• Watch the video on Acquired Situational Narcissism

The Narcissistic Personality Disorder (NPD) is a systemic, all-pervasive condition, very much like pregnancy: either you have it or you don't.Once you have it, you have it day and night, it is an inseparable part of the personality, a recurrent set of behavior patterns.

Recent research (1996) by Roningstam and others, however, shows that there is a condition which might be called "Transient or Temporary or Short Term Narcissism" as opposed to the full-fledged version. Even prior to their discovery, "Reactive Narcissistic Regression" was well known: people regress to a transient narcissistic phase in response to a major life crisis which threatens their mental composure.

Reactive or transient narcissism may also be triggered by medical or organic conditions. Brain injuries, for instance, have been known to induce narcissistic and antisocial traits and behaviors.

But can narcissism be acquired or learned? Can it be provoked by certain, well-defined, situations?

Robert B. Millman, professor of psychiatry at New York Hospital - Cornell Medical School thinks it can. He proposes to reverse the accepted chronology. According to him, pathological narcissism can be induced in adulthood by celebrity, wealth, and fame.

The "victims" - billionaire tycoons, movie stars, renowned authors, politicians, and other authority figures - develop grandiose fantasies, lose their erstwhile ability to empathize, react with rage to slights, both real and imagined and, in general, act like textbook narcissists.

But is the occurrence of Acquired Situational Narcissism (ASN) inevitable and universal - or are only certain people prone to it?

 

It is likely that ASN is merely an amplification of earlier narcissistic conduct, traits, style, and tendencies. Celebrities with ASN already had a narcissistic personality and have acquired it long before it "erupted". Being famous, powerful, or rich only "legitimized" and conferred immunity from social sanction on the unbridled manifestation of a pre-existing disorder. Indeed, narcissists tend to gravitate to professions and settings which guarantee fame, celebrity, power, and wealth.

As Millman correctly notes, the celebrity's life is abnormal. The adulation is often justified and plentiful, the feedback biased and filtered, the criticism muted and belated, social control either lacking or excessive and vitriolic. Such vicissitudinal existence is not conducive to mental health even in the most balanced person.

The confluence of a person's narcissistic predisposition and his pathological life circumstances gives rise to ASN. Acquired Situational Narcissism borrows elements from both the classic Narcissistic Personality Disorder - ingrained and all-pervasive - and from Transient or Reactive Narcissism.

Celebrities are, therefore, unlikely to "heal" once their fame or wealth or might are gone. Instead, their basic narcissism merely changes form. It continues unabated, as insidious as ever - but modified by life's ups and downs.

In a way, all narcissistic disturbances are acquired. Patients acquire their pathological narcissism from abusive or overbearing parents, from peers, and from role models. Narcissism is a defense mechanism designed to fend off hurt and danger brought on by circumstances - such as celebrity - beyond the person's control.

Social expectations play a role as well. Celebrities try to conform to the stereotype of a creative but spoiled, self-centered, monomaniacal, and emotive individual. A tacit trade takes place. We offer the famous and the powerful all the Narcissistic Supply they crave - and they, in turn, act the consummate, fascinating albeit repulsive, narcissists.

 

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next: The Narcissist's Reality Substitutes

Perhaps the best brief summary of Diseasing of America.

North Shore (Vancouver) News, June 7, 1999
Reprinted with permission of North Shore News.

Ilana Mercer
Vancouver, Canada

An anti-drug rally held in Abbotsford last week and fronted by former heavy weight boxer George Chuvalo and federal MP Randy White sported the usual confused rhetoric about drugs and addiction.

It was a mixture of demands and accusations to government; the tone resembling an ideological hangover from the days of the Temperance Movement and the Prohibition, topped with a dose of AA scare tactics.

Incidentally, the misconceptions about addiction unite social conservatives and liberals alike. Both factions seem to feel it is the humane thing to describe what is essentially a problem of behaviour, as a disease, even though it is not.

Liberals as much as conservatives, support coercive means of treatment. All are oblivious to the stupidity of forcing an occasional user to confess to a life-long debilitating "disease." All are blind to the violation of liberty and the futility of forcing someone into rehab.

In a radio interview, MP Randy White expressed his well-meaning support for the disease conception of addiction.

Asked to explain why proponents of the disease model of addiction refuse to address the fact that drug addiction involves choices, values and preferences, he refused to do so.

"Have you not made a mistake ever?" he admonished the host.

As if embarking on a life of drugs was about one unfortunate glitch. The dangers of gathering more and more behaviours under the disease label is not something about which politicians or health-care specialists care to think, despite the scary ramifications for a society already committed to "morality lite" and to diminished personal responsibility.

One esteemed addiction researcher, Stanton Peele, is different.

In his book Diseasing of America, Peele states that the disease conceptions of misbehaviour are bad science, and morally and intellectually sloppy.

"Once we treat alcoholism and addiction as diseases," writes Peele, "we cannot rule out that anything people do but shouldn't is a disease, from crime to excessive sexuality to procrastination."

The application of the medical disease model to addictions was developed to "remove the stigma from these behaviours."

There is, however, no genetic marker for alcoholism or drug addiction. Still, the misconception that these behaviours are linked to a genetic vulnerability is aired repeatedly by the media, all in the absence of evidence.

The rationale for using the disease model to describe addiction, even though it is intellectually dishonest, is that medical treatment is effective. This is also untrue.

An overview of controlled studies indicates that "treated patients do not fare better than untreated people with the same problems."

The evaluation of one program for heroin addiction, for instance, showed a recidivism rate of 90% soon after treatment. This is because a behavioural problem cannot be remedied by medical intervention. Addicts are cured when they decide to give up the habit.

Most cigarette smokers who quit give up cold turkey with no help, and there is no indication treatment for smokers is any more effective than no treatment.

The disease conception of addiction is a means of separating the behaviour from the person.

Much like the flu, drugs are said to "get a hold" of you, to use Mr. Chuvalo's words when describing his son. But an honest look is always more productive than a clouded one, and an honest look at drug-use means we cannot separate it from a person's values, strengths or lack thereof.

Once someone becomes involved with drugs, we explain everything they do by saying it was because of the drug, neglecting in the process of this circular argument to note that the source of the addiction is the person and not the drug.

Heroin addicts are highly disposed to having social problems even before they become addicted. And good predictors of future drug use are truancy and smoking behaviour, indicating that certain people by virtue of their personality characteristics or social circumstances are more at risk than others. If you fail to hold the kid who goes astray responsible for his actions — then you cannot praise the kid who doesn't. That's the logic of diminished responsibilities all round.

Once again the myths about drug use in the general population come from what Dr. Peele calls "extremely self-dramatizing addicts who report for treatment, and who in turn are extremely attractive to the media." Which calls into question the wisdom of using video footage such as was used during the rally, in which a heroin addict, described in positive personal terms, tells about his life.

This portrays the addict as a hero, and separates the addict from his behaviour with the protective rampart of a disease label.

Indeed, there are activist groups downtown campaigning for respect for the addict, pointing towards the degree of confusion in our thinking. Because the more undeserved respect addicts get, the more events they attend as "witnesses," the more they will stay addicts and the more addiction will be glamorized.

Positive reinforcement increases rather than extinguishes behaviour. Pavlov's dog could tell you that.

Unfortunately, the various accelerated programs school kids are exposed to year in and year out are breeding out of them the protective effects of personal responsibility, and the healthy disdain for addicts.

They are taught by mouthpieces of the activist industry that "It" can happen to anyone, that they have little control and that once "diagnosed" as an addict always an addict.

This sets in motion — where there is already some drug use — a self-defeating cycle of abstinence and relapse, not to mention an overall rise in drug-related involvement.

All in all, most teens and college students outgrow their occasional binges and turn into responsible adults. For doing what teens and college students do as a rite of passage, youngsters do not deserve to be labelled diseased.

It is plain stupid.

The paranoia of the temperance and the prohibition era, which has culminated in AA disease dogma, needs to be replaced with an emphasis on personal, parental, and community power.

next: The Conflict Between Public Health Goals and the Temperance Mentality
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• Watch the video on Narcissism Misdiagnosed as General Anxiety Disorder

Anxiety Disorders - and especially Generalised Anxiety Disorder (GAD) - are often misdiagnosed as Narcissistic Personality Disorder (NPD).

Anxiety is uncontrollable and excessive apprehension. Anxiety disorders usually come replete with obsessive thoughts, compulsive and ritualistic acts, restlessness, fatigue, irritability, difficulty concentrating, and somatic manifestations (such as an increased heart rate, sweating, or, in Panic Attacks, chest pains).

By definition, narcissists are anxious for social approval or attention (Narcissistic Supply). The narcissist cannot control this need and the attendant anxiety because he requires external feedback to regulate his labile sense of self-worth. This dependence makes most narcissists irritable. They fly into rages and have a very low threshold of frustration.

Like patients who suffer from Panic Attacks and Social Phobia (another anxiety disorder), narcissists are terrified of being embarrassed or criticised in public. Consequently, most narcissists fail to function well in various settings (social, occupational, romantic, etc.).

Many narcissists develop obsessions and compulsions. Like sufferers of GAD, narcissists are perfectionists and preoccupied with the quality of their performance and the level of their competence. As the Diagnostic and Statistical Manual (DSM-IV-TR, p. 473) puts it, GAD patients (especially children):

"...(A)re typically overzealous in seeking approval and require excessive reassurance about their performance and their other worries."

This could apply equally well to narcissists. Both classes of patients are paralysed by the fear of being judged as imperfect or lacking. Narcissists as well as patients with anxiety disorders constantly fail to measure up to an inner, harsh, and sadistic critic and a grandiose, inflated self-image.

 

The narcissistic solution is to avoid comparison and competition altogether and to demand special treatment. The narcissist's sense of entitlement is incommensurate with the narcissist's true accomplishments. He withdraws from the rat race because he does not deem his opponents, colleagues, or peers worthy of his efforts.

As opposed to narcissists, patients with Anxiety Disorders are invested in their work and their profession. To be exact, they are over-invested. Their preoccupation with perfection is counter-productive and, ironically, renders them underachievers.

It is easy to mistake the presenting symptoms of certain anxiety disorders with pathological narcissism. Both types of patients are worried about social approbation and seek it actively. Both present a haughty or impervious facade to the world. Both are dysfunctional and weighed down by a history of personal failure on the job and in the family. But the narcissist is ego-dystonic: he is proud and happy of who he is. The anxious patient is distressed and is looking for help and a way out of his or her predicament. Hence the differential diagnosis.

Bibliography

Goldman, Howard G. - Review of General Psychiatry, 4th ed. - London, Prentice-Hall International, 1995 - pp. 279-282

Gelder, Michael et al., eds. - Oxford Textbook of Psychiatry, 3rd ed. - London, Oxford University Press, 2000 - pp. 160-169

Klein, Melanie - The Writings of Melanie Klein - Ed. Roger Money-Kyrle - 4 vols. - New York, Free Press - 1964-75

Kernberg O. - Borderline Conditions and Pathological Narcissism - New York, Jason Aronson, 1975

Millon, Theodore (and Roger D. Davis, contributor) - Disorders of Personality: DSM IV and Beyond - 2nd ed. - New York, John Wiley and Sons, 1995

Millon, Theodore - Personality Disorders in Modern Life - New York, John Wiley and Sons, 2000

Schwartz, Lester - Narcissistic Personality Disorders - A Clinical Discussion - Journal of Am. Psychoanalytic Association - 22 (1974): 292-305

Vaknin, Sam - Malignant Self Love - Narcissism Revisited, 6th revised impression - Skopje and Prague, Narcissus Publications, 2005

 

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next: Acquired Situational Narcissism

• Watch the video on Asperger Disorder and Narcissism

Asperger's Disorder is often misdiagnosed as Narcissistic Personality Disorder (NPD), though evident as early as age 3 (while pathological narcissism cannot be safely diagnosed prior to early adolescence).

In both cases, the patient is self-centered and engrossed in a narrow range of interests and activities. Social and occupational interactions are severely hampered and conversational skills (the give and take of verbal intercourse) are primitive. The Asperger's patient body language - eye to eye gaze, body posture, facial expressions - is constricted and artificial, akin to the narcissist's. Nonverbal cues are virtually absent and their interpretation in others lacking.

Yet, the gulf between Asperger's and pathological narcissism is vast.

The narcissist switches between social agility and social impairment voluntarily. His social dysfunctioning is the outcome of conscious haughtiness and the reluctance to invest scarce mental energy in cultivating relationships with inferior and unworthy others. When confronted with potential Sources of Narcissistic Supply, however, the narcissist easily regains his social skills, his charm, and his gregariousness.

Many narcissists reach the highest rungs of their community, church, firm, or voluntary organization. Most of the time, they function flawlessly - though the inevitable blowups and the grating extortion of Narcissistic Supply usually put an end to the narcissist's career and social liaisons.

The Asperger's patient often wants to be accepted socially, to have friends, to marry, to be sexually active, and to sire offspring. He just doesn't have a clue how to go about it. His affect is limited. His initiative - for instance, to share his experiences with nearest and dearest or to engage in foreplay - is thwarted. His ability to divulge his emotions stilted. He is incapable or reciprocating and is largely unaware of the wishes, needs, and feelings of his interlocutors or counterparties.

 

Inevitably, Asperger's patients are perceived by others to be cold, eccentric, insensitive, indifferent, repulsive, exploitative or emotionally-absent. To avoid the pain of rejection, they confine themselves to solitary activities - but, unlike the schizoid, not by choice. They limit their world to a single topic, hobby, or person and dive in with the greatest, all-consuming intensity, excluding all other matters and everyone else. It is a form of hurt-control and pain regulation.

Thus, while the narcissist avoids pain by excluding, devaluing, and discarding others - the Asperger's patient achieves the same result by withdrawing and by passionately incorporating in his universe only one or two people and one or two subjects of interest. Both narcissists and Asperger's patients are prone to react with depression to perceived slights and injuries - but Asperger's patients are far more at risk of self-harm and suicide.

The use of language is another differentiating factor.

The narcissist is a skilled communicator. He uses language as an instrument to obtain Narcissistic Supply or as a weapon to obliterate his "enemies" and discarded sources with. Cerebral narcissists derive Narcissistic Supply from the consummate use they make of their innate verbosity.

Not so the Asperger's patient. He is equally verbose at times (and taciturn on other occasions) but his topics are few and, thus, tediously repetitive. He is unlikely to obey conversational rules and etiquette (for instance, to let others speak in turn). Nor is the Asperger's patient able to decipher nonverbal cues and gestures or to monitor his own misbehavior on such occasions. Narcissists are similarly inconsiderate - but only towards those who cannot possibly serve as Sources of Narcissistic Supply.

 

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next: Misdiagnosing Narcissism - Generalised Anxiety Disorder (GAD)

It is important to keep in mind that the person with Alzheimer's Disease needs to be treated with dignity and respect.

Make sure you explain the person's cultural or religious background, and any rules and customs, to anyone from a different background so that they can behave accordingly. These may include:

• respectful forms of address
• what they can eat
• religious observances, such as prayer and festivals
• particular clothing or jewelry that they (or those in their presence) should or should not wear
• any forms of touch or gestures that are considered disrespectful
• ways of undressing
• ways of dressing the hair
• how they wash or use the toilet.

Acting with courtesy

Many people with Alzheimer's have a fragile sense of self-worth; it's especially important that people continue to treat them with courtesy, however advanced their Alzheimer's.

• Be kind and reassuring to the person you're caring for without talking down to them.
• Never talk over their head as if they are not there - especially if you're talking about them. Include them in conversations.
• Avoid scolding or criticizing them - this will make them feel small.
• Look for the meaning behind their words, even if they don't seem to be making much sense. Whatever the person is saying, they are usually trying to communicate with you about how they feel.
• Try to imagine how you would like to be spoken to if you were in their position.

Respecting privacy and Alzheimer's

• Try to make sure that the person's right to privacy is respected.
• Suggest to other people that they should always knock on the person's bedroom door before entering.
• If they need help with intimate personal activities, such as washing or using the toilet, do this sensitively and make sure the door is kept closed if other people are around.

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Offer simple choices and Alzheimer's

• Make sure that, whenever possible, you inform and consult the person about matters that concern them. Give them every opportunity to make their own choices.
• Always explain what you are doing and why. You may be able to judge the person's reaction from their expression and body language.
• People with Alzheimer's can find choice confusing, so keep it simple. Phrase questions so that they only need a 'yes' or 'no' answer, such as 'Would you like to wear your blue jumper today?' rather than 'Which jumper would you like to wear today?'

Expressing feelings and Alzheimer's

Alzheimer's affects people's thinking, reasoning and memory, but the person's feelings remain intact. A person with Alzheimer's will probably be sad or upset at times. In the earlier stages, the person may want to talk about their anxieties and the problems they are experiencing.

• Try to understand how the person feels.
• Make time to offer them support, rather than ignoring them or 'jollying them along'.
• Don't brush their worries aside, however painful they may be. Listen and show them that you are there for them.

Tips for making the person feel good about themselves

• Avoid situations in which the person is bound to fail, as this can be humiliating. Look for tasks they can still manage and activities they enjoy.
• Give them plenty of encouragement. Let them do things at their own pace and in their own way.
• Do things with them, rather than for them, to help them retain their independence.
• Break activities down into small steps so that they feel a sense of achievement, even if they can only manage part of a task.
• Our self respect is often bound up with the way we look. Encourage the person to take a pride in their appearance, and compliment them on how they look.

Sources:

• UK Alzheimer's Society - Carers' Advice Sheet 524

next: Respect and Caring for Someone with Alzheimer'

I saw this article I wanted to share with you. A very interesting perspective, even if you aren't into religion. The writer, Alice Fryling, is a speaker and author of   "A Handbook for Engaged Couples : A Communication Tool for Those About to Be Married."

History teaches us that people believe what they want to hear. Lies can sound so true when people are starving for truth. Even whole societies will feast on their promises. The Inquisition was based on the lie that some people could force other people to change their religious beliefs. American colonists believed the lie that people of one race had the right to own, buy and sell people of another race. More recently, hundreds of thousands of people believed Hitler's lie that the Jewish race should be eradicated. Most of us can hardly imagine that anyone could have believed these lies. And yet we swallow other lies all the time.

Our society is starving for intimacy. And many of the lies we believe in our culture have to do with our hunger for relationship. We want acceptance, loving relationships and deep intimacy, and yet we believe the lie that sex will satisfy our hunger. It's true that we are profoundly sexual beings, but it's time to examine some of the lies we feast on: the lie that premarital sex is one of our unalienable rights, the lie that sexual intercourse is the route to intimacy, and the lie that premarital abstinence is obsolete at best and repressive at worst. These are all lies.

We have bought into these lies because we are a starving people. We are people who long to be loved, touched and understood in a world of declining family ties and epidemic dysfunction. Our desires are certainly not new; they are as old as humanity. The difference in our world today is that people are trying to fulfill these longings in strange ways: through machines (TV's, CD players, and computers), through sports, material possessions, institutions and sex. Especially through sex. "Try it just once and you'll be fulfilled." "Go for variety and you won't be bored." "A life without sex is a life without belonging." Sexual experience has become a personal right, a need to be met and a norm to be accepted.

The tragedy of all this is that people are dying of emotional starvation, and they are looking for food in the wrong places. I would like to identify seven lies that our society is making about sex. The truth is that sex outside of marriage is not all it's cracked up to be. There is no pot of gold at the end of that rainbow.

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Lie #1: Sex creates intimacy. Genital sex is an expression of intimacy, not the means to intimacy. True intimacy springs from verbal and emotional communion. True intimacy is built on a commitment to honesty, love and freedom. True intimacy is not primarily a sexual encounter. Intimacy, in fact, has almost nothing to do with our sex organs. A prostitute may expose her body, but her relationships are hardly intimate.

Premarital sexual intercourse may actually hinder intimacy. Donald Joy writes that indulging in sexual intercourse prematurely short-circuits the emotional bonding process. He cites one study of 100,000 women that links early sexual experience with dissatisfaction in their present marriages, unhappiness with the level of sexual intimacy and a prevalence of low self-esteem (Christianity Today, October 3, 1986).

Lie #2: Starting sex early in a relationship will help you get to know one another and become better partners later. Sexual intercourse and extensive physical exploration early in a relationship do not reflect sex at its best. Of course there is sensual pleasure for those who engage in premarital sexual experiences, but they are missing out on the best route to marital happiness. Sex is an art that is learned best in the safe environment of marriage. I met with one student whose disappointment with her sexual encounters prompted her to overcome great embarrassment and ask me point blank: "Is sex in marriage as bad as it is outside of marriage?" She had arrived at the end of the rainbow, looking for the promised pot of gold, and she had found only disillusionment.

When unrestrained physical intimacy dominates a relationship, other parts of that relationship suffer. In healthy marriages, sex takes its natural place beside the intellectual, emotional and practical aspects of life. Married couples spend less time in bed than they do in conversation, in problem solving, and in emotional communion. The lie that premarital sex prepares you for marriage denies the fact that sexual happiness grows only through years of intimate relationship. The height of sexual pleasure, psychologists tell us, usually comes after ten to twenty years of marriage.

Good sex begins in the head. It depends on intimate knowledge of your partner. The Bible uses the words "to know" to describe sexual intercourse: "Adam knew his wife Eve and she conceived . . ." (Genesis 4:1, NRSV). This choice of words elevates human sexuality from mere animal sex where availability is the main requirement to a full, intimate expression of love and commitment.

Lie #3: Casual sex without long-term commitments is both fun and freeing. Those who settle for short-term sexual relationships are settling for second-best sex. Journalist George Leonard observed that "casual recreational sex is hardly a feast-not even a good hearty sandwich. It is a diet of fast food served in plastic containers. Life's feast is available only to those who are willing and able to engage life on a deeply personal level, giving all, holding back nothing." (Quoted by Joyce Huggett in Dating, Sex & Friendship, InterVarsity Press, p. 82.) For a woman, particularly, sex can reveal hidden fears and lack of trust. Good sex-which can be a healing agent over time-requires trust, trust which grows best in the context of the life-long commitment of marriage.

next: Talking Your Kids About Sex

Medication

Medications such as stimulants have long been employed in the treatment of Attention Deficit Disorder. These medications are presumed to improve a chemical imbalance in the brain which is causing the symptoms. The PET scan studies do show that the brain functioning of Attention Deficit Disorder patients does improve and appears to be more like the normal group after they have taken their prescribed medication.

Medications usually used to treat Attention Deficit Disorder stimulate the production of two neurotransmitters known as dopamine and norephinephrine. Specific neurotransmitters (brain chemicals) are necessary to carry a nerve impulse (message) along a neuropathway (circuit). When a neurotransmitter is under supplied, a message may be stopped short of its intended destination. When this happens, the function regulated by that circuit may not work as well as it should.

Brain circuits, like those of a computer are either on or off. When some circuits are on they make something happen such as helping a child focus on a learning situation. When other circuits are on they prevent something from happening. For instance, some circuits prevent emotional reactions to situations. If the circuit is not on or only partially on, the child may react too quickly to a minor incident which may lead to a temper tantrum.

Medications that treat Attention Deficit Disorder are not tranquilizers or sedatives. They do not slow down the nervous system. They actually stimulate various areas of the brain to be more active so that the attention and concentration functions and the self-control functions work better. The use of stimulant medications helps to keep the circuits on when they should be turned on.

Most individuals who are treated with medication take Ritalin® (a psychostimulant). This drug appears to be very beneficial for many who take it. Though Ritalin® has received much bad press, it is actually a very effective form of treatment and is relatively safe. When Ritalin® does not work or there are contraindications for its use, other amphetamine drugs may be used. Also, antidepressants and beta blockers have proven to be effective with certain individuals. Medication is the most frequently employed treatment method for Attention Deficit Disorder. It is often employed along with psychological techniques such as behavior modification and patient/family education. Focus is a psychoeducational program that designed so that it can be used as either an adjunct or as an alternative to medication.

Diet and nutrition

Scientific research does not support the use of diet and nutrition in the treatment of Attention Deficit Disorder. At one time, the Feingold Diet was very popular and seen as an alternative to medication. The elimination of sweets may help some individuals to reduce the symptoms but is usually not sufficient to adequately control the symptoms. Common sense, however, would dictate that a good diet and nutrition are suggested for the well being of any individual.

Supplements

One substance, L-Tyrosine, which is an amino acid (protein), has been demonstrated to be effective in some cases. This natural substance is used by the body to synthesize (produce) norepinephrine (a neurotransmitter) which is known to be elevated by the use of amphetamines. Many new "natural" products have been recently introduced into the market as "cures" for Attention Deficit Disorder.

Psychological treatment

Traditional child psychotherapy, such as play therapy or non-directive talking therapy, has not proven to be effective in the treatment of Attention Deficit Disorder nor has traditional family therapy. Providing individual psychotherapy for one or both of the parents also does not work. Research has demonstrated that modern psychological treatment methods, especially behavior modification, cognitive behavioral therapy and relaxation training can have a positive effect. In some studies, one or several of these techniques used in combination have proven to be as effective as medication in reducing Attention Deficit Disorder symptoms. Counseling alone is used not to provide treatment but to provide education for the child and the family to help them better understand the disorder and how to cope with it. Counseling may also be used to help build self-esteem that has been damaged as a result of having Attention Deficit Disorder.

Modern psychological treatment methods can result in actual changes in mental functioning When there are changes in mental functioning (how we think and process information) there are corresponding changes in brain function. Changes in brain function then results in changes in brain metabolism (how and where the brain is chemically active). Thus, mental functioning and brain chemistry can be altered without the use of medication. Even more important, some of the newer research indicates that changes in brain functioning with the resulting changes in brain chemistry, remain permanent over time. These studies emphasize the importance of using psychological methods in treating Attention Deficit Disorder either alone or in conjunction with medication. The ADD Focus Store has a number of items that can help ADD/ADHD children and teens improve their performance at school.

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This book is based on interviews with addicts and alcoholics who recovered without treatment. The authors draw important conclusions from, first, the phenomenon of self-cure, and second, from the methods used by addicts to "come clean."

In: Robert Granfield and William Cloud, Coming Clean: Overcoming Addiction Without Treatment
© Copyright 1999 Stanton Peele. All rights reserved.

Writing a preface to Coming Clean is a bit like being the best man at a wedding between two people you introduced—Bob Granfield (in the sociology department) and William Cloud (in the social work school) were both teaching courses at the University of Denver on drugs. Both were using my book Diseasing of America. When William learned this, he immediately contacted Bob—and one of the results is the volume that follows (as well as a strong friendship between the two men and their families).

Both Bob and William recognized that, as Diseasing and another of my books, The Truth About Addiction and Recovery, maintain, the disease theory of alcoholism and addiction does more harm than good. This approach is inaccurate and also self-defeating—how many people reckon they can improve their lives when they decide they are stricken with an "incurable" disease?

One proof that the disease theory is inaccurate comes when contemplating the words of such prominent disease theory advocates as Robert Dupont, former director of the National Institute on Drug Abuse. Dupont expressed the conventional disease wisdom when he wrote, "Addiction is not self-curing. Left alone addiction only gets worse, leading to total degradation, to prison, and ultimately to death."

But on what do Dupont and others of his persuasion base their view that addiction is incurable without their help? On the minority of patients who come to such professionals for treatment, the smaller minority who find such treatment helpful, and the finally tiny minority who maintain whatever benefits they acquire from stays in treatment programs or membership in AA and similar groups.

Yet, there is a large mass of people out there who refuse, reject, or fail at treatment. And this group is not helpless. Many of them, more in absolute terms and possibly a higher percentage of them than those who succeed at treatment, do get better. How would we hear about them? Some of the reasons they may have rejected treatment are that they don't like to call attention to themselves, or perhaps they refuse to acknowledge they are addicts, as treatment centers and AA and NA insist they must. And there certainly is no group to promote their success at self-cure.

But where is it written that the only route out of addiction is through attending group sessions and announcing you were born and will die an addict—one whose only salvation is the 12-step group or philosophy, acknowledgment of powerlessness, and submission to a higher power? Was this on the tablet Moses forgot to deliver to the children of Israel?

Forgive my sarcasm, but often the bromides of the 12-step movement are presented with exactly this degree of religious self-assuredness. And we know that nothing about humans is this cut and dried. William and Bob set about proving this in a way that confronts the disease theory at its most vulnerable point—all those individuals who succeeded without accepting its principles. As researchers, they identified self-curing addicts, ones who felt they were better off going it on their own, and who proved it.

Ask anyone you know in AA or NA or a treatment center about the people you will read about in this book. These professionals' reactions will be informative. They will speak of the denial of those who don't enter treatment or a 12-step group. You, in turn, must wonder about their own peculiar brand of denial—one that prevents them from recognizing the most common form of remission from addiction. This path, self-cure, is described in Coming Clean.

Here's a trick you can attempt at home—ask any 12-step counselor or group member what the hardest addiction is to quit. Inevitably, the person will indicate smoking. Then ask the person if he or she or a family member ever smoked and quit. If so, ask how he or she or the family member accomplished this—only one person in 20 will say it was due to therapy or a support group. Muse with this person over how, while believing all addiction requires treatment and group assistance to overcome, this person or those closest to him or her beat the hardest addiction on their own.

And so too is it with heroin, cocaine, and alcohol. While individuals who solve their problems with these substances on their own are often reluctant to come forward, theirs is the standard path to remission, not the one advertised by grateful 12-step program attendees. This startling conclusion—as driven home in this book—should cause us all to revise our notions of drugs, of addiction, of drug policy and treatment, and of our views on what people are capable of. Robert Granfield and William Cloud are to be commended, first for their strength of mind in determining the truths of addiction, and second for forcing Americans to confront their views on these topics. Even I, who played some role in directing the authors towards their recognition of the frequency and importance of natural remission in addiction, was forced to remind myself of the potency of human resolve and self-preservation by the remarkable stories told in Coming Clean.

next: How Does Social Class Affect Drug Abuse?
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Interview

Speaking with Judith Orloff was both a privilege and a treat. A psychiatrist, intuitive, and author of the new book "Dr. Judith Orloff's Guide to Intuitive Healing" (Times Books, 2000), Judith hails from a long line of doctors -- there are twenty-five physicians in her family including both her parents. As a child Judith was not allowed to talk much about her premonitions and in medical school she struggled to reconcile her intuitive abilities with her scientific studies. This struggle became the subject of her first book, Second Sight (Warner Books, 1997). It wasn't until her mother lay dying that Judith learned of her special legacy -- many of the women on her mother's side of the family were intuitive healers.

In both her private practice in Los Angeles and her assistant professorship at the University of California in Los Angeles, Judith passionately integrates intuition with conventional health care and healing. With the help of a UCLA resident, she works to create "a prototype for a new program in medicine". While the integration of intuition with medicine may be controversial today, Judith believes that in the future it will be "a moot point". In fact, change is already in the air. The prestigious and highly conservative American Psychiatric Association chose Judith to speak at their May convention in Chicago on "How Intuition Can Enhance Patient Care."

In her new book, Judith uses five basic steps to guide us as we travel the path towards discovering our inner voice, or intuition, which is really the voice of our spirit and our connection to all life. The book contains three parts: The Body, Emotions and Relationships, and Sexual Wellness. It is wonderfully well-written with a voice both compassionate and intelligent. I've read a fair number of books on similar subjects and this is the best.

In my own life, I've been frustrated with my inability to tap into my dreams. Using Judith's advice, I started keeping a dream journal and voila - the dreams are coming. But I think it's more than the simple act of journal keeping, which I've done before. Judith's abilities as a healer come through loud and clear in the pages of her book which I believe triggered something in me. This book can help you begin an exciting journey towards self-discovery.

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SML: You outline five steps throughout the book: 1) Notice your beliefs; 2) Be in your body; 3) Sense your body's subtle energy; 4) Ask for inner guidance; and 5) Listen to your dreams. They seem like an excellent framework to help us really get at ways to hear what's going on inside.

Dr. Orloff: When people want to develop their intuition, a strategy really helps. Most people feel intuition hits them spontaneously. It seems like an unknowable realm that they have no relationship with. I use the five steps to help my patients find something very real inside -- their intuition -- which I feel is the authentic language of spirit. I frame everything in terms of the five steps which I use in my own life as well. They penetrate the mystery and help people find the answer inside themselves that is most true, rather than just using their minds to make a list of positive and negatives. When we look at our beliefs we have to determine which are loving and which aren't since these beliefs shape the context of our healing. Notice which ones make sense and which are fear-based or outmoded, particularly about the body. In Western culture we have so much loathing for the physical body and its secretions. It's important to compassionately process those beliefs so they don't weigh us down in case illness comes. We don't want to be hating our body while at the same time trying to heal it. When we're clear about what we believe we create a very solid relationship with ourselves.

SML: Still, it must be difficult to get rid of beliefs that don't serve you even if you recognize them as such.

Dr. Orloff: It's very hard, but I believe people on a spiritual path need to make the decision to live a life based on love and to frame everything in that context. When we come upon a negative belief like, "I think I'm ugly," or, "I'm never going to succeed", we need to realize it's not the truth and try to bring a loving, compassionate view in order to reframe it. This is a philosophy that permeates everything. The universe is compassionate. It wants us to heal. I truly have an optimistic view.

SML: What about step two, be in your body?

Dr. Orloff: Most people live from the neck up and have no conception of the rest of their bodies. Part of healing is realizing that not only do we have a body but it's an incredible intuitive receptor. It give us clues we need to listen to. For instance, certain situations might make you feel nauseous or give you a headache or a knot in the stomach. It's about honoring the signals the body sends in every situation. It's also important to learn the workings of our bodies and where our organs are. I suggest that people get Gray's Anatomy Coloring Book or something similar. We have an absolutely gorgeous three dimensional universe inside us and nothing about it is yucky or weird. The way our culture is, especially womens' magazines that show just the surface - hair, skin, eyes, lips - we believe that's all we are.

SML: They make the rest unspeakable.

Dr. Orloff: Yes. It's taboo or disgusting.

SML: Then it's scary when something's happening inside and we don't have any idea what it is.

Dr. Orloff: Exactly. So if you do the kind of work I'm suggesting before you get sick you have a big head start.

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SML: What is the subtle energy referred to in step three?

Dr. Orloff: In addition to flesh and blood, our bodies are made up of energy fields that penetrate through the body and beyond it. When you're sensitive you can feel them projecting many feet outside the body. Hindu mystics call it shakti, Chinese medical practitioners call it chi. It is the same energy we understand as chakras. Some people have the ability to see it, others may feel it instead. When a lot of people get together, their energy fields combine which can be quite overwhelming if you don't know how to work with it. Children are especially sensitive to this energy. When I was a little girl, for instance, I couldn't go into shopping malls without coming out feeling exhausted. At that time I didn't understand what was going on. Now I know I'm what is called an intuitive empath. A lot of people are but they don't know it. As part of my workshops I teach people how to deal with subtle energy because so many are burdened by it. People in health care get burned out by their patients; agoraphobics can't go outside because they don't know how to process this subtle energy.

SML: Can you explain how to ask for inner guidance, step four?

Dr. Orloff: Most people don't know how to go inside and ask because they don't believe there's anything in there. So when a patient comes to me, my first task is to help them find something inside. I do this by gradually desensitizing them to the silence through meditation. People are very frightened of silence; they have misconceptions about it, and are unable to stay with it, but they must. If you want to find your intuitive voice you have to be quiet. You can ask for inner guidance for any kind of problem: a relationship, if you're thinking about going into business, if you're faced with difficult choices about healing such as chemotherapy or radiation treatment. All of these practical issues can benefit from asking for inner guidance. It's a way of correlating the external world of business forecasts or doctors' opinions with what's inside.

SML: How do we tell that voice from all the other voices in there?

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Dr. Orloff: There are a couple of ways. In my experience the intuitive voice comes through either as a neutral voice with information or as compassion. I question anything that comes through as fearful or that's too emotionally charged. I encourage people to keep journals about their intuitions and about their dreams. I've had premonitory intuitions or dreams that have come true in the next week or next year or even ten years later. With intuitive work it's critical to get feedback to see where you're accurate and where you're not.

SML: In my life I pay attention to signs or messages from nature when I'm unsure of what I'm doing or if I'm getting advice that doesn't sound right. A kind of communication happens. I see or hear the sign, like a sudden bird song or a cloud formation that is full of meaning and I just know what I see is the answer. And then I have to trust it of course.

Dr. Orloff: The hero's path is trusting it. So many people get signals like you describe and think it's weird or don't believe it. Great violence is done to the human soul when these signs or communications aren't acknowledged. It takes a strong belief to follow them independent of what others are saying and I know it's hard. I went through so many years of not trusting in my own life. I learned that nothing good ever comes from it. You have to learn to trust.

SML: I think once you know what it feels like to trust your inner knowing you never forget it and you can come back to it, compare this knowing to that one.

Dr. Orloff: That's the point. Once you have it, you can recognize it. It becomes real and you get stronger in your belief. For instance, with health problems the doctors could be saying one thing but you feel what they're telling you isn't right. You need the courage to believe in yourself. It's important to get into the habit of asking, "What should I do here?" and then listening -- not thinking or analyzing --just listening for what comes. Bringing intuition into a crisis situation gives you an organic link with what to do. It's important to get used to asking for inner guidance so that in times of crisis you'll have something to turn to.

SML: The last step, listening to your dreams, sounds so easy but sometimes they just don't come.

Dr. Orloff: And you can't force them. That's why I suggest people keep a dream journal next to the bed. It's also important not to wake up too quickly in the morning. You need to lay there for maybe five minutes just luxuriating between sleep and waking.

SML: How does an alarm clock fit into that?

Dr. Orloff: It destroys it.

SML: But most of us need to get up to an alarm clock on work days, at least.

Dr. Orloff: Allow enough time to put the alarm on snooze control for five minutes. Whatever you retrieve is vital. A lot of people dream metaphorically so those can be hard to interpret. If there's an emergency situation you can specify before you go to sleep, "Please give this to me in simple language so I know what to do". You can develop a dialog with the dream world.

SML: Does this take time?

Dr. Orloff: Yes.

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SML: So it's not like I'm going to be able to go to bed tonight and say something to myself and miraculously wake up tomorrow morning and have something to write down.

Dr. Orloff: You might. Sometimes it comes instantaneously. Sometimes it's a process that takes many weeks. It depends on how much a person wants it. Often if you're going through something challenging and your ego's too involved or the situation is so emotionally charged that you can't get to your intuition, you can turn to your dreams because the ego is by-passed in the dream realm, making it easier for information to come through.

SML: How can we let go of the hook fear has that prevents us from seeing clearly to help someone we love? For example, I know the universe is literally shouting at one of my sons to notice something because of what keeps happening to him. But my fear for his safety prevents me from seeing anything at all.

Dr. Orloff: You can always ask a dream because fear isn't translated in the dream realm. You can ask a question before you go to sleep tonight and then just let it go. In the morning don't wake up too quickly and see what you get. Another technique I use is to practice neutrality. Go into meditation and breathe, breathe, breathe. Ask Spirit to take away the fear so you can see clearly. Sometimes you have to put in a prayer to have the fear lifted because you may be afraid to see certain things. You have to be ready to accept what you see. Acceptance is a big part of spiritual practice. Of course we want children to be happy and healthy and not have to go through anything painful, but that's unrealistic. Each person has their own soul's growth path, whatever it may be. The way to find more neutrality is through the breath and by asking the fear to be lifted so you can see clearly.

SML: I found the sections on death and dying in your book especially interesting. It seemed like you were saying that fear of death inhibits our capacity to live full lives.

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Dr. Orloff: It does, especially in health care. Doctors are so afraid of death that it permeates everything. Intuition gives you the ability to really know there's something beyond this life. I feel very strongly that each of us needs to have a first hand experience that death is not the end. It should be part of our collective or cultural education. The work that can be done around death is to help people intuitively experience the transition first hand to know that it is absolutely safe to make this transition. We are in human form but our spirit isn't limited to it. This isn't a theory or philosophy; it's real. People need to know this and when they do, so much anxiety lifts. I work with all my patients on this level and I'm always working with at least one or two people who are making the passage.

SML: I was especially moved by your experience of being with your father when he died.

Dr. Orloff: Sometimes we are asked to be with those we love while they die. When we have a deep belief that death is not the end we can help a loved one pass over in such a beautiful way that we shine light on them as opposed to shining fear. It's part of loving someone. The time will come when we all have to leave here. I think about death every day. I have since I've been a little girl. Not in a morbid sense, rather as a touchstone to the cycles of spirit.

SML: My mother died of cancer eighteen years ago when I was pregnant with my youngest son. I wanted to be with her but it wasn't possible. She had a strong faith and wasn't afraid of death. I'm not either but what I've always been afraid of is the pain of losing someone I love. When I was little, I'd pretend that my cat and my mother had died so I could feel the grief and not be so overwhelmed when it happened.

Dr. Orloff: Grief is very different from the process of leaving the body. People need to understand this. Grief is tormenting and devastating. It's also purifying and healing. It calls for us to go deep into our hearts and gain courage and connection to the universe. Grief is an incredibly spiritual experience if you open up to it. I had the very clear realization that when my father died I was going to open my arms and let the winds of grief just blow through me whatever they were. It's wild and raw and purifying and it takes you to another place if you can open up to it.

SML: My mother came to me after she died. The last time I saw her I said, "I wish you could know this baby. But who knows, maybe in your own way you will." She replied, "Yes, who knows?" She died in August and Colin was born in December. The night after he was born we both fell asleep on the couch. Just before dawn I awoke and there was my mother standing at the foot of the steps. Immediately I knew this was her way of letting me know that she knew Colin. I have such peace because of that. I miss her of course, her physicality, our conversations, and hugs, but in a very real way she's just as much a part of my life now as she was when she was alive. She sends me dreams occasionally.

Dr. Orloff: Yes. And when people know that the spirit lives on it brings a lot of comfort and solace. It's common that loved ones come in dreams or visions to let you know they're okay. They sometimes come back in dreams as guides to offer us love or guidance when we're in hard periods. Another point to remember is that an intuitive disconnection does come after someone dies and it's important to honor this. It's a subtle energetic disassociation that is quite painful. It's like there's a hole that needs to be rewoven in a different way. You see, a real bond, the earthly bond, is cut and we experience it as pain. On an energetic level it's felt as an absence. It's wrenching but it does reweave itself.

SML: I was really struck by a statement you made when you were writing about someone losing a four year old child to cancer and how could there ever be a good reason for that? You said, "Faith in the face of the greatest possible loss may be more significant in the cosmic scheme of things than any one life itself, no matter how dear." To me it was one of the most profound sentences in the whole book.

Dr. Orloff: I agree with you. I'm impressed that you found it.

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SML: I believe in the evolution of consciousness as one of the reasons for life so I saw that statement as saying that having faith and loving in and of themselves have a purpose in the grander scheme of things and they may be even more powerful in times of great pain when it might be reasonable, and certainly easier, to rail against the injustice of God. I don't know if other people would resonate with it the same way but it gives a deeper purpose to something than just my own personal experience.

Dr. Orloff: It's something for people to contemplate.

SML: Another thing I thought about is that in other cultures in the past and even the present, maintain rituals where the family prepares the body for burial in a loving way. In our culture we consign these rituals to the undertaker.

Dr. Orloff: Exactly. In other culture the body is washed, dressed in robes that beautify, and loved. When my mother died my instinct was to hug her body. But no one was touching her so I thought there was something wrong with it. Then when my father died I just knew I had to stay with his body. I spent about an hour just touching him and letting go of him, preparing him in some way. Grief work can be facilitated by spending time with the body. Some people don't want to touch the body but if they do it's a beautiful way to say good-bye to the physical form.

SML: We're rather repulsed by it in this culture.

Dr. Orloff: Yes, but for me the grieving was so helped by being able to put my head on my father's chest and not hear his heart beat. That was a closure for me. It was important. Hopefully this article will give people permission to do these kinds of things so they can ease their own grief and gain closure.

SML: While I was reading your book I took lots of notes -- until I got to the section on sexual awareness. In fact, I was almost dreading getting to that part of the book.

Dr. Orloff: Really?

SML: Yes. Some of the relationships I've had were just so painful, especially the last one, that I felt like, as you mention in the book, my "veil was torn". There's a part of me that feels I'm never going to have a relationship with a man again. Is there a way to repair that veil?

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Dr. Orloff: Yes, of course. It regenerates itself through self-love. It absolutely does. I'm a big believer in keeping the heart open. I know what that's asking and I am fully aware that many people decide they don't want to love again because of how hurt they are. That's a path that might cause one to shut down. But it's your decision. There certainly are times for not being in a relationship for a while or perhaps never again. If your intuition is saying never again you have to trust that and try to love in different ways. There's no right or wrong. You have to do what your soul wants. If you ever feel a longing again to get involved, or that the shutting off is inhibiting you then healing work needs to be done. If you're feeling fine then you stay that way.

SML: I guess the chapter on sexual wellness was such a hook for me because I associate sexual wellness with sex so I though, well, this doesn't apply to me when, in fact, it does.

Dr. Orloff: I want to make the strong point that you don't have to be in a relationship to be erotic and sexual. It's part of our birthright as intuitive beings connected to the Earth. We can be madly erotic and sexual and never have intercourse. I know many women in particular who haven't been in relationships for a long time who feel their sexuality is on hold and it's just not necessary.

SML: One of the things that concerns me is the health of the Earth. How can we heal ourselves when the Earth is so polluted and degraded? There is a relationship between the health of the Earth and the health of our bodies and our spirits.

Dr. Orloff: Yes, there's an intimate relationship. Intuitively we are connected with all living things and so we can't help but feel the ravages of the Earth. You can't help but see the parallel in the prevalence of auto-immune diseases, for example. But human beings have an infinite capacity to regenerate and love is the key. If we work on loving ourselves and healing our bodies this will reflect to the Earth, too. There's an invisible, intuitive interconnection, an interspecies connection. You have to really know it and live it in the minutia of every day life. The more we live it, the more healing occurs.

Susan Meeker-Lowry is a writer who lives the White Mountains in Fryeburg, Maine with her family. Dr. Orloff's website can be found at www.drjudithorloff.com.

interviews index

next:Interviews: On Forgiveness An Interview with Dr. Sam Menahem

Two months ago, I lost a dear friend to cancer and it led me to think about the journey of the spirit that I was taken on through out the process of both the cancer and the spirit taking over my friend's life. Every day I went to see her, I would be brought back to the peace and calm of her journey until it enveloped me. Suddenly, my children were next to perfect gifts and my life was a walking dream.

I am so fortunate to have this incredible sunshine to always follow me, and it really made me wonder how a woman could give to me the gift of this incredible experience as she slowly withered and shrunk before my eyes. So large was her faith that it enveloped and surrounded me til one day it took over and I was able to deal with singing in the choir at her funeral and planning her luncheon afterwards. It was not until recently that I managed to see that each person we encounter leads us into a special and wonderful space all its own and that we are specifically chosen to go there.

As I now meet each person in my life, I am finding that they are there to enhance mine and I am seeing a whole new world. I pray this stays with me always, and that I can give back what I have received. I am so grateful to my friend for sharing with me how to grieve and what to do for myself in that. Your sight feeds and offers more of this to all who read it. Thank you for your insight, quotes and ability to reach. Also, there is a special place in this confused and crazy world for someone who can minister to the spiritually seeking and needy alike.

Written by Patti Dragland

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