅燈):習近平預計在 2027 年 8 月的中共黨代會與北戴河會議上尋求第四任期,若在此之前拿下台灣,能成為鞏固其黨內歷史地位與續任支持的極大籌碼。 [1]
- 暫時踩煞車的 2 項指標(綠燈/黃燈):分別是解放軍戰備完整度(越充分成功率越高)與中國當前面臨的經濟壓力(如銀行風險、青年失業、貿易摩擦等),這些經濟與內部不穩定因素是目前讓習近平相對謹慎的防禦性原因。 [1]
- 北京的戰略判斷:習近平與中共高層可能因此評估,華府在未來短期內將沒有足夠且持久的防禦資源能同時開闢第二戰場來全面支援台灣。這給了北京更強烈的理由「不再久等」,可能促使其將犯台時間表大幅提前。 [1]
Please tell me about the drug treatment of C-PTSD, thanks. (ChatGPT, 2026-8-20)
Certainly. The first point is rather important: as of 2026, there is essentially no established pharmacotherapy specifically for ICD-11 Complex PTSD (C-PTSD). Almost all drug evidence comes from ordinary PTSD trials and is then extrapolated to C-PTSD. The specifically “complex” component—ICD-11’s disturbances in self-organization (DSO): affect dysregulation, persistent negative self-concept, and relational disturbance—has remarkably little pharmacological evidence. A 2025 BMJ review likewise emphasizes individualized, usually multi-component treatment rather than a C-PTSD drug algorithm.
So, clinically, I would conceptualize medication in C-PTSD as symptom-modifying rather than disorder-curing:
|
Target |
Reasonable pharmacological approach |
Evidence |
|
Core PTSD syndrome |
Sertraline, paroxetine, venlafaxine |
Best established |
|
Depression/anxiety accompanying C-PTSD |
Usually SSRI/SNRI according to phenotype |
Reasonable |
|
Trauma nightmares |
Prazosin |
Useful specifically for nightmares |
|
Insomnia |
Treat symptomatically; sometimes sedating antidepressants clinically |
Much weaker PTSD-specific evidence |
|
Severe affective instability |
No established C-PTSD mood stabilizer |
Poor evidence |
|
Dissociation |
No established medication |
Very poor |
|
Negative self-concept / shame |
No established medication |
Essentially psychotherapy territory |
|
Relational disturbance |
No established medication |
Psychotherapy territory |
|
Psychotic/severe refractory symptoms |
Occasionally specialist antipsychotic use |
Exception rather than routine |
|
Benzodiazepines |
Avoid as routine PTSD treatment |
Evidence/risk unfavorable |
1. SSRIs/SNRI remain the pharmacological backbone
The current VA/DoD evidence assessment gives its strongest medication support to only three drugs:
sertraline, paroxetine, and venlafaxine. Sertraline and paroxetine are the two drugs FDA-approved for PTSD; venlafaxine has similarly good efficacy evidence.
Typical evidence-based PTSD ranges are:
- Sertraline 50–200 mg/day
- Paroxetine 20–60 mg/day
- Venlafaxine XR roughly 75–300 mg/day in the VA/DoD dosing table.
For C-PTSD, I would expect these drugs principally to reduce intrusive symptoms, hyperarousal, generalized anxiety and depressive affect. I would be much less optimistic that increasing the dose will somehow repair the characteristic C-PTSD phenomena of chronic shame, identity disturbance, attachment pathology, dissociation, or inability to trust another person.
That distinction strikes me as clinically fundamental:
Medication may turn down the volume of the alarm system; it does not reconstruct the damaged world of self-and-other.
And C-PTSD is disproportionately about the latter.
2. Prazosin: useful if the target is nightmares—not “C-PTSD”
Prazosin occupies an interestingly precise position. The 2023 VA/DoD guideline suggests it for PTSD-associated nightmares, while suggesting against using it for global PTSD symptoms.
The VA dosing appendix starts at 1 mg at bedtime, with slow titration, emphasizing orthostatic hypotension and first-dose syncope; its listed range is approximately 3–20 mg at bedtime.
So I would think of it as:
nightmare → prazosin, rather than
C-PTSD → prazosin.
This phenotype-oriented way of prescribing probably makes more sense throughout C-PTSD.
3. What about mirtazapine, trazodone, quetiapine, etc.?
Here everyday psychiatric practice and evidence-based PTSD guidelines separate somewhat.
Mirtazapine or trazodone may obviously be useful when depression + marked insomnia coexist, and quetiapine sometimes makes a dramatic symptomatic difference to insomnia, agitation or affective instability. But that doesn’t mean they are established C-PTSD therapies.
VA/DoD currently regards evidence as insufficient to recommend for or against mirtazapine, escitalopram, fluoxetine, duloxetine, pregabalin, quetiapine, olanzapine, lamotrigine, topiramate, and many others as PTSD monotherapy. Risperidone is specifically suggested against for PTSD; quetiapine and olanzapine have weak evidence with significant metabolic cost.
This suggests a useful distinction between:
treating the PTSD/C-PTSD, versus
treating something troublesome occurring in a person with C-PTSD.
Quetiapine for severe insomnia may accomplish the second without having demonstrated the first.
4. Mood stabilizers are less convincing than one might intuitively expect
This is particularly interesting in C-PTSD because affect dysregulation can look as though it ought to respond to anticonvulsant mood stabilizers.
But the evidence doesn’t really support that inference. Divalproex is suggested against for PTSD, and evidence is insufficient for lamotrigine and several others.
Obviously, if there is genuine comorbid bipolar disorder, that becomes a different matter. Indeed, VA/DoD explicitly cautions that antidepressants can destabilize bipolar illness and that this may necessitate mood stabilization.
This is another place where C-PTSD easily generates diagnostic confusion:
affect dysregulation ≠ bipolarity.
5. Dissociation is the pharmacological desert
For me, this is one of the biggest limitations of the whole pharmacological approach.
C-PTSD often includes derealization, depersonalization, emotional numbing, discontinuity of experience, body alienation, and sometimes striking fragmentation. There is no reliably established medication for dissociation itself.
Attempts involving naltrexone, lamotrigine and various serotonergic/glutamatergic strategies have produced scattered signals, but nothing remotely analogous to the SSRI evidence for depression.
And this perhaps tells us something about the level at which the pathology exists: dissociation is not simply “too much anxiety.” It is often an organization—or disorganization—of experience.
6. Benzodiazepines: particularly unattractive in complex trauma
VA/DoD strongly recommends against benzodiazepines for PTSD. There is no convincing evidence of sustained PTSD benefit, while concerns include dependence, cognitive impairment, disinhibition and potentially poorer engagement with trauma-focused psychological processes.
For C-PTSD, I think the objection is even more interesting than merely “addiction risk.”
Patients with chronic developmental trauma can understandably discover that benzodiazepines provide an extremely efficient way of achieving:
I don’t have to experience this.
That is precisely why they can become phenomenologically attractive—and therapeutically problematic.
Short-term, highly circumscribed use for another indication is of course a different clinical question, but I would avoid making benzodiazepines the organizing principle of C-PTSD treatment.
7. What about ketamine, MDMA and psychedelics?
This field is active, but we should distinguish excitement from established treatment.
The 2023 VA/DoD guideline suggests against ketamine as PTSD monotherapy because the evidence considered was inadequate, and does not currently recommend MDMA augmentation. A 2026 review of investigational PTSD drugs emphasizes how little pharmacological progress has occurred despite extensive work; only sertraline and paroxetine remain FDA-approved.
There is now interesting thinking about therapy-aligned entactogens specifically for complex PTSD, precisely because a drug might transiently modify fear, trust, social threat and plasticity sufficiently to alter what becomes possible inside psychotherapy. But this remains an emerging research program rather than routine C-PTSD pharmacotherapy.
And that distinction is conceptually fascinating: perhaps the future drug will not treat trauma, but temporarily alter the conditions under which another relationship to trauma can become possible.
8. My practical formulation
If I were reducing the pharmacotherapy of C-PTSD to a clinical algorithm, it would be something like this:
First, identify the pharmacologically tractable layer.
Intrusion/hyperarousal + anxiety/depression → sertraline / paroxetine / venlafaxine.
Dominant nightmares → consider prazosin.
Major depressive episode, bipolar illness, ADHD, substance-use disorder, psychosis, severe insomnia, etc. → treat the genuine comorbidity on its own terms, rather than pretending every symptom is C-PTSD.
Then stop asking medication to do things medication has very little evidence of doing.
In particular:
chronic shame → not an SSRI deficiency
fragmented identity → not a serotonin deficiency
inability to trust → not a norepinephrine disorder
relational reenactment → not something quetiapine repairs
dissociation → not simply insufficient antidepressant dosage
The 2026 C-PTSD psychotherapy literature makes essentially the complementary observation: established treatments can reduce conventional PTSD symptoms, while the DSO component is often harder to change.
So I would describe pharmacotherapy in C-PTSD as supporting treatment from underneath, rather than constituting the treatment itself.
And perhaps the most interesting implication is that C-PTSD exposes the limit of biological psychiatry unusually clearly: the further one moves from fear/intrusion/hyperarousal toward shame, selfhood, dissociation and relationship, the more rapidly the pharmacological signal fades. That does not make medication unimportant; it tells us which ontological level medication is acting upon.