I experienced episodes of severe mania and depression for most of my life. With the lack of help available to me at the time, and out of frustration, my first research project was on how people with psychiatric symptoms get well and stay well. Prior to my research and the implementing of self-help strategies, I underwent numerous hospitalizations and medication trials that weren't helpful. I have achieved long-term wellness and stability by using many of the coping strategies I learned through my research. For the last ten years, I've been studying how people who experience psychiatric symptoms relieve these symptoms and get on with their lives.

I wanted to share what I had discovered through my research and started publishing my findings. You may have read some of my books:

• The Depression Workbook: A Guide to Living with Depression and Manic Depression,
• Living without Depression and Manic Depression: A Guide to Maintaining Mood Stability,
• Wellness Recovery Action Plan,
• The Adolescent Depression Workbook,
• The Worry Control Workbook, and
• Winning Against Relapse.

I'm also the co-producer of the video Coping with Depression and producer of the audio tape, Strategies for Living with Depression and Manic Depression.

I have two new books, The Loneliness Workbook and a book on relieving the effects of trauma, entitled "Healing The Trauma of Abuse," written with Dr. Maxine Harris. All of these resources are based on my on-going study of the day-to-day coping strategies of people who experience psychiatric symptoms, and how people have gotten well and stayed well.

A Bit About My Personal Life

I am married, but have only been married to my husband for the last seven years. I was married twice previously --once for twenty years and once for five years--to men who were abusive. In those days, I didn't know that I had any value and that I should not allow myself to be treated badly. I have now learned those lessons well and my marriage is wonderful. However, I have regular appointments with a wonderful counselor who knows me well and who helps me build my self esteem--to cherish myself-- and reminds to take very good care of myself.

My husband and I work together. I write and teach about mental health self help and recovery. He takes care of administrative details, book sales and travel arrangements. We have a small farm and he manages our gardens and orchard.

My husband and I have seven grown children, a foster daughter and twelve grandchildren. Several of them live nearby and we enjoy rollicking family times together. I am sure my depression and mood instability have affected my children. Some of them have to work very hard to keep their moods stabilized. The good thing about that is that they know how to do it. And they know it is up to them, with the help they need from others, to do it for themselves.

I am trying to curtail my travel so I can spend more time at home. I am doing this by holding seminars in a nearby inn. These seminars are teaching participants basic recovery skills and how to share these skills with others. My goal in this work is to spread the word about recovery, self help and the Wellness Recovery Action Plan as widely as possible.

Self-help can work effectively either by itself or in conjunction with therapy and/or meds. In my view, the treatment scenario and the effectiveness of self help strategies depends on the willingness of the person to work hard on managing their symptoms, their preferences, and the cause and severity of the symptoms. In my work I do not advocate for or against any treatment protocol. I firmly believe that the person who experiences the symptoms must, if at all possible, determine the course of their own treatment. While this may be impossible when symptoms are very acute, that responsibility should be returned to the person experiencing the symptoms as soon as possible. If the person has a good crisis plan, they can stay in control even when their symptoms are out of control and they cannot make decisions for themselves.

In my own case, I use self-help along with counseling. I work every day to manage my symptoms. I have used psychiatric medications in the past, but have had allergic reactions to those that would be most helpful to me. In an emergency, I would use specific psychiatric medications to relieve the symptoms quickly.

I do work closely with a nutritionist and a naturopathic physician and, with their guidance, have made adjustments to my diet and take recommended food supplements and amino acids.

The purpose of this website is to:

1. educate people about recovery and the self help tools and strategies they can use to relieve psychiatric symptoms, or that they can share with others;
2. acquaint them with the Wellness Recovery Action Plan which can be used by people with any kind of illness or issue;
3. to empower people to take back control of their own lives
4. expand people's thinking about mental health care and treatment
5. reduce stigma against people who experience psychiatric symptoms
6. introduce you to self-help books and the other related resources
7. share stories of hope and recovery

I hope you get a lot from my site. I'm glad you came by.

Mary Ellen Copeland

next: The Purpose of the Mental Health Recovery Website
~ back to Mental Health Recovery homepage
~ depression library articles
~ all articles on depression

The words herbal and natural aren't synonymous with safe. Discover how some herbal products can be dangerous to your health.

Heavy Metals on Herbal Products

Excessive amounts of arsenic, lead and mercury have been found in some herbal products. Among 251 Asian medicines collected from herbal stores in California, 24 contained lead, 36 contained arsenic and 35 contained mercury. Da Huo Lo Dan (Herbal Pill), a commercial product containing 17 herbs, was found to contain excessive amounts of heavy metals. Some, but not all, herbal product manufacturers have their raw herbs assayed for heavy metal content.

Prescription Drugs with Harmful Substances

Prescription drugs such as phenobarbital, ephedrine, chlorpheniramine, NSAIDs, benzodiazepines, corticosteroids and methyltestosterone have been found in some herbal products, most often those containing multiple herbs that were manufactured overseas. Among 243 Asian medicines collected in California herbal stores, 17 contained undeclared pharmaceuticals. Five Chinese herbal products for control of blood sugar sold by two California companies were removed from the market in the U.S. after they were found to contain glyburide and phenformin. Cases of liver damage associated with the use of jin bu h uan (also known as jin bu huan anodyne), may have been due to adulteration with a Chinese pharmaceutical not listed on the label.

Misidentification of Herbs

The fact that some herbs can cause serious toxicity is well documented. The identification of raw herbs is traditionally made on the basis of appearance, taste, smell and feel. This may not be sufficient when the desired herb closely resembles a toxic botanical. In these instances, chemical analysis is required.

In some cases, misidentified herbs have caused serious adverse effects. The addition of a misidentified, toxic herb to a herbal product for weight loss marketed in Belgium resulted in severe kidney damage in about 100 women. Another herbal product containing the same toxic herb species, Aristochlia, caused kidney failure in two English women.

Summary

Herbal medicines can be manufactured and marketed without strict quality control or standardization, and consumers should consider the risks before using any herbal product.

The information on this web page is from the Rx Consultant newsletter and is included here, by permission, from the original article:

Rx Consultant

Traditional Chinese Medicine

The Western Use of Chinese Herbs

Paul C. Wong, PharmD, CGP and Ron Finley, RPh

next: Major Areas of CAM

Austin Vickers, Guest Author

This is one of the most powerful, over-all affirmations I have ever had the opportunity to experience. Make reading it part of your daily routine. Believe it, change your behavior accordingly and your life will be forever transformed! Thank you, Austin, for this magnificent gift to the universe. - Larry James

I acknowledge that every circumstance and relationship in my life is a direct or indirect result of choices I have made, or failed to make. I understand that I am the supreme creator of my life and everything in it, and I choose every day to accept my present circumstances and relationships exactly as they are, unless I am consciously acting to change them.

I believe that life is exactly as we choose to see it. All people, places and things can present both a negative and positive perspective. We, as observers, make the choice of which side we will focus upon. Because I want to fill my life with joy, I choose to recognize the positive in all things.

I will try to have every choice I make be consistent with the highest vision I have of myself. Rather than try to control or manipulate others to conform to my addictive behaviors or programming, I will allow others to simply be, and will learn to change my addictions into preferences. I know this is the only way I can be truly happy.

I know it is better to live my life without expectations or attachment to results. Although I may plan for the future, I must not become too attached to the fulfillment of those plans or I may miss other more fulfilling opportunities. If life takes me in a direction different than the one I have planned, I believe it is for my ultimate good.

I want to approach each and every moment of every day with the same level of enthusiasm, happiness, passion and present-moment focus as I have making love. Life and everything in it, like sex, is a wonderful experience that I know I must appreciate, using all of my senses to fully enjoy it.

continue story below

Honesty is one of the single greatest principles in life, and I will approach every person, circumstance or situation with a commitment to be honest with myself, to openly and honestly present my true thoughts and feelings to others, and to never lie, deceive or mislead another person.

I believe in being sensitive, and before acting or reacting to any situation or person, I will try my best to act or react in a way that I would want to be treated under the same circumstances.

I cannot judge any person, situation or thing for I do not know all of the facts. My experience with anything is limited to my interaction with that person, situation or thing - and that is not the complete picture. Therefore, I cannot judge whether anything or anyone is good or bad, right or wrong. I also know I should not judge myself too harshly, for I am a learning, loving human being that can draw strength from my weaknesses and experiences.

I recognize that I can only view life through my own rose-colored glasses, and the beliefs, opinions or standards of any group or person, including my own beliefs, are not necessarily universal truths.

I have a thirst and love for knowledge and understanding, and I recognize that true learning and growth comes only from effort, experience and a willingness to accept some new ideas, even if it means the rejection of previously held beliefs.

I love living and I know that a healthy body is an essential part of maintaining the quality of my life experience. Consequently, I will exercise my body and will feed it with healthy air, food and drinks, I will heal it and rest it when necessary, and I will treat my body with loving care. I will touch others and smile at others often, for it is my true nature to be kind. I will also laugh a lot.

I believe in God, Spirit, or the Soul - whatever name we give to that power in the universe that exists beyond our obvious senses. Life becomes magical when we see the clues that spirit offers and I will strive to find them. I also know that inviting Spirit into my life allows me to make better choices than I would otherwise make, for it allows me to view life from the perspective of heaven.

I believe that each of us can contribute to the world in some unique way. For me it is to share with others the principles that I hold dear, in the hope that these principles will benefit others as much as they have given benefit to me. I am fulfilled and happy when I act in service to others.

The real purpose of life is love. Love is our very essence, the all which created us and is us. This day I will work to remove that which blocks my love from flowing freely. I will learn to love myself and I will liberally share my love with others. I will be kind, understanding and compassionate. I will make love a daily focus and priority in my life, and I will try to fill every moment of my life and yours with love. I will tell you how much I love you as often as I can.

These are my governing principles. I have not yet attained to them, but I am struggling to do it. I may not ever totally achieve them, but you may. So go on! Learn what you may from me, open your eyes with the light that I offer, but learn to walk for yourself. Don't be afraid - I am walking too . . . not behind you or in front of you, but beside you making my own way. As we walk along together we can look out for each other . . . help each other. I will be there for you . . . and you for me . . . and together we will realize our dreams.

Copyright © - Austin Vickers. All rights reserved. Reprinted with Permission. - Austin Vickers is a former trial lawyer and has represented numerous Fortune 500 companies. In September 2000, Austin resigned his position at the top of his career to pursue full-time his passion for changing people's lives. In January 2002, Austin released his first book, "Soul Matters;" an in-depth discussion of the principles that lead to deeper peace, enduring happiness, and transformational love. He has gone from "missionary to mercenary and back again" in his life path and is committed to what he believes are the most sacred ideals; "TLC for the Soul: Truth, Love and Courage." Austin currently writes, speaks and teaches these principles and others in the fields of spirituality, relationship dynamics, life strategy and management. www.AustinVickers.com.

NOTE: Clicking on the book cover or link below will take you to that book on Amazon.com where you will find the list price, the price you will pay, how many $$$ you will save, how fast you can get it and if you choose, you can add it to your shopping cart and purchase the book. Shopping online with Amazon.com is 100% safe. GUARANTEED.

Soul Matters - Austin Vickers - This book is about learning how to be who you really are, how to recreate yourself, and how to love in action and reaction to all things. In essence, it is the advocacy of a new model of thinking designed to create lasting happiness and a deeper understanding of the principles that enhance our experience of the soul. Soul Matters provides principles and solutions for dealing with the frailties of the human mind and experience, and helps guide the reader to develop "TLC for the Soul: Truth, Love & Courage."

next: Some Things Can Be Fixed. . . Others Must Heal

What to do when you find yourself in the caretaker role for a person with a mental illness whose condition seems to be steadily deteriorating.

Supporting Someone with Bipolar - For Family and Friends

There are those among us who seem to be natural-born caretakers. Often it's due to the way we grew up in our nuclear families -- Mom was ill for years or Dad was an alcoholic, and the list goes on. Doesn't it seem that, as adults, caretakers would run toward normalcy? Unfortunately, it doesn't usually play out that way. For caretakers, what they knew as children was the norm.

In fact, we may pair up with someone who needs to be taken care of, so we can continue devoting the better part of our energies to a partner's problems. The years go by, with crisis after crisis, until the caretaker feels drained, frightened, and filled with despair. The caretaker may no longer feel healthy. He/she wonders if loving the ill partner even figures into the equation any longer. Meanwhile, the partner may turn on the caring spouse, seeming resentful and filled with hate and even rage toward the very person who has tried to make life bearable.

But the illness itself is another entity in the house, a strange, alien presence that exacts its toll. The ill partner may refuse to attend Alcoholics Anonymous groups, relapse, and start drinking more than ever. The depressed or bipolar partner stops taking medications and cancels appointments with the therapist. When the spouse had hoped fervently that they were finally on the road to a healthy relationship, the bottom falls out. Friends and family may have turned away, weary of the ill partner's abuse, insults, or weird behaviors, and the couple becomes isolated.

The healthy spouse dreams of cutting bait/jumping ship, but is filled with guilt and shame for "not being able to make it work." Worse, the spouse feels overwhelmed, and in psychic pain. What's the answer -- leave the relationship, or dig in for the long haul, no matter what? Again, this is one of those entirely personal decisions.

If you find yourself in the caretaker role for a person with a mental illness whose condition seems to be steadily deteriorating and you're at a loss about what to do next, it's likely that at some point you will need counseling for yourself. At very least, it may help you to understand what lies ahead, and to sort through your own options.

next: Taking Care of the Caregiver
~ bipolar disorder library
~ all bipolar disorder articles

Some children with ADHD need special accommodations which make it easier to sit for a school exam and produce a better result.

If your child with ADHD has a special educational need, you must plan early for any examinations he will be sitting. The fact that a student has a Statement of Special Educational Need does not qualify him automatically for special arrangements.

Regulations and Guidance Relating to Candidates with Particular Requirements is published each September for the approaching academic year, and is available from the organisations mentioned overleaf, from whom parents can obtain their own copies. It covers GCEs, VCEs, GC SEs and GNVQs.

Each autumn, this booklet is circulated by the English Examining Bodies to all examination centres (e.g. schools). It describes the special arrangements that are considered to be acceptable for students with special needs, what criteria have to be met and how to organise these special arrangements in examination situations. The booklet contains all the information and forms, which the Examining Bodies require schools, educational psychologists or others to complete for each candidate.

There is a clear requirement for continuity between the classroom and the examination room: "the candidate's usual method of working in the classroom will be considered by the Examining Body when special arrangements are being made".

Submitting Requests for Special Accommodations

Establishing and agreeing the nature and extent of the student's difficulties must beg early enough for the student to receive support and for special arrangements to be made in the classroom well before the request for special arrangements in examinations and assessments is submitted to the Examining Body. Assessment of your child's special educational needs and organising what on-going help he should receive in the classroom must begin as early as possible, therefore. The resulting documents and reports will then be available to support an application to the Examining Body when the student starts on his examination courses.

All requests for special arrangements must be supported with evidence in the form of a report from an appropriately qualified teacher completed within 2 years of the examination series, OR a report from a qualified psychologist proving a history of literacy difficulty completed or updated within 2 years.

It is vital that Heads of Examining Centres submit their requests on the appropriate forms as early as possible. Unless sufficient notice is given to an Examining Body it may not be possible to provide special versions of question papers, or to agree to any other arrangements.

Attention problems, language disorders, communication disorders including autism and Asperger Syndrome and emotional and behavioural problems are mentioned on page 38. "There are, however, others for whom particular special arrangements may be made, related to their own individual needs. ... For such candidates and others not specifically mentioned, early discussion with awarding bodies is essential so that decisions may be made on the nature of the evidence required and the arrangements that will be permissible. In most of these cases psychological and/or medical evidence will be needed."

Depending on the disability, special arrangements may be made, including amongst others: up to 25% extra time, supervised breaks/rest periods, enlarged print, Braille, OCR scanners, use of computers or word processors, modification of language or amplification for aural tests for the hearing-impaired, use of flashcards, colour overlays, dictation of answers onto tape, use of a prompter, use of an amanuensis, use of a practical assistant in practical examinations, alternative accommodation in exceptional circumstances.

Heads and Principals are empowered to grant the 25% extra time and/or rest breaks without prior application, but any additional. Extra time considered necessary must be applied for.

All other modifications have to be applied for, and it is crucial to make sure that your child's school, especially if it is a mainstream (i.e. not a special needs) school is fully aware of all these implications: early assessment of needs, on-going classroom intervention to address the needs, early requests for any special arrangements required during examinations backed by the appropriate forms and reports.

Patoss (Professional Association of Teachers of Students with Specific Learning Difficulties), www.patoss-dyslexia.org.

In the UK there is The Qualifications and Curriculum Authority (QCA). Here you will find details of a Booklet called "Special arrangements for the National Curriculum Assessment". On the site they say:

"The Qualifications and Curriculum Authority (QCA) is committed to building a world-class education and training framework that meets the changing needs of individuals, business and society. We lead developments in curriculum, assessments, examinations and qualifications.

Special Arrangements for the National Curriculum Assessment

Further clarification and information about some changes to special arrangements for the National Curriculum Assessment Tests are included in the Assessment and Reporting Arrangements booklets which QCA sent to all schools in October. These include:

• use of prompters;
• compensatory awards in the mental maths and spelling tests for pupils with profound hearing loss;
• special consideration - allows a pupil's final level to be adjusted in very exceptional circumstances;
• dealing with disruption during the test.

Guidance has also been updated on the use of word processors, amanuenses, transcripts and readers; special arrangements for the mental maths tests, and rest breaks. There is also more detailed guidance on the use of additional time and early opening of papers."

Suggestions For Parents / (Residential School) Teachers

Be aware of how your child or student's particular difficulties need way he affecting him/her at this time.

Preparation:

1. Take an interest in the exam timetable of your child/student. Offer to help with revision; liase with teachers; find out any concerns or stress triggers and aim to reduce these.
2. Ensure revision materials taken home at weekends 1 half terms with full instructions and schedules. Do not expect your child / student to he able to decide how much they should do, what they should do, etc. Advise. Liase.
3. Where at all possible make sure exam candidates are familiar with where they will be sitting their exam. If students have ADD/ADHD, ensure it is ADD/ADHD.
4. Talk them through what will happen when they arrive at the examination room. Are they able to 'line up' quietly? Do they understand all the rules of the examination room? Do they understand that someone - possibly unknown to them - will be invigilating?

The evening before:

1. Make sure any areas of likely upset (got his/her favourite breakfast cereal?) in the approach to exams are covered.
2. Don't plan anything tiring the night before. Make sure they have a relaxing time, have a good meal and plenty of water to drink, and get to bed early.
3. Get their clothes ready the night before - no panics first thing in the morning as to 'what to wear!'

The morning of the exam:

1. Make sure your child/student gets up in good time to shower, dress and eat a proper, relaxed, breakfast. Cooked one is best. Too much sugary food (i.e. cereals alone) gives quick but short 'lift', followed by a 'down mood. If exam is in the afternoon, make sure lunch too is a favourite but nutritious one.
2. Ensure they have the correct items for the exam/s they are taking that day: maths equipment, pen or pencil, eraser, ruler, calculator, etc.

Afterwards:

Know what time the exam finishes and how your child/student may be feeling. Consider some sort of treat ... favourite cake? Let them 'chill out' a bit.

Other:

1. Support your child/student all the way. Care for how they are feeling. Do not leave them to prepare alone. Do not be negative.
2. Remember that with some disorders, what you see is not what you get. For example, Asperger Syndrome anxiety will magnify the effects of the disorder. They may say they're OK and have a smiling face, but this may not be correct.
3. Help with relaxation. Watch out for obsessive tendencies and rituals taking over. 4. Send a good luck card. Send a well-done card - whatever the outcome!

Below is a list by Bonnie Mincuof possible accommodations which may be worth asking about. Bonnie is a business and personal coach, specializing in AD/HD. She is located in NYC. You can hire Bonnie by visiting Coach Network at Coaches and searching under "New York".

• Untimed testing
• Extended time testing (x 1 ½, x2, etc.) or lab work time (proctored/unproctored?)
• Coaching
• Tutors
• Composition assistance-e.g., special meetings w/ instructor, evaluation of rough drafts, editor review before submission.
• Note-taking assistance-equipment such as laptop computer or tape recorder (including recorder positioning at podium/teacher's desk).
• Note-taking assistance-scribes (note-takers): from paid professionals with specialized training/experience to paid students to volunteers to the copying of notes of peer classmates (privilege to have this done anonymously).
• Books-on-Tape (requires early booklist provision)
• Flexible scheduling of tests--time extension, optimum score of successive (repeated) administrations, subdividing exams into parts of days or over multiple days
• Flexible setting of tests--individual administration, small-group administration, adaptive or special equipment at the regular testing session, or at a separate location, auditory tape presentation of test items; use of aides to interpret test items; distraction-free environment; white-noise generator or Walkman with music via earphones or out loud if in a separate test area, earplugs
• Flexible test format-large print editions, changes in presentation in terms, changes in wording or format (e.g., line or item spacing, or emphasis [key words]) of directions, changes in format or space for answers, oral presentation of test, oral responses, oral presentation & responses ("oral exam"), taped responses, printed responses, masks to cover test portions
• Flexible rating format-e.g., optional special projects for credit with reduced emphasis on exams
• Markers/highlighters (in texts, in tests)
• FM radio transmission, teacher to hearing aid
• Magnification devices
• Calculator usage
• Electronic speller usage
• Access to computers in classroom
• Access to computers outside of classroom hours
• Allowing printing when standard specification is cursive
• Waiving of foreign language requirements
• Preferential instructor selection (for style)
• Early or preferential registration (for selection of times or instructors or class size)
• Reduced class size
• Reduced course load
• Single dorm room
• Counseling/advisement with mentor/adviser knowledgeable in ADHD
• Vocational Guidance
• Preferential seating (front of room; away from door or distractions; separate desk)
• Permission to stand/move in back of room during class or test; to take tests standing, on floor, or on desks
• Permission to leave class for brief periods without permissions per each.

• Watch the video on Narcissist Embarrassment

I was convinced that I possess an unerring sense of rhythm until my wife told me I had none. I thought that my comments, observations, and insights are original and pithy - until I discovered that I am numbingly verbose, repetitive, and coarse. I attributed to myself a great sense of humour until I re-read some of my writings and found how convoluted and dull my pitiful efforts at being witty were. To my mind, my prose was arabesque but lucid and incisive. I have since learned that it is no such thing.

This utter lack of self-awareness is typical of the narcissist. He is intimate only with his False Self, constructed meticulously from years of lying and deceit. The narcissist's True Self is stashed, dilapidated and dysfunctional, in the furthest recesses of his mind. The False Self is omnipotent, omniscient, omnipresent, creative, ingenious, irresistible, and glowing. The narcissist often isn't.

Add combustible paranoia to the narcissist's divorce from himself - and his constant and recurrent failure to assess reality fairly is more understandable. The narcissist overpowering sense of entitlement is rarely commensurate with his accomplishments in his real life or with his traits.

When the world fails to comply with his demands and to support his grandiose fantasies, the narcissist suspects a plot against him by his inferiors.

The narcissist rarely admits to a weakness, ignorance, or deficiency. He filters out information to the contrary - a cognitive impairment with serious consequences. Narcissistic are likely to unflinchingly make inflated and inane claims about their sexual prowess, wealth, connections, history, or achievements.

All this is mighty embarrassing to the narcissist's nearest, dearest, colleagues, friends, neighbours, even on-lookers. The narcissist's tales are so patently absurd that he often catches people off-guard. Unbeknownst to him, the narcissist is derided and mockingly imitated. He fast makes a nuisance and an imposition of himself in every company.

But the narcissist's failure of the reality test can have more serious and irreversible consequences. Narcissists, academically unqualified to make life-and-death decisions often insist on rendering them. I "treated" my father for muscular pain for five days at home. All that time, he was enduring a massive heart attack. My vanity wouldn't let me admit my diagnostic error. He survived. Many others don't. Narcissists pretend to be economists, engineers, or medical doctors - when they are not. But they are not con-artists in the classic, premeditated sense. They firmly believe that, though self-taught at best, they are more qualified than even the properly accredited sort. Narcissists believe in magic and in fantasy. They are no longer with us.

next: Grandiosity and Intimacy - The Roots of Paranoia

• Watch the video on The Narcissist Grandiosity Gap

The narcissist often strikes people are "laid back" - or, less charitably: lazy, parasitic, spoiled, and self-indulgent. But, as usual with narcissists, appearances deceive. Narcissists are either compulsively driven over-achievers - or chronic under-achieving wastrels. Most of them fail to make full and productive use of their potential and capacities. Many avoid even the now standard path of an academic degree, a career, or family life.

The disparity between the accomplishments of the narcissist and his grandiose fantasies and inflated self image - the "grandiosity gap" - is staggering and, in the long run, insupportable. It imposes onerous exigencies on the narcissist's grasp of reality and social skills. It pushes him either to seclusion or to a frenzy of "acquisitions" - cars, women, wealth, power.

Yet, no matter how successful the narcissist is - many of them end up being abject failures - the grandiosity gap can never be bridged. The narcissist's False Self is so unrealistic and his superego so sadistic that there is nothing the narcissist can do to extricate himself from the Kafkaesque trial that is his life.

The narcissist is a slave to his own inertia. Some narcissists are forever accelerating on the way to ever higher peaks and ever greener pastures.

Others succumb to numbing routines, the expenditure of minimal energy, and to preying on the vulnerable. But either way, the narcissist's life is out of control, at the mercy of merciless inner voices and internal forces.

Narcissists are one-state machines, programmed to extract narcissistic supply from others. To do so, they develop early on a set of immutable routines. This propensity for repetition, this inability to change and rigidity confine the narcissist, stunt his development, and limit his horizons. Add to this his overpowering sense of entitlement, his visceral fear of failure, and his invariable need to both feel unique and be perceived as such - and one often ends up with a recipe for inaction.

The under-achieving narcissist dodges challenges, eludes tests, shirks competition, sidesteps expectations, ducks responsibilities, evades authority - because he is afraid to fail and because doing something everyone else does endangers his sense of uniqueness. Hence the narcissist's apparent 'laziness"and "parasitism". His sense of entitlement - with no commensurate accomplishments or investment - aggravates his milieu. People tend to regard such narcissists as "spoiled brats".

In specious contrast, the over-achieving narcissist seeks challenges and risks, provokes competition, embellishes expectations, aggressively bids for responsibilities and authority and seems to be possessed with an eerie self-confidence. People tend to regard such specimen as "entrepreneurial", "daring", "visionary", or "tyrannical". Yet, these narcissists too are mortified by potential failure, driven by a strong conviction of entitlement, and strive to be unique and be perceived as such.

Their hyperactivity is merely the flip side of the under-achiever's inactivity: it is as fallacious and as empty and as doomed to miscarriage and disgrace. It is often sterile or illusory, all smoke and mirrors rather than substance. The precarious "achievements" of such narcissists invariably unravel. They often act outside the law or social norms. Their industriousness, workaholism, ambition, and commitment are intended to disguise their essential inability to produce and build. Theirs is a whistle in the dark, a pretension, a Potemkin life, all make-belief and thunder.

next: The Embarrassing Narcissist

• Watch the video on Dynamic Personality

The personality is not a static structure which immutably permeates our being. It is a dynamic, on-going, process. It is a series of cognitive and emotional interactions compounded by extraneous input and endogenous feedback. It is ever-evolving, though following our formative years, all subsequent changes are subtle and infinitesimal. This labyrinthine complex of reactions, behaviour patterns, beliefs, and defence mechanisms consumes a lot of psychic energy. The more primitive the personality, the less organized, the more disordered - the greater the amount of energy required to maintain it in a semblance of balance, however precarious.

The predicament of the narcissist, the histrionic, and the borderline is even more multifarious. People suffering from these all-pervasive and pernicious personality disorders externalize most of the available energy in an effort to secure narcissistic supply and, thus, regulate a vicissitudinal sense of self-worth.

Normally, one's energy is expended on the proper functioning of one's personality. The personality disordered devote any shred of vitality to the projection and maintenance of a False Self, whose sole purpose is to elicit attention, admiration, approval, acknowledgement, fear, or adulation from others. The "narcissistic supply" thus obtained helps these unfortunates to calibrate a wildly fluctuating self-esteem and, thus, fulfils critical ego functions.

Yet, the constant pursuit of this drug, the need to stay permanently attuned to one's human environment and to manipulate it ceaselessly - inevitably depletes the narcissist's vigor. His emotional exoskeleton - derived and Sisyphically constructed from the outside - is far more demanding than the normal endoskeletons that healthy people possess. To borrow from Freud, we can say that the narcissist sublimates his libido. He is an artist with himself as his sole creation. His entire energy is committed to the theatre production that is his False Self.

Hence the narcissist's constant fatigue and ennui, his short attention span, his tendency to devalue sources of supply, even his transformed aggression.

The narcissist can afford to dedicate resources only to the most promising founts of narcissistic supply. The "path of least investment" - criminal shortcuts, violence, cheating, con-artistry, lies and confabulations - is always preferred by the narcissist because his élan is so run down, his vitality so drenched, and his verve so exhausted by the unusual need to secure from the outside what most people effortlessly produce internally and take for granted.

next: Whistling in the Dark

"In a war, soldiers are forced to deny their emotions in order to survive. This emotional denial works to help the soldier survive the war but later can have devastating delayed consequences. The medical profession has now recognized the trauma and damage that this emotional denial can cause, and have coined a term to describe the effects of this type of denial. That term is "Delayed Stress Syndrome."

In a war, soldiers have to deny what it feels like to see friends killed and maimed; what it feels like to kill other human beings and have them attempting to kill you. There is trauma caused by the events themselves. There is trauma due to the necessity of denying the emotional impact of the events. There is trauma from the effects the emotional denial has on the person's life after he/she has returned from the war because as long as the person is denying his/her emotional trauma she/he is denying a part of her/himself.

The stress caused by the trauma, and the effect of denying the trauma, by denying self, eventually surfaces in ways which produce new trauma - anxiety, alcohol and drug abuse, nightmares, uncontrollable rage, inability to maintain relationships, inability to hold jobs, suicide, etc.

Codependence is a form of Delayed Stress Syndrome

Instead of blood and death (although some do experience blood and death literally), what happened to us as children was spiritual death and emotional maiming, mental torture and physical violation. We were forced to grow up denying the reality of what was happening in our homes. We were forced to deny our feelings about what we were experiencing and seeing and sensing. We were forced to deny our selves.

We grew up having to deny the emotional reality: of parental alcoholism, addiction, mental illness, rage, violence, depression, abandonment, betrayal, deprivation, neglect, incest, etc. etc.; of our parents fighting or the underlying tension and anger because they weren't being honest enough to fight; of dad's ignoring us because of his workaholism and/or mom smothering us because she had no other identity than being a mother; of the abuse that one parent heaped on another who wouldn't defend him/herself and/or the abuse we received from one of our parents while the other wouldn't defend us; of having only one parent or of having two parents who stayed together and shouldn't have; etc., etc.

We grew up with messages like children should be seen and not heard; big boys don't cry and little ladies don't get angry; it is not okay to be angry at someone you love - especially your parents; God loves you but will send you to burn in hell forever if you touch your shameful private parts; don't make noise or run or in any way be a normal child; do not make mistakes or do anything wrong; etc., etc.

We were born into the middle of a war where our sense of self was battered and fractured and broken into pieces. We grew up in the middle of battlefields where our beings were discounted, our perceptions invalidated, and our feelings ignored and nullified.

The war we were born into, the battlefield each of us grew up in, was not in some foreign country against some identified "enemy" - it was in the "homes" which were supposed to be our safe haven with our parents whom we Loved and trusted to take care of us. It was not for a year or two or three - it was for sixteen or seventeen or eighteen years.

We experienced what is called "sanctuary trauma" - our safest place to be was not safe - and we experienced it on a daily basis for years and years. Some of the greatest damage was done to us in subtle ways on a daily basis because our sanctuary was a battlefield.

It was not a battlefield because our parents were wrong or bad - it was a battlefield because they were at war within because they were born into the middle of a war. By doing our healing we are becoming the emotionally honest role models that our parents never had the chance to be. Through being in Recovery we are helping to break the cycles of self-destructive behavior that have dictated human existence for thousands of years.

Codependence is a very vicious and powerful form of Delayed Stress Syndrome. The trauma of feeling like we were not safe in our own homes makes it very difficult to feel like we are safe anywhere. Feeling like we were not lovable to our own parents makes it very difficult to believe that anyone can Love us.

Codependence is being at war with ourselves - which makes it impossible to trust and Love ourselves. Codependence is denying parts of ourselves so that we do not know who we are.

Recovery from the disease of Codependence involves stopping the war within so that we can get in touch with our True Self so that we can start to Love and trust ourselves."

2. Why can't drug addicts quit on their own?

Nearly all addicted individuals believe in the beginning that they can stop using drugs on their own, and most try to stop without drug addiction treatment. However, most of these attempts result in failure to achieve long-term abstinence. Research has shown that long-term drug use results in significant changes in brain function that persist long after the individual stops using drugs. These drug-induced changes in brain function may have many behavioral consequences, including the compulsion to use drugs despite adverse consequences. This may be the defining characteristic of addiction.

Long-term drug use results in significant changes in brain function that persist long after the individual stops using drugs.

Source: National Institute of Drug Abuse, "Principles of Drug Addiction Treatment: A Research Based Guide."

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