Promise yourself to live your life as a revolution and not just a process of evolution.
Anthony J. D’Angelo
Stepping Stones Headline Animator
Friday, 28 August 2009
Attack thoughts towards others
There is no peace without forgiveness. Attack thoughts towards others are attack thoughts towards ourselves. The first step in forgiveness is the willingness to forgive........Marianne Williamson
Of course things don’t always happen the way we wish they would. There are moments in which we feel we are seeking something that is not meant for us, knocking on doors that don’t open, waiting for miracles that don’t manifest themselves.
But the true warrior of light believes.
Because they believe in miracles, the miracles begin to happen.
Because they are certain that their thoughts can change their lives, their lives begin to change.
Because they are certain they will find love, this love appears.
Sometimes they are disappointed. Sometimes they feel hurt.
Then they hear the comments, “you are so naïve!”
But the warrior knows it is worth the price.
To each defeat, there are two conquests in his favor.
Of course things don’t always happen the way we wish they would. There are moments in which we feel we are seeking something that is not meant for us, knocking on doors that don’t open, waiting for miracles that don’t manifest themselves.
But the true warrior of light believes.
Because they believe in miracles, the miracles begin to happen.
Because they are certain that their thoughts can change their lives, their lives begin to change.
Because they are certain they will find love, this love appears.
Sometimes they are disappointed. Sometimes they feel hurt.
Then they hear the comments, “you are so naïve!”
But the warrior knows it is worth the price.
To each defeat, there are two conquests in his favor.
Thursday, 27 August 2009
Distinct criticism of self-help groups from mental health professionals.
There has been distinct criticism of self-help groups from mental health professionals. Katz and Liu believe that groups working to a Twelve Step program are harmful because they do not promote the possibility of a full recovery, personal responsibility or self reliance. Instead the groups encourage life long membership in fear that the Codependent will not have learnt their lessons and are able to help themselves through any future difficulties. In contrast to this view they explain that many people who experience addictive or destructive behaviour do not go for treatment or to self-help groups, that they manage to break free of their behaviour via their own volition and commitment to getting better. They feel that recovery can only be made possible by a person's realisation that they have suffered enough and their own self motivation/commitment to their recovery. Once they have made the choice to get better the mode of treatment is not necessarily the most important factor in recovery.
They also stress that many people who join self-help groups "are not true addicts. They are people with problems who need guidance and support and acceptance, but they are not powerless. They can recover completely. They can achieve self-reliance. For these people self-help programs may provide the best way to begin the recovery process but in the long run they do more harm than good." (Katz and Liu pg. xiv -xv of Introduction).
Katz and Liu also argue that self-help groups do not place enough emphasis on the conditions that members experience as being a result of their own choices and actions. That in self-help groups they are told "something" has happened to affect the individual, that someone or something else was responsible. "The overriding lesson of the Steps is not personal responsibility and morality, but conformity and dependence." pg. 48. They compare self-help groups to cults who "maintain that salvation lies in the ability to give yourself up to a Higher Power. But that the real key to salvation is not relinquishing the control to a treatment program or guru or your Inner Child. The highest power lies within your own fully developed Self." pg. 23. They also identify through a number of patient cases that sometimes the groups views are so ingrained in the minds of its members that it appears like brainwashing. Members can rattle off chapter and verse of the Twelve Steps program and treat anyone who does not wish to succumb to its teachings/help as being in "denial".
They also feel that the Codependency movement places too much emphasis on relationships in the home being the only factor in creating people with behavioural/addictive problems. They do not look at wider influences such as friends, colleagues or the media. They highlight that studies have also shown that growing up in a dysfunctional family doesn't necessarily mean a child born in to it will grow up requiring psychological treatment in adulthood. That sometimes things work out all on their own and the adult is able to work out their own issues to build a happy life for themselves.
Katz and Liu further criticise self-help groups for perpetuating "disease theory" and unnecessarily pathologising people who are essentially normal but may need a little guidance to help them get through stressful situations and bad times. They state the groups help to keep members in the past, focusing on the need to control old behaviours that may or may not appear again in the future. The repetitive nature of the discussions they have in groups keeps the memory of how it felt in the past when someone abused them in the forefront of their minds and as a result members will relate to those feelings in all future relationships. They argue that this doesn't promote self-reliance because people are still clinging to old situations, old partners, old feelings etc. where they were reliant on something or someone else.
All people are different; they react differently to different events and to different treatments. Some psychologists have concerns that self-help groups do not provide individual treatment. Katz and Liu advise that other conditions and issues are not discussed in self-help groups concentrating on a specific area and as a result even minor incidents can linger as a "reason" for the pain. In addition the Twelve Steps were adapted from guidelines to help those specifically suffering from Alcoholism a very different condition at a time when religion was still prevalent in society.
One of the most obvious and damming criticisms of self-help groups are that they are not regulated by an official body. There is no measure of the standard of care that participants are receiving as a result of "working the program". The groups are not lead by professionally trained Therapists. Usually the only requirement to being a group leader is that you have experienced the condition personally and that you are knowledgeable in the workings of the Twelve Steps program. Katz and Liu maintain that just because someone has experienced the same conditions and feelings as you doesn't necessarily mean that they are the best people to guide you through your recovery. They feel that people who have themselves been successful in areas you are not are probably in a better position to be able to do this.
The second option open to a Codependent is therapy. By this means Katz and Liu feel a person is more likely to receive a non biased evaluation of their condition from a trained professional who is objective (hopefully having a healthy sense of Self and a respect for others) and can provide them with individual treatment to address their problems and issues. They are also more likely to get help that is focused on self-reliance as opposed to dependence on a group dynamic for future support. They do accept that mixing a group dynamic with Therapy can be beneficial in allowing the patient to identify with others who have gone through similar experiences but they do not see self-help groups as being a suitable long term treatment.
Medication can also be prescribed by a doctor for symptoms that a Codependent experiences such as depression, high blood pressure etc. in conjunction to any other therapy that is chosen.
Patterns of "Failed Love"
Patterns of "Failed Love"
In his book "If Love Could Think" Gratch outlines seven patterns of "failed love" relationships that he has observed through treatment of patients. I have included them in this section on Codependency because I personally believe that many of them are reflected in codependent relationships.
The first pattern is Narcissistic Love. Narcissists are needy, often self-destructive people with hidden low self-esteem and as such they require someone who is willing to cater to their needs. This person is usually required to give up their own needs for those of the Narcissist. Gratch warns that "if you are generally a giving, supportive person who avoids center stage and thrives on taking care of others, you are naturally at risk for Narcissistic Love." pg. 37.
Narcissists need an Echo, someone who can mirror their view of themselves as special. Like a Codependent the mythical Echo is a reactionary, she doesn't initiate speech she is compelled to wait for others to speak first. Echo herself has leanings towards narcissism because she seeks to regulate her self-esteem through Narcissus. She wants to be like him but feels she can't. She wants to be by his side so she can reflect some of his power, confidence, strength, beauty etc. In this way if he does well and is respected by others and she takes care of his needs, she too does well and is respected.
Narcissistic relationships often encounter difficulties because they are based on an idealised image that neither the Narcissist nor their partner can live up to long term. Whilst Gratch maintains that "falling in love always involves some idealization" pg. 34 he shows that the idealisation and devaluation in these types of relationships makes for unstable relationships.
He also states it is possible to gauge if someone is in Narcissistic love by looking at their sense of self "the greater the discrepancy between our previous sense of self and our current, while in love, the greater the chances that we are using the other person for internal narcissistic reasons" and that in "more realistic love what makes us feel valued is the connection with the other person, not the external goods they bring to our life. In Narcissistic Love, on the other hand, we can't quite be certain that if our partner suddenly lost his money or power or health or youth, we would still want to be with him." pg. 35. Also if "our feelings for our date or partner change in accordance with how he is viewed by others" pg. 36 this is another indicator of being concerned with our image.
The second pattern is Virtual Love. This is when "We are in love with a prefabricated construction of our own making, which has little to do with the actual person we are dating. Unfortunately, we don't always know this early enough in the relationship because unconsciously we choose people and situations that obscure reality." pg. 55. This is evident in passionate long distant relationships and love that blossoms through the Internet. These relationships are not built on true intimacy and as a result when a couple finally decides to make a real go of the relationship possibly relocating so they can live together or meeting up in real life they are disappointed to find that the other person doesn't match up to their expectations.
The third pattern is One-Way Love. Here there is an "inclination to fall in love or be drawn to emotionally unavailable people" pg. 91. On the flip side there is also a strong tendency not be interested in people who are attracted to you, emotionally available and capable of returning your love. Gratch advises that this is as a result of a need to "hold on to the fantasy of perfect beauty, intelligence, and spirituality and thereby cling to the illusion of pure love." pg. 91.
In addition some people can alternate between being in love with someone who is unavailable early on in the relationship, then loose their feelings of love for them if the other person starts to love them back. This kind of relationship can yo-yo back and forth as both take turns falling in and out of love with each other.
Gratch warns that it is necessary to break the pattern of this type of love early on in adulthood and those who are in their 30's and 40's are less likely to be able to change their pattern in time to find a suitable partner as a result of what he sees as a "market economy" where by "the best candidates are picked early." pg. 98. However, while his view may be initially correct, in a modern world where many people are deferring making commitments to other people in early adulthood, delaying marriage and having children there may be scope to be able to work on breaking the pattern of one-way love and going on to develop a satisfying relationship later on in life. There may also be prospective partners who work on issues later in life that also go on to recover and form good relationships.
The fourth pattern, Triangular Love, operates on the dynamic that another person or thing is present as a barrier within the relationship. This type of relationship usually involves one of the partners having a lover outside of the relationship but it can involve the commitment of a partner to a hobby, sport or job. It can also be a relationship with a particular friend or family member.
Having a third person or interest in the relationship is an unconscious act that purposefully triangulates the relationship to detract from the fact that the parties involved have not come to terms with their mixed feelings for their partners. Even the partner who is the "victim" represses the "bad" feelings they have towards their partner preferring to blame the third party or the activity rather than accept that there is something else wrong with the relationship.
The fifth pattern is that of Forbidden Love. Here two lovers may come together amidst social disapproval because the relationship goes against social norms and values. The lovers may come from different religious backgrounds, different cultures, the same family, or involve relationships where one person is seen to abuse their position e.g. a romance that blossoms between a Teacher and their student. Often people get into such relationships without accepting the difficulty of their situation in terms of how they will be perceived and treated by other people outside the relationship. The excitement of meeting up in secret can make everything seem worthwhile but as time goes on the risk of getting found out or wanting to be together permanently makes it hard to avoid being caught and criticised. When the relationship is out in the open often the passion fades and the partners face the reality that the relationship doesn't fit in to their place in society or that the excitement is gone.
The sixth pattern is Sexual Love. In this type of relationship the emphasis is on the physical side of the relationship and not the emotional. Maybe the partners come together perfectly in the bedroom but fail outside of it, possibly one of the them has multiple affairs or an addiction to sex. It could even be that one uses sex as a means to feel better about themselves. Sometimes there is no sex in the relationship at all because one of the partners has extreme sexual fantasies that they are ashamed of. Ultimately relationships that are based solely on sexual feelings do not last the test of time as the women will tend to feel used and the men tend to feel guilty.
The final pattern is that of Androgynous Love. In this relationship the socially accepted gender roles are reversed. The woman is the strong, assertive, ambitious type and the man is the sensitive, nurturing one in the relationship. These dynamics usually arise as a reluctance of at least one of the lovers to identify with their same sex parent e.g. a woman who saw her mother as a doormat for an aggressive father may vow not to be like her when she grows up and has relationships of her own. Gratch explains that in these circumstances a strong woman may become frustrated with a sensitive lover over time if he is not driven or doesn't behave like a man because she will see them as a "wimp". Conversely a man who picks a strong woman may end up seeing her as a "bully". To overcome this Gratch feels that each needs to take time to tune in to their natural disposition which is largely dictated by their sex, that they take on some of the characteristics of their same sex parent in order to redress the balance.
In his book "If Love Could Think" Gratch outlines seven patterns of "failed love" relationships that he has observed through treatment of patients. I have included them in this section on Codependency because I personally believe that many of them are reflected in codependent relationships.
The first pattern is Narcissistic Love. Narcissists are needy, often self-destructive people with hidden low self-esteem and as such they require someone who is willing to cater to their needs. This person is usually required to give up their own needs for those of the Narcissist. Gratch warns that "if you are generally a giving, supportive person who avoids center stage and thrives on taking care of others, you are naturally at risk for Narcissistic Love." pg. 37.
Narcissists need an Echo, someone who can mirror their view of themselves as special. Like a Codependent the mythical Echo is a reactionary, she doesn't initiate speech she is compelled to wait for others to speak first. Echo herself has leanings towards narcissism because she seeks to regulate her self-esteem through Narcissus. She wants to be like him but feels she can't. She wants to be by his side so she can reflect some of his power, confidence, strength, beauty etc. In this way if he does well and is respected by others and she takes care of his needs, she too does well and is respected.
Narcissistic relationships often encounter difficulties because they are based on an idealised image that neither the Narcissist nor their partner can live up to long term. Whilst Gratch maintains that "falling in love always involves some idealization" pg. 34 he shows that the idealisation and devaluation in these types of relationships makes for unstable relationships.
He also states it is possible to gauge if someone is in Narcissistic love by looking at their sense of self "the greater the discrepancy between our previous sense of self and our current, while in love, the greater the chances that we are using the other person for internal narcissistic reasons" and that in "more realistic love what makes us feel valued is the connection with the other person, not the external goods they bring to our life. In Narcissistic Love, on the other hand, we can't quite be certain that if our partner suddenly lost his money or power or health or youth, we would still want to be with him." pg. 35. Also if "our feelings for our date or partner change in accordance with how he is viewed by others" pg. 36 this is another indicator of being concerned with our image.
The second pattern is Virtual Love. This is when "We are in love with a prefabricated construction of our own making, which has little to do with the actual person we are dating. Unfortunately, we don't always know this early enough in the relationship because unconsciously we choose people and situations that obscure reality." pg. 55. This is evident in passionate long distant relationships and love that blossoms through the Internet. These relationships are not built on true intimacy and as a result when a couple finally decides to make a real go of the relationship possibly relocating so they can live together or meeting up in real life they are disappointed to find that the other person doesn't match up to their expectations.
The third pattern is One-Way Love. Here there is an "inclination to fall in love or be drawn to emotionally unavailable people" pg. 91. On the flip side there is also a strong tendency not be interested in people who are attracted to you, emotionally available and capable of returning your love. Gratch advises that this is as a result of a need to "hold on to the fantasy of perfect beauty, intelligence, and spirituality and thereby cling to the illusion of pure love." pg. 91.
In addition some people can alternate between being in love with someone who is unavailable early on in the relationship, then loose their feelings of love for them if the other person starts to love them back. This kind of relationship can yo-yo back and forth as both take turns falling in and out of love with each other.
Gratch warns that it is necessary to break the pattern of this type of love early on in adulthood and those who are in their 30's and 40's are less likely to be able to change their pattern in time to find a suitable partner as a result of what he sees as a "market economy" where by "the best candidates are picked early." pg. 98. However, while his view may be initially correct, in a modern world where many people are deferring making commitments to other people in early adulthood, delaying marriage and having children there may be scope to be able to work on breaking the pattern of one-way love and going on to develop a satisfying relationship later on in life. There may also be prospective partners who work on issues later in life that also go on to recover and form good relationships.
The fourth pattern, Triangular Love, operates on the dynamic that another person or thing is present as a barrier within the relationship. This type of relationship usually involves one of the partners having a lover outside of the relationship but it can involve the commitment of a partner to a hobby, sport or job. It can also be a relationship with a particular friend or family member.
Having a third person or interest in the relationship is an unconscious act that purposefully triangulates the relationship to detract from the fact that the parties involved have not come to terms with their mixed feelings for their partners. Even the partner who is the "victim" represses the "bad" feelings they have towards their partner preferring to blame the third party or the activity rather than accept that there is something else wrong with the relationship.
The fifth pattern is that of Forbidden Love. Here two lovers may come together amidst social disapproval because the relationship goes against social norms and values. The lovers may come from different religious backgrounds, different cultures, the same family, or involve relationships where one person is seen to abuse their position e.g. a romance that blossoms between a Teacher and their student. Often people get into such relationships without accepting the difficulty of their situation in terms of how they will be perceived and treated by other people outside the relationship. The excitement of meeting up in secret can make everything seem worthwhile but as time goes on the risk of getting found out or wanting to be together permanently makes it hard to avoid being caught and criticised. When the relationship is out in the open often the passion fades and the partners face the reality that the relationship doesn't fit in to their place in society or that the excitement is gone.
The sixth pattern is Sexual Love. In this type of relationship the emphasis is on the physical side of the relationship and not the emotional. Maybe the partners come together perfectly in the bedroom but fail outside of it, possibly one of the them has multiple affairs or an addiction to sex. It could even be that one uses sex as a means to feel better about themselves. Sometimes there is no sex in the relationship at all because one of the partners has extreme sexual fantasies that they are ashamed of. Ultimately relationships that are based solely on sexual feelings do not last the test of time as the women will tend to feel used and the men tend to feel guilty.
The final pattern is that of Androgynous Love. In this relationship the socially accepted gender roles are reversed. The woman is the strong, assertive, ambitious type and the man is the sensitive, nurturing one in the relationship. These dynamics usually arise as a reluctance of at least one of the lovers to identify with their same sex parent e.g. a woman who saw her mother as a doormat for an aggressive father may vow not to be like her when she grows up and has relationships of her own. Gratch explains that in these circumstances a strong woman may become frustrated with a sensitive lover over time if he is not driven or doesn't behave like a man because she will see them as a "wimp". Conversely a man who picks a strong woman may end up seeing her as a "bully". To overcome this Gratch feels that each needs to take time to tune in to their natural disposition which is largely dictated by their sex, that they take on some of the characteristics of their same sex parent in order to redress the balance.
Basics of Borderline Personality Disorder
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (1994) identifies those with BPD as having:
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1.Frantic efforts to avoid real or imagined abandonment.
2.A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called "splitting."
3.Identity disturbance: markedly and persistently unstable self-image or sense of self.
4.Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
5.Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6.Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7.Chronic feelings of emptiness.
8.Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9.Transient, stress-related paranoid ideation or severe dissociative symptoms.
It is called "Borderline" because at the time of conceptualization of BPD the symptoms patients exhibited were in between the borders of neurosis (mild mental illness) and psychosis (severe mental disorder where contact is lost with reality).
Often BPD doesn't stand alone. Suffers of BPD may suffer from elements of other personality disorders. This is due mainly to the fact that it is not possible to define an exact set of criteria for each personality disorder which will apply to all cases. Personality disorders are a relatively new field of research and it is likely the criteria used to define specific disorders will change over time.
Most sufferers diagnosed with BPD are women.
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1.Frantic efforts to avoid real or imagined abandonment.
2.A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called "splitting."
3.Identity disturbance: markedly and persistently unstable self-image or sense of self.
4.Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
5.Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6.Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7.Chronic feelings of emptiness.
8.Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9.Transient, stress-related paranoid ideation or severe dissociative symptoms.
It is called "Borderline" because at the time of conceptualization of BPD the symptoms patients exhibited were in between the borders of neurosis (mild mental illness) and psychosis (severe mental disorder where contact is lost with reality).
Often BPD doesn't stand alone. Suffers of BPD may suffer from elements of other personality disorders. This is due mainly to the fact that it is not possible to define an exact set of criteria for each personality disorder which will apply to all cases. Personality disorders are a relatively new field of research and it is likely the criteria used to define specific disorders will change over time.
Most sufferers diagnosed with BPD are women.
basics of Narcissistic Personality Disorder What is the criterion for NPD?
What is the criterion for NPD?
Not everyone who has narcissistic tendencies has NPD. It is not easy for an ordinary person to tell the difference between someone who has strong narcissistic traits and a person with full blown NPD. It is a condition that can only be diagnosed by a mental health professional and even they can make errors in their diagnosis.
The European diagnostic criterion for NPD is not clearly laid out. In America, The Diagnostic and Statistical Manual of Mental Health Disorders - Fourth Edition (DSM-IV) sets out the criteria for NPD where sufferers exhibit:
"Behaviour or a fantasy of grandiosity, a lack of empathy and a need to be admired by others. As indicated by at least five of the following:
A.Grandiose sense of self-importance.
B.Fantasies of and preoccupied with beauty, brilliance, ideal love, power, or unlimited success.
C.A belief of being special and unique and can only be understood or a need to associate with people of high status.
D.A need for excessive admiration.
E.An unreasonable expectation of being treated with favour or excepting an automatic compliance to her / his wishes.
F.Will use others to achieve her / his goals.
G.Lacks empathy.
H.Believes others are envious of her / him or is envious of others.
I.Contemptuous or haughty attitudes / behaviours."
Often NPD doesn't stand alone. Suffers of NPD may suffer from elements of other personality disorders. This is due mainly to the fact that it is not possible to define an exact set of criteria for each personality disorder which will apply to all cases. Personality disorders are a relatively new field of research and it is likely the criteria used to define specific disorders will change over time.
Most sufferers diagnosed with NPD are men.
Not everyone who has narcissistic tendencies has NPD. It is not easy for an ordinary person to tell the difference between someone who has strong narcissistic traits and a person with full blown NPD. It is a condition that can only be diagnosed by a mental health professional and even they can make errors in their diagnosis.
The European diagnostic criterion for NPD is not clearly laid out. In America, The Diagnostic and Statistical Manual of Mental Health Disorders - Fourth Edition (DSM-IV) sets out the criteria for NPD where sufferers exhibit:
"Behaviour or a fantasy of grandiosity, a lack of empathy and a need to be admired by others. As indicated by at least five of the following:
A.Grandiose sense of self-importance.
B.Fantasies of and preoccupied with beauty, brilliance, ideal love, power, or unlimited success.
C.A belief of being special and unique and can only be understood or a need to associate with people of high status.
D.A need for excessive admiration.
E.An unreasonable expectation of being treated with favour or excepting an automatic compliance to her / his wishes.
F.Will use others to achieve her / his goals.
G.Lacks empathy.
H.Believes others are envious of her / him or is envious of others.
I.Contemptuous or haughty attitudes / behaviours."
Often NPD doesn't stand alone. Suffers of NPD may suffer from elements of other personality disorders. This is due mainly to the fact that it is not possible to define an exact set of criteria for each personality disorder which will apply to all cases. Personality disorders are a relatively new field of research and it is likely the criteria used to define specific disorders will change over time.
Most sufferers diagnosed with NPD are men.
Characteristics of Co-dependent People Are:
•An exaggerated sense of responsibility for the actions of others
•A tendency to confuse love and pity, with the tendency to “love” people they can pity and rescue
•A tendency to do more than their share, all of the time
•A tendency to become hurt when people don’t recognize their efforts
•An unhealthy dependence on relationships. The co-dependent will do anything to hold on to a relationship; to avoid the feeling of abandonment
•An extreme need for approval and recognition
•A sense of guilt when asserting themselves
•A compelling need to control others
•Lack of trust in self and/or others
•Fear of being abandoned or alone
•Difficulty identifying feelings
•Rigidity/difficulty adjusting to change
•Problems with intimacy/boundaries
•Chronic anger
•Lying/dishonesty
•Poor communications
•Difficulty making decisions
Questionnaire To Identify Signs Of Co-dependency
This condition appears to run in different degrees, whereby the intensity of symptoms are on a spectrum of severity, as opposed to an all or nothing scale. Please note that only a qualified professional can make a diagnosis of co-dependency; not everyone experiencing these symptoms suffers from co-dependency.
1. Do you keep quiet to avoid arguments?
2. Are you always worried about others’ opinions of you?
3. Have you ever lived with someone with an alcohol or drug problem?
4. Have you ever lived with someone who hits or belittles you?
5. Are the opinions of others more important than your own?
6. Do you have difficulty adjusting to changes at work or home?
7. Do you feel rejected when significant others spend time with friends?
8. Do you doubt your ability to be who you want to be?
9. Are you uncomfortable expressing your true feelings to others?
10. Have you ever felt inadequate?
11. Do you feel like a “bad person” when you make a mistake?
12. Do you have difficulty taking compliments or gifts?
13. Do you feel humiliation when your child or spouse makes a mistake?
14. Do you think people in your life would go downhill without your constant efforts?
15. Do you frequently wish someone could help you get things done?
16. Do you have difficulty talking to people in authority, such as the police or your boss?
17. Are you confused about who you are or where you are going with your life?
18. Do you have trouble saying “no” when asked for help?
19. Do you have trouble asking for help?
20. Do you have so many things going at once that you can’t do justice to any of them?
If you identify with several of these symptoms; are dissatisfied with yourself or your relationships; you should consider seeking professional help. Arrange for a diagnostic evaluation with a licensed physician or psychologist experienced in treating co-dependency.
How is Co-dependency Treated?
Because co-dependency is usually rooted in a person’s childhood, treatment often involves exploration into early childhood issues and their relationship to current destructive behavior patterns. Treatment includes education, experiential groups, and individual and group therapy through which co-dependents rediscover themselves and identify self-defeating behavior patterns. Treatment also focuses on helping patients getting in touch with feelings that have been buried during childhood and on reconstructing family dynamics. The goal is to allow them to experience their full range of feelings again.
When Co-dependency Hits Home
The first step in changing unhealthy behavior is to understand it. It is important for co-dependents and their family members to educate themselves about the course and cycle of addiction and how it extends into their relationships. Libraries, drug and alcohol abuse treatment centers and mental health centers often offer educational materials and programs to the public.
A lot of change and growth is necessary for the co-dependent and his or her family. Any caretaking behavior that allows or enables abuse to continue in the family needs to be recognized and stopped. The co-dependent must identify and embrace his or her feelings and needs. This may include learning to say “no,” to be loving yet tough, and learning to be self-reliant. People find freedom, love, and serenity in their recovery.
Hope lies in learning more. The more you understand co-dependency the better you can cope with its effects. Reaching out for information and assistance can help someone live a healthier, more fulfilling life.
•A tendency to confuse love and pity, with the tendency to “love” people they can pity and rescue
•A tendency to do more than their share, all of the time
•A tendency to become hurt when people don’t recognize their efforts
•An unhealthy dependence on relationships. The co-dependent will do anything to hold on to a relationship; to avoid the feeling of abandonment
•An extreme need for approval and recognition
•A sense of guilt when asserting themselves
•A compelling need to control others
•Lack of trust in self and/or others
•Fear of being abandoned or alone
•Difficulty identifying feelings
•Rigidity/difficulty adjusting to change
•Problems with intimacy/boundaries
•Chronic anger
•Lying/dishonesty
•Poor communications
•Difficulty making decisions
Questionnaire To Identify Signs Of Co-dependency
This condition appears to run in different degrees, whereby the intensity of symptoms are on a spectrum of severity, as opposed to an all or nothing scale. Please note that only a qualified professional can make a diagnosis of co-dependency; not everyone experiencing these symptoms suffers from co-dependency.
1. Do you keep quiet to avoid arguments?
2. Are you always worried about others’ opinions of you?
3. Have you ever lived with someone with an alcohol or drug problem?
4. Have you ever lived with someone who hits or belittles you?
5. Are the opinions of others more important than your own?
6. Do you have difficulty adjusting to changes at work or home?
7. Do you feel rejected when significant others spend time with friends?
8. Do you doubt your ability to be who you want to be?
9. Are you uncomfortable expressing your true feelings to others?
10. Have you ever felt inadequate?
11. Do you feel like a “bad person” when you make a mistake?
12. Do you have difficulty taking compliments or gifts?
13. Do you feel humiliation when your child or spouse makes a mistake?
14. Do you think people in your life would go downhill without your constant efforts?
15. Do you frequently wish someone could help you get things done?
16. Do you have difficulty talking to people in authority, such as the police or your boss?
17. Are you confused about who you are or where you are going with your life?
18. Do you have trouble saying “no” when asked for help?
19. Do you have trouble asking for help?
20. Do you have so many things going at once that you can’t do justice to any of them?
If you identify with several of these symptoms; are dissatisfied with yourself or your relationships; you should consider seeking professional help. Arrange for a diagnostic evaluation with a licensed physician or psychologist experienced in treating co-dependency.
How is Co-dependency Treated?
Because co-dependency is usually rooted in a person’s childhood, treatment often involves exploration into early childhood issues and their relationship to current destructive behavior patterns. Treatment includes education, experiential groups, and individual and group therapy through which co-dependents rediscover themselves and identify self-defeating behavior patterns. Treatment also focuses on helping patients getting in touch with feelings that have been buried during childhood and on reconstructing family dynamics. The goal is to allow them to experience their full range of feelings again.
When Co-dependency Hits Home
The first step in changing unhealthy behavior is to understand it. It is important for co-dependents and their family members to educate themselves about the course and cycle of addiction and how it extends into their relationships. Libraries, drug and alcohol abuse treatment centers and mental health centers often offer educational materials and programs to the public.
A lot of change and growth is necessary for the co-dependent and his or her family. Any caretaking behavior that allows or enables abuse to continue in the family needs to be recognized and stopped. The co-dependent must identify and embrace his or her feelings and needs. This may include learning to say “no,” to be loving yet tough, and learning to be self-reliant. People find freedom, love, and serenity in their recovery.
Hope lies in learning more. The more you understand co-dependency the better you can cope with its effects. Reaching out for information and assistance can help someone live a healthier, more fulfilling life.
What is a Dysfunctional Family
What is a Dysfunctional Family and How Does it Lead to Co-dependency?
A dysfunctional family is one in which members suffer from fear, anger, pain, or shame that is ignored or denied. Underlying problems may include any of the following:
•An addiction by a family member to drugs, alcohol, relationships, work, food, sex, or gambling.
•The existence of physical, emotional, or sexual abuse.
•The presence of a family member suffering from a chronic mental or physical illness.
Dysfunctional families do not acknowledge that problems exist. They don’t talk about them or confront them. As a result, family members learn to repress emotions and disregard their own needs. They become “survivors.” They develop behaviors that help them deny, ignore, or avoid difficult emotions. They detach themselves. They don’t talk. They don’t touch. They don’t confront. They don’t feel. They don’t trust. The identity and emotional development of the members of a dysfunctional family are often inhibited
Attention and energy focus on the family member who is ill or addicted. The co-dependent person typically sacrifices his or her needs to take care of a person who is sick. When co-dependents place other people’s health, welfare and safety before their own, they can lose contact with their own needs, desires, and sense of self.
A dysfunctional family is one in which members suffer from fear, anger, pain, or shame that is ignored or denied. Underlying problems may include any of the following:
•An addiction by a family member to drugs, alcohol, relationships, work, food, sex, or gambling.
•The existence of physical, emotional, or sexual abuse.
•The presence of a family member suffering from a chronic mental or physical illness.
Dysfunctional families do not acknowledge that problems exist. They don’t talk about them or confront them. As a result, family members learn to repress emotions and disregard their own needs. They become “survivors.” They develop behaviors that help them deny, ignore, or avoid difficult emotions. They detach themselves. They don’t talk. They don’t touch. They don’t confront. They don’t feel. They don’t trust. The identity and emotional development of the members of a dysfunctional family are often inhibited
Attention and energy focus on the family member who is ill or addicted. The co-dependent person typically sacrifices his or her needs to take care of a person who is sick. When co-dependents place other people’s health, welfare and safety before their own, they can lose contact with their own needs, desires, and sense of self.
Why do we become codependent? What causes it?
It’s widely believed we become codependent through living in systems (families) with rules that hinder development to some degree. The system (usually parents and relatives) has been developed in response to some problem such as alcoholism, mental illness or some other secret or problem.
General rules set-up within families that may cause codependency may include:
It’s not okay to talk about problems
Feelings should not be expressed openly; keep feelings to yourself
Communication is best if indirect; one person acts as messenger between two others; known in therapy as triangulation
Be strong, good, right, perfect
Make us proud beyond realistic expectations
Don’t be selfish
Do as I say not as I do
It’s not okay to play or be playful
Don’t rock the boat.
Many families have one or more of these rules in place within the family. These kinds of rules can constrict and strain the free and healthy development of people’s self-esteem, and coping. As a result, children can develop non-helpful behavior characteristics, problems solving techniques, and reactions to situations in adult life
General rules set-up within families that may cause codependency may include:
It’s not okay to talk about problems
Feelings should not be expressed openly; keep feelings to yourself
Communication is best if indirect; one person acts as messenger between two others; known in therapy as triangulation
Be strong, good, right, perfect
Make us proud beyond realistic expectations
Don’t be selfish
Do as I say not as I do
It’s not okay to play or be playful
Don’t rock the boat.
Many families have one or more of these rules in place within the family. These kinds of rules can constrict and strain the free and healthy development of people’s self-esteem, and coping. As a result, children can develop non-helpful behavior characteristics, problems solving techniques, and reactions to situations in adult life
Codependency - What is it?
Codependency is when a person has a strong desire to control people around them, including their spouse, children or co-workers. Codependents believe they are somehow more capable than others, who need their direction or suggestions to fulfill tasks they are responsible to complete. They feel compassion for people who may be hurting and feel they should be the one to help them. Codependent people give of their time, emotions, finances, and other resources. They have a very difficult time saying "no" to any requests made of them.
Codependency - A Matter of Control
Codependency, for others, doesn't express itself in a desire to control, but instead, in the need to be controlled by others. Because it is nearly impossible for Codependents to say "no" to people, they may find themselves the victims in physically and emotionally abusive relationships. They believe that if they can be good enough, or loving enough, they can change the other person's behavior. They sometimes blame themselves for the abusive behavior: "If only I had not forgotten to do the dishes, he would not have had to hit me."
Codependency causes internal struggles with the opinions of others. Codependents may make decisions based on what they think other people want them to do. While they may believe that their motive for helping people is compassion, in reality they are doing it because they want love or approval. They may come to recognize the underlying nature of their behavior when they become hurt or angry at people they have helped who didn't return the same amount of help, love, or appreciation when they themselves were in need. They have difficulty understanding that instead of helping others by providing things they need, they may actually be hurting them by creating a dependent relationship.
Codependency can also cause struggles in the area of time management. Codependents may feel they never have enough time to fulfill all of their commitments because they have made too many. The most important commitments and relationships are often neglected because they are too busy helping other people, participating in multiple activities, and running from one event to another throughout the week. This also relates to their inability to say "no" when asked to volunteer, attend a function, or help a friend. The idea of not volunteering, not helping or not attending is unthinkable. They may believe they are not being responsible, not being a good friend, or not being a good person if they refuse any requests. However, many of those situations and relationships leave them feeling hurt, angry, or resentful.
Codependency - The Questions
Do you find yourself making decisions based on other people's opinions?
Is it important to you that people like you and want to be your friend?
Do you have a strong desire to help others, but deep down you know you do it so that they will like or love you?
Do you seem to notice everyone else's problems and have a need to tell them what you think they should do to solve them?
Do you feel anxious, angry or upset when people don't do things you want them to do, or do things the way you want them to do them?
Do you find yourself in relationships where you do all the giving and the other person does all the taking?
Are you involved in activities that demand all of your time and energy and you are neglecting your family or yourself?
Codependency - A Matter of Control
Codependency, for others, doesn't express itself in a desire to control, but instead, in the need to be controlled by others. Because it is nearly impossible for Codependents to say "no" to people, they may find themselves the victims in physically and emotionally abusive relationships. They believe that if they can be good enough, or loving enough, they can change the other person's behavior. They sometimes blame themselves for the abusive behavior: "If only I had not forgotten to do the dishes, he would not have had to hit me."
Codependency causes internal struggles with the opinions of others. Codependents may make decisions based on what they think other people want them to do. While they may believe that their motive for helping people is compassion, in reality they are doing it because they want love or approval. They may come to recognize the underlying nature of their behavior when they become hurt or angry at people they have helped who didn't return the same amount of help, love, or appreciation when they themselves were in need. They have difficulty understanding that instead of helping others by providing things they need, they may actually be hurting them by creating a dependent relationship.
Codependency can also cause struggles in the area of time management. Codependents may feel they never have enough time to fulfill all of their commitments because they have made too many. The most important commitments and relationships are often neglected because they are too busy helping other people, participating in multiple activities, and running from one event to another throughout the week. This also relates to their inability to say "no" when asked to volunteer, attend a function, or help a friend. The idea of not volunteering, not helping or not attending is unthinkable. They may believe they are not being responsible, not being a good friend, or not being a good person if they refuse any requests. However, many of those situations and relationships leave them feeling hurt, angry, or resentful.
Codependency - The Questions
Do you find yourself making decisions based on other people's opinions?
Is it important to you that people like you and want to be your friend?
Do you have a strong desire to help others, but deep down you know you do it so that they will like or love you?
Do you seem to notice everyone else's problems and have a need to tell them what you think they should do to solve them?
Do you feel anxious, angry or upset when people don't do things you want them to do, or do things the way you want them to do them?
Do you find yourself in relationships where you do all the giving and the other person does all the taking?
Are you involved in activities that demand all of your time and energy and you are neglecting your family or yourself?
Do you obsess about your appearance?
Do you obsess about your appearance?
Do you feel guilty after you eat?
Do you feel “fat” one day and thin the next?
Are you unrealistic about your body size and shape?
If you answer “Yes” to these questions you may have challenges with body image.
What Do We Mean By Body Image
Body image is complex and multi-dimensional. It involves emotions, perception, personal history, social context, sensations and physiology. Body image is influenced by messages in childhood, our health and illness history, ethnic or cultural identity and our relationships. It reflects how we see ourselves, how we think others see us, and how we physically feel living in our body.
Cultural Influences to Body Image Development
Today’s culture bombards us with images and messages about perfection. The media and advertising industries sell us the idea that we will be rewarded if we achieve an idealized standard of beauty. The myth is that we can look like the models we see in the ads if we buy this product, try that diet, or go on the next exercise regime.
The fashion industry is brilliant at convincing us that our next purchase will create the improvement we need in order to feel attractive and likable. What we are really being sold is a sense of inadequacy and defeat. We can never achieve those idealized looks because they are not real. They are airbrushed, digitalized and fake images. In spite of these facts, we remain under the influence and buy in.
The Influence from Family and Peers
Many beliefs and feelings about our bodies were shaped by early childhood experiences and may still be frozen in time. Before we developed language, we perceived ourselves and our environment through touch, sight and sound. We relaxed when touched and talked to lovingly, and we tightened when touched and talked to aggressively. Negative body image can result from early experiences of body deprivation when needs get frustrated or unmet (i.e. hunger, sleep, physical comfort, etc). The opposite is also true. Positive body image can result from sufficient attention to core needs, being treated with compassion, and feeling physically safe and protected.
Family stories can contribute to how we see ourselves in our bodies. If we are told that we look like Aunt Sally who was small and frail, we may have a sense that we, too, are frail, even if we aren’t. In addition, histories of illnesses and surgeries can cause trauma and influence us to feel like our bodies are defective.
Biology also plays a role. We come in all sizes. Some of us are big-boned or small-boned, tall or short. How our environment responds to these givens, and how we relate to the responses, has an effect on our body image. Being the shortest or the tallest person in the grade, being the fastest or slowest, keeping “baby fat,” carrying weight before growth spurts, having a narrow or wide frame, being teased, bullied or criticized for our appearance, succeeding or not succeeding at sports … all these ways of being ourselves in our natural bodies has an impact on how others respond to us and how we then perceive ourselves.
Why Body Image Is Hard To Change
Our brain has a filtering system that determines what information gets recognized and how that information gets interpreted. Filters organize what we notice, what we attend to, what we remember, and then what we believe. If we believe that we are unattractive and someone tells us differently, we are likely to dismiss the feedback and consider it simply an exception to the rule. We don’t consider that our mindset is a result of our mind’s filtering system and not necessarily a reflection of an objective reality.
Negative body image is hard to change, but it can be done. Our brain patterns can change when we practice new ways of thinking and behaving that break the old patterns and establish new ones. We can actually change our brains over time.
Positive body image doesn’t require that we love and be thrilled with every aspect of our physical being. It requires a willingness to maintain an attitude of self-acceptance, self compassion, and the hard work of replacing body criticism with neutral language that promotes self-esteem.
Tips For Creating A Healthy Body Image
1) Question whether or not the body image that you have today is current with the reality of your body shape and size. You may be carrying a child’s image of yourself that is no longer appropriate in the here and now. For example, if you had been a chubby child and are now slim, you may still be feeling chubby even when you are not.
2) Become aware of perfectionism. Stop comparing yourself to idealized images.
3) Resist comparing your body to others. Be realistic about your body size and shape and your genetic predisposition.
4) Identify one part of your body that you like or feel friendly towards. Appreciate this body part for all that it has done for you. You might say a gratitude prayer for it.
5) Pay attention to the people around you and whether or not they support you to hold a positive body image. Do your friends think it’s funny to kid you about your weight? Your nose? Your big hands? Be assertive for yourself and tell people to stop saying hurtful things.
6) Ask a trusted friend to tell you 3 things they like about your appearance.
7) Learn to listen to your body for hunger cues and for when you are satisfied with what you have eaten.
8) Find ways to exercise for pleasure and health, not just for weight control.
9) Resist the temptation to weigh yourself frequently. Remember that your weight and shape will fluctuate daily, weekly and monthly. It is preferable to know your weight range from how you feel in your clothes rather than from a number on the scale.
10) Avoid reading fashion magazines. They sell unrealistic images and want you to buy into dissatisfaction with your body.
Do you feel guilty after you eat?
Do you feel “fat” one day and thin the next?
Are you unrealistic about your body size and shape?
If you answer “Yes” to these questions you may have challenges with body image.
What Do We Mean By Body Image
Body image is complex and multi-dimensional. It involves emotions, perception, personal history, social context, sensations and physiology. Body image is influenced by messages in childhood, our health and illness history, ethnic or cultural identity and our relationships. It reflects how we see ourselves, how we think others see us, and how we physically feel living in our body.
Cultural Influences to Body Image Development
Today’s culture bombards us with images and messages about perfection. The media and advertising industries sell us the idea that we will be rewarded if we achieve an idealized standard of beauty. The myth is that we can look like the models we see in the ads if we buy this product, try that diet, or go on the next exercise regime.
The fashion industry is brilliant at convincing us that our next purchase will create the improvement we need in order to feel attractive and likable. What we are really being sold is a sense of inadequacy and defeat. We can never achieve those idealized looks because they are not real. They are airbrushed, digitalized and fake images. In spite of these facts, we remain under the influence and buy in.
The Influence from Family and Peers
Many beliefs and feelings about our bodies were shaped by early childhood experiences and may still be frozen in time. Before we developed language, we perceived ourselves and our environment through touch, sight and sound. We relaxed when touched and talked to lovingly, and we tightened when touched and talked to aggressively. Negative body image can result from early experiences of body deprivation when needs get frustrated or unmet (i.e. hunger, sleep, physical comfort, etc). The opposite is also true. Positive body image can result from sufficient attention to core needs, being treated with compassion, and feeling physically safe and protected.
Family stories can contribute to how we see ourselves in our bodies. If we are told that we look like Aunt Sally who was small and frail, we may have a sense that we, too, are frail, even if we aren’t. In addition, histories of illnesses and surgeries can cause trauma and influence us to feel like our bodies are defective.
Biology also plays a role. We come in all sizes. Some of us are big-boned or small-boned, tall or short. How our environment responds to these givens, and how we relate to the responses, has an effect on our body image. Being the shortest or the tallest person in the grade, being the fastest or slowest, keeping “baby fat,” carrying weight before growth spurts, having a narrow or wide frame, being teased, bullied or criticized for our appearance, succeeding or not succeeding at sports … all these ways of being ourselves in our natural bodies has an impact on how others respond to us and how we then perceive ourselves.
Why Body Image Is Hard To Change
Our brain has a filtering system that determines what information gets recognized and how that information gets interpreted. Filters organize what we notice, what we attend to, what we remember, and then what we believe. If we believe that we are unattractive and someone tells us differently, we are likely to dismiss the feedback and consider it simply an exception to the rule. We don’t consider that our mindset is a result of our mind’s filtering system and not necessarily a reflection of an objective reality.
Negative body image is hard to change, but it can be done. Our brain patterns can change when we practice new ways of thinking and behaving that break the old patterns and establish new ones. We can actually change our brains over time.
Positive body image doesn’t require that we love and be thrilled with every aspect of our physical being. It requires a willingness to maintain an attitude of self-acceptance, self compassion, and the hard work of replacing body criticism with neutral language that promotes self-esteem.
Tips For Creating A Healthy Body Image
1) Question whether or not the body image that you have today is current with the reality of your body shape and size. You may be carrying a child’s image of yourself that is no longer appropriate in the here and now. For example, if you had been a chubby child and are now slim, you may still be feeling chubby even when you are not.
2) Become aware of perfectionism. Stop comparing yourself to idealized images.
3) Resist comparing your body to others. Be realistic about your body size and shape and your genetic predisposition.
4) Identify one part of your body that you like or feel friendly towards. Appreciate this body part for all that it has done for you. You might say a gratitude prayer for it.
5) Pay attention to the people around you and whether or not they support you to hold a positive body image. Do your friends think it’s funny to kid you about your weight? Your nose? Your big hands? Be assertive for yourself and tell people to stop saying hurtful things.
6) Ask a trusted friend to tell you 3 things they like about your appearance.
7) Learn to listen to your body for hunger cues and for when you are satisfied with what you have eaten.
8) Find ways to exercise for pleasure and health, not just for weight control.
9) Resist the temptation to weigh yourself frequently. Remember that your weight and shape will fluctuate daily, weekly and monthly. It is preferable to know your weight range from how you feel in your clothes rather than from a number on the scale.
10) Avoid reading fashion magazines. They sell unrealistic images and want you to buy into dissatisfaction with your body.
Co-dependency is a learned behavior that can be passed down from one generation to another.
Co-dependency is a learned behavior that can be passed down from one generation to another. It is an emotional and behavioral condition that affects an individual’s ability to have a healthy, mutually satisfying relationship. It is also known as “relationship addiction” because people with codependency often form or maintain relationships that are one-sided, emotionally destructive and/or abusive. The disorder was first identified about ten years ago as the result of years of studying interpersonal relationships in families of alcoholics. Co-dependent behavior is learned by watching and imitating other family members who display this type of behavior.
Wednesday, 19 August 2009
Some Really Bad Choices as Lover
Some Really Bad Choices as Lovers
I realize that I may be tempted to chose a damaged or unavailable person to date or fall in love with, probably because they are unavailable or out of my own kindness or codependence. I realize that the prospects of a happy long-term love relation (which is what I say I want) are so low with the following types of people that it would be self-destructive to start dating or stay in a love relation with any of them:
an active addict or alcoholic, or other dysfunctional person who needs but is not in psychotherapy or a 12-step program, or both,
anyone in AA or any other 12-step program with less than a year of continuous sobriety,
anyone who I know (in my heart of hearts) is incapable of or unwilling to love me,
anyone who I know (in my heart of hearts) is not attracted to me sexually,
anyone who I know (in my heart of hearts) I am not attracted to sexually,
anyone living more then 75 miles from me who has no present plan to move here, unless I have a present plan to move there (no long distance relationships),
anyone currently married to (or in a romantic relationship with) someone else, or still living with the "ex-lover,"
anyone who admits that s/he is emotionally unavailable (whether constitutionally, because of a recent breakup, or otherwise),
anyone over 30 who has not previously been in love unless s/he has been recently treated in therapy or 12-Step recovery program,
anyone terminally ill,
anyone chronically and seriously mentally ill, whether hospitalized or not, unless the illness is being satisfactorily treated by therapy or medication or both, as needed,
for someone gay, anyone straight (or not sure s/he's gay, or just "trying it out"),
for someone straight, anyone gay (or not sure s/he's straight, or just "trying it out"),
an immigrant who does not have good prospects of getting legal, long-term resident status,
anyone involved in criminal activity (especially a drug dealer), or
a criminal with more than 1 year yet to serve in prison.
(Add a disaster or two from your personal experience:)
________________________________________________
________________________________________________
If I start to feel ANYTHING romantic for ANY of these people, I must STOP seeing them FAST! I may have 10 minutes to bail out after I feel the first warm tendrils of infatuation. Wait any longer than that and I will be hooked and in the relationship until it runs its course. That's the "10-Minute Rule." I can't say that I wasn't warned.
I realize that I may be tempted to chose a damaged or unavailable person to date or fall in love with, probably because they are unavailable or out of my own kindness or codependence. I realize that the prospects of a happy long-term love relation (which is what I say I want) are so low with the following types of people that it would be self-destructive to start dating or stay in a love relation with any of them:
an active addict or alcoholic, or other dysfunctional person who needs but is not in psychotherapy or a 12-step program, or both,
anyone in AA or any other 12-step program with less than a year of continuous sobriety,
anyone who I know (in my heart of hearts) is incapable of or unwilling to love me,
anyone who I know (in my heart of hearts) is not attracted to me sexually,
anyone who I know (in my heart of hearts) I am not attracted to sexually,
anyone living more then 75 miles from me who has no present plan to move here, unless I have a present plan to move there (no long distance relationships),
anyone currently married to (or in a romantic relationship with) someone else, or still living with the "ex-lover,"
anyone who admits that s/he is emotionally unavailable (whether constitutionally, because of a recent breakup, or otherwise),
anyone over 30 who has not previously been in love unless s/he has been recently treated in therapy or 12-Step recovery program,
anyone terminally ill,
anyone chronically and seriously mentally ill, whether hospitalized or not, unless the illness is being satisfactorily treated by therapy or medication or both, as needed,
for someone gay, anyone straight (or not sure s/he's gay, or just "trying it out"),
for someone straight, anyone gay (or not sure s/he's straight, or just "trying it out"),
an immigrant who does not have good prospects of getting legal, long-term resident status,
anyone involved in criminal activity (especially a drug dealer), or
a criminal with more than 1 year yet to serve in prison.
(Add a disaster or two from your personal experience:)
________________________________________________
________________________________________________
If I start to feel ANYTHING romantic for ANY of these people, I must STOP seeing them FAST! I may have 10 minutes to bail out after I feel the first warm tendrils of infatuation. Wait any longer than that and I will be hooked and in the relationship until it runs its course. That's the "10-Minute Rule." I can't say that I wasn't warned.
Foundations for peace of mind.
Dont look for the differences,I started working in prisons with addicted prisoners and found much of this work released the addicts from emotional pain, Foundations for peace of mind.
“Listen to the patient, s/he is telling you the diagnosis” – this again comes from William Osler, the sharpest clinician in the early twentieth century. Certainly this is the best medical aphorism I ever heard. It is not difficult to see why diagnosis is the single most crucial aspect of medical practice. Obviously where there are problems which you want to sort out, you will wish to apply the most efficacious solution. So the key is to find out what is the root of the problem – namely the diagnosis – for if you miss this, then any remedies you apply will not work, indeed risk doing additional harm, while the original disease carries on in its merry way, untrammelled, wreaking the havoc it threatened in the first place.
Needing to know what is going on, is also the first requirement for exercising adequate responsibility – if you respond to the wrong signal, or miss an important sense-data, then you reduce your adaptability by precisely the same degree. I recommend applying the same approach to wider social, indeed political problems – there are various social and global ‘diseases’ which need far better diagnoses than they currently receive – only thereafter are available remedies likely to work.
The triad of Truth, Trust and Consent arose directly from my work with the most violent prisoners in the UK prison system. I listened to them, as Osler advised, and they listened to me – and the violence which characterised their earlier behaviour, evaporated, proven by the total absence of alarm bells for three years, a unique record of any maximum security wing worldwide. Truth here, measures how closely reality correlates with your mental picture of it.
Trust, in clinical terms, is the sovereign remedy for fear. Fear gives warning, on the individual scale, of a threat to health, or indeed to life (very much as pain does on the physical scale). If you were not fearful of walking across busy motorways, then your contemplation of this philosophical nicety would be short-lived. Trust is another amorphous term, which needs to be earned rather than defined. Its relationship to fear is easily demonstrated. Suppose you were frightened of walking over a rickety bridge – your fear of being dashed to pieces on the rocks below would be entirely appropriate and realistic. However, if I could persuade you to trust me that the bridge was safe – your fear of it would disappear, and realistically so.
So here we have two of the three components that are indispensable for any stability or peace of mind.The first is Truth – how closely does your picture of reality reflect that reality itself? Secondly, Trust – how much do you accept my reassurances that your current fears are groundless? The third and final component is Consent – do you accept what I say, not through coercion, but because it makes sense to you and you agree to accept it voluntarily. Make it your own – join your intent with mine. Here we touch again on the ‘spiritual ping-pong ball’, if I may term it thus, which our joint intents can keep aloft despite the incessant ravages of an unfriendly world.
Now while these three are indispensable to peace of mind on the individual level, they are also crucial to social stability at the community, national or global level – after all, the chief component of such communities are human beings, rather similar to ourselves, and they too require adequate supplies of Truth, Trust and Consent to maintain a dynamic security amid an ever changing and not necessarily cooperative world.
Truth is a commodity which needs to be valued far more highly. If it is in short supply globally, we all lose. Promoting Truth actively assists our social health. The less there is and the more irresponsible our media and our politicians become, then the poorer our social health is likely to be. We need calls for greater responsibility being exercised nationally and globally, else we will misdiagnose the very real problems which face us, and therefore fail to adapt – a penalty we as living organisms should rightly fear. As I write this, I’ve just received a letter from a prisoner I know who complained that the tabloid press keeps repeating a myth regarding what occurred in one of the crimes he witnessed. It is an especially gory myth. It is quite untrue. It continues in circulation, untrammelled, because it sells more papers. If we are concerned about social stabilities and social well being then Truth is certainly a commodity we must value more highly. What we need is a better apparatus for ensuring more responsibility in the media, at all levels. For this we need an adequate rationale to support it, and a clearer perception of the damage we all suffer when deceit is so widely tolerated. Weapons of mass destruction, 45 minute warnings – these are just the latest in an ongoing political tradition which is socially unhealthy in the extreme.
Trust has been so widely corrupted in the current financial credit crunch that its vital social value hardly needs further emphasis. Consent is perhaps the least well understood. It has been found in democracies, to be the most stable form of government – my view on this is that every citizen has the responsibility to ensure that the policies being propounded centrally, are True, and more likely to improve our adaptation to our environment, than otherwise.
– just as Ethan was, and just as we all have been. Of course this contradicts certain religious dogmas that we are fundamentally born evil, or that we have in some awesome way ‘fallen’ – I find no place for this in my clinical work, and do not commend it to those who wish to make an impact in this field. On the contrary, I take great delight in resting back on the assurance that we were indeed all born Lovable, Sociable and Non-Violent – and further, that we wish to return there. Not only wish, but are fully capable of so doing, given enough insightful emotional support.Consent empowers – a critical feature, whether among massively deprived prisoners, or more widely across the globe.
Discussing emotions closely with 100 long term prisoners, including 60 murderers and 6 serial killers taught me a great deal. I taught them that their irrationality, including their violence, had been learnt in their appalling childhoods, and that it could be unlearnt. They taught me that all crime is revenge, a topic we need to defer at this point. They also taught me that they had been born Lovable, Sociable and Non-Violent
I cannot resist inserting here a paragraph from a book review by the geneticist Steven Rose which he recently wrote for a Sunday newspaper, since it rather complements the points put forward.
On the contrary, brains are not primarily cognitive devices designed to solve chess problems, but evolved organs adapted to enhance the survival chances of the organisms they inhabit. Their primary role is to respond to the challenges the environment presents by providing the cellular apparatus enabling the brain's owner to assess current situations, compare them with past experience, and generate the appropriate emotions and hence actions. It is this evolutionary imperative within the particular line of descent leading to Homo sapiens that has resulted in our large and complex brains. As feminist sociologist Hilary Rose points out, Descartes’ famous "cogito ergo sum" should be replaced by "amo, ergo sum."
The reference to Descartes indicates just how deep is the need to go back to philosophical fundamentals which have so lead us astray in the last 100 years, ever since Kaiser Wilhelm set out to leapfrog the British Empire. In that conflagration, which continued in various scenarios for the rest of that century, much in the way of idealism, and the inherent nature of human values was smashed to pieces in the abominable trenches. I have not the least doubt that without this human cataclysm, we would never have suffered from the Wittgenstein Fallacy to the extent we have. I have taken Wittgenstein as the paradigm – he was responding to the current ethos – hopefully we can now do better.
in closing
In closing, I’d like to offer a brief glimpse as to why human beings are so prone to irrationality. There is no doubt in my mind that we developed as the aquatic ape. This accounts for so many of our physiological features as to be irrefutable in my view. We are hairless because hair gets waterlogged. We are bipedal because that way we can wade deeper, avoid more predators, and seek more fish. We are sensitive to subtle changes in pressure sensors in our skin which work in water, but not so well in air. And crucially for our infantile development, we arrive at birth better equipped with subcutaneous fat than other primates, and cling to parental head hair, which thickens during pregnancy to allow the automatic clinging which politicians find newborn infants are so good at. This simple adaptation prevents us floating away from parental support.
However this evolutionary development has two serious adverse consequences. The first is that being bipeds we cannot run as fast as quadrupeds – either towards our prey or away from predators. Accordingly in order to survive, indeed to flourish, we needed a different evolutionary strategy than our speedier quadrupedal associates. And this, it turns out is our ability to socialise. We work together. We communicate, we plan, we socialise. This way we can exterminate all the mega-fauna in the Americas and elsewhere, which otherwise would have had no difficulty exterminating us. Thus, any infringement of our ability to socialise, diminishes our evolutionary advantage (as per irresponsibility), and reduces our chances of surviving. Bipedalism entails socialising – it’s what our minds are for, it’s what we most enjoy, and it is the principal loss when irrationality reigns.
The second serious consequence is our complete inability to support ourselves at birth. Other primate neonates can cling to maternal or paternal body fur – our parents have none, so we cannot. We were evolved to float neonatally – so becoming terrestrial animals opens the possibility of being dropped on hard ground – hence the vital importance of early, reliable, and comprehensive parental attachment. Where this goes awry, for whatever reason, there the roots of irrationality are to be found – indeed by honing in on this central emotional discrepancy, these roots can be cut most efficaciously, allowing mature, emotionally self-confident adults to emerge.
Irrationality therefore arises simply because every human infant is born 100% dependent. Thus every one of us in infancy, requires a sound parental attachment – vital to future mental stability. It is well established that all children, when faced with threats to this attachment, resort to ‘denial’ – “this isn’t happening to me.” Unexpectedly, many cannot then in later life, say “this has stopped happening to me”. Most of course can, especially given adequate support, but for those who cannot, the consequences can be dire. For when fear persists in this pathological manner, the threat may go, but the terror does not. The afflicted individual then becomes too fearful of reality to double-check the validity or truth of their mental picture of it. And here is the root of irrationality – afflicted individuals continue to deploy a perfectly logical reason, but one that is based on a reality that no longer obtains, significantly one in which parents were three times your size and infinitely more powerful. Irrationality occurs when reason is based on a past reality – viewed in this way, all that is required to restore rationality, is to bring that internal reality up-to-date. Again this is easier done than said, and to accept once experienced.
Are you feeling strong? If so, we can venture deeper here and talk of life’s purpose, normally an unforgiving minefield. For myself, I find I have no need to believe in the supernatural – the natural is quite awesome enough for me. So what’s the purpose of life, and why is life worth living ? Well, for me it’s all a question of being Lovable, Sociable and Non-Violent. Life’s purpose, certainly as far as humanity is concerned is to interact socially so as to regain what some of us lost in difficult childhoods. Sociability, social interchange is what we have been aiming for since we developed our unique knee joints 3 million years ago. The point can easily be proved by interacting with other people, by joining your intent with theirs, by battling the threats of the world which assail us cooperatively, together, using our minds for what they were meant. This way, it seems to me, we can gain the height of positive emotions – joy, cheerfulness, optimism. It is a positive delight to know that anyone can do it. Sublime. Sex and drugs don’t even come close.
in sum – the good, the bad and the future.
In sum, I have just drawn an astonishing, hugely optimistic and glorious picture of the human being. Our species can now claim to have intent, by virtue of being alive, and to have more of it than any other living organism. This is enormously enhanced by verbal communication – but we overlook the pitfalls inherent in that communication at our peril. Released from the ineradicable rigidities of words, we can expand our view of what life processes actually do – they organise – only when dead, does their entropy increase. But to stay alive, we need to respond and adapt to changes in our surroundings. From this emerges a new moral precept, which can counter our current moral illiteracy (and indeed our rampant nihilism). This moral does not hang in the air like a wish to be good, nor depend on the religious veneration of any god or gods. If you or any of us fails to act responsibly, being primarily living organisms ourselves, the penalty is not a nasty glance from aunty, it’s death. Or in our highly socially-dependent species, on various forms of partial social death and isolation up to and including dying itself.
If we can release our intent from its current verbal shackles, and apply our reason as the Enlightenment fervently hoped, we also need a clear, obvious, utterly reliable and repeatable account of irrationality – since that is what scuppered earlier expeditions in this area. Irrationality is the application of reason from infantile environs to today’s adult reality. The roof is falling in, you need to escape – the rational cries “where’s the exit?”, the irrational, “where’s mum?”. Irrationality, including violence, and of course war, is essentially infantile. Violence is a learned disease and can be unlearned.
We are born sociable, we need to develop dynamic social security, based on consent, on trust and on the truth of the situation. Then we, as a social species can flourish. Given enough resources it is not difficult to persuade the irrational individual to grow up emotionally – but you’ve got to put in the effort. This offers a 100% guaranteed cure for all psychiatric morbidity – provided you finish the course.
It is fear that corrupts rational thought – hence the significance of Frank Furedi’s work. If you abate the fear, with trustworthy, non-authoritarian consent-dependent support, then rationality blossoms. This again is easier done than said, easier seen than described in cold print – but if this approach survived, as it did, in the bowels of the British prison system, among the most violent and disturbed in the nation – then it augurs well for its success elsewhere.
Now for the bad. The worst thing about this view, is that it is unbelievable. It runs counter to so many contemporary shibboleths, so much conventional wisdom. This accounts for why it has made so little progress since I first excavated it, way back in 1960. I needed to keep away from the sterile teachings of the day – but when I attempted to bring my findings back, I found I had no standing. Politically too, the notion that violence can be cured is unacceptable. The Home Secretary of the day closed the Special Unit in Parkhurst Prison on political grounds, while the prison press office of the time stated “it is quite wrong for Dr Johnson to claim he did any good in the Special Unit in Parkhurst Prison”. Only last autumn the present Home Secretary chose to suppress the fact that no alarm bells had been rung in that maximum security wing for three years. In 1998, the then Prime Minister explicitly vetoed my attempts to reform psychiatry.
Medieval feudalism is alive and flourishing in Britain today.
As for the future, this depends, as with all living organism on what we do next. A global nuclear holocaust is still available, still supported by our infantile (and horrendously costly) political strategies. Why cooperation should be so much harder to implement than confrontation needs a rational explanation – in my view, we need to examine its appalling provenance, starting in 1914. But the evidence that we are all born sociable is confirmed by every positive trustworthy communication with like minds. When you or I exercise our sociability faculty, and overcome the childhood prejudices we learnt so deeply, we enter upon a glorious win-win situation.
Being living human beings, we are all licensed to dip our tongues into the great soul of humanity – sunny emotions then come bubbling up, all by themselves, for all of us – whatever our sect, colour, gender, age, wealth or outlook. What fun.
Dr Bob Johnson Tuesday, 13 January 2009
REVIEW OF TALKING CURES FOR SCHIZOPHRENIA
REVIEW OF TALKING CURES FOR SCHIZOPHRENIA –
THE BASIS OF PSYCHOSIS
ALISTAIR CAMPBELL describes his own mental breakdown as him knowing something was dreadfully wrong, and finding that everything he could think of to put it right, only made it worse. There was a lump of mental furniture right in the middle of his mind, at that time, which blocked him from implementing any sensible resolution. This, as explained below, is ‘denial’ at work – an item becomes too painful to be tackled unaided. Simple social support has repeatedly been shown to cure psychoses. I was trained in the “Therapeutic Community” approach, in 1963, an optimistic, successful approach which present day psychiatry abandoned around 1980. Its equivalent was implemented at the Quaker Retreat in York 1796 to 1850, and yielded better results at curing psychosis than ever since, as did the Soteria movement – see sample below. In contrast the so-called ‘antipsychotics’ have consistently been shown to prolong psychosis, since the late 1950s [see ‘Mad in America’ by Robert Whitaker, Perseus, ISBN 0738203858 www.madinamerica.com].
The Soteria movement, proven to be effective in curing psychosis, tells a wonderfully descriptive story. One young man with psychosis told the friendly but untrained Soteria support staff that Martians were arriving at Los Angeles airport at 4 a.m. the following morning. So they went. When the aliens failed to materialise, he said that they must have got the date wrong – I suggest this was the first time he had ever been taken seriously – his ‘consent’ mattered. He was, for the first time, getting relevant assistance for his mental stresses. Compare that with the appalling destruction of civil rights in today’s psychiatry, and you can see quite how bankrupt contemporary psychiatric has become. Human rights are therapeutic.
1) WHAT’S WRONG Before 1900, the ‘germ theory of disease’ struggled – microscopes were few, and bacteria remained invisible to the naked eye. Male midwives notoriously refused to wash their hands between deliveries. Psychiatry today is in a similarly profound and damaging state of ignorance. This time the cause of the trouble is not only invisible – it’s also that the customer (aka the patient) is unable to say what’s really gone wrong, as with Alistair above. This derails the standard medical expectations. Whereas medics are used to solving problems posed to them – here they are asked to solve problems which are determinedly tangential to the main pathology. Psychiatry is offered the wrong end of the stick, is presented with a plausible red-herring, and being unaware of the pathology of ‘denial’ the orthodox practitioner grabs it, with calamity all round.
2) WHAT’S RIGHT Sufferers from psychiatric symptoms decline to say what's wrong, simply because they don’t want to know. And the reason they don't want to know is equally simple – it’s because it’s too frightening. They wax voluble on the painful symptoms, while remaining resolutely mute (even violently combative) on where these really come from. The root of this paradox is childishly simple. It comes directly from the standard response of any infant to trauma or abuse – i.e. denial – “this isn’t happening to me”. They grow into adult life, and cannot say “this has stopped happening to me”. Often of course they can, and the problems evaporate – but for those that cannot, the symptoms they suffer – phobias, panics, hysteria, psychoses, bipolar, personality disorders of all types, anorexia, self harm, suicidality – all arise, and can be evaporated, by tracing their origin back to a ‘frozen terror’, an infantile seizure when the infant decided that the end had come, and they did not want to know reality anymore. Persuade them to ‘grow up emotionally’ and the cure is 100% guaranteed, provided they finish the course.
3) WHAT TO DO NOW. Restore dignity and respect to sufferers from emotional distress. They are adult human beings, with full human rights, except they are currently operating on infantile survival strategies. They need help to pull themselves together – they’ve done what they can, and now need help with the remainder. In other words, it is essential to enlist the determination of the sufferer to deal with the problem from the inside. This is Emotional Education or Cognitive Emotional Therapy. There is no danger that the individual does not wish to rid themselves of the painful symptoms – they just need help, support and guidance as to how to do this. Truth, Trust and Consent are essential ingredients, since the co-operation and determination of the sufferer is crucial to any re-evaluation of the ‘frozen terror’. Bring the emotional survival strategies up to date, and the symptoms evaporate. The key is to appreciate and convey that every emotional resource is being used by the customer to prevent the dreaded truth coming out – the process of denial is heaviest in the best endowed mentally. The customer is fooling themselves as to the true root of the pain – whence fooling inept medics is child’s play. You and I know that any and all infantile damage is well and truly over – but the sufferer does not. They still inhabit a nursery nightmare where abuse or trauma is going to happen ‘next’ and the only remedy they know is not to look – to deny. Reverse this, and the glories of adulthood blossom.
Dr Bob Johnson Consultant Psychiatrist,
P O Box 49, Ventnor, Isle of Wight, PO38 9AA UK Sunday, 26 October 2008
THE BASIS OF PSYCHOSIS
ALISTAIR CAMPBELL describes his own mental breakdown as him knowing something was dreadfully wrong, and finding that everything he could think of to put it right, only made it worse. There was a lump of mental furniture right in the middle of his mind, at that time, which blocked him from implementing any sensible resolution. This, as explained below, is ‘denial’ at work – an item becomes too painful to be tackled unaided. Simple social support has repeatedly been shown to cure psychoses. I was trained in the “Therapeutic Community” approach, in 1963, an optimistic, successful approach which present day psychiatry abandoned around 1980. Its equivalent was implemented at the Quaker Retreat in York 1796 to 1850, and yielded better results at curing psychosis than ever since, as did the Soteria movement – see sample below. In contrast the so-called ‘antipsychotics’ have consistently been shown to prolong psychosis, since the late 1950s [see ‘Mad in America’ by Robert Whitaker, Perseus, ISBN 0738203858 www.madinamerica.com].
The Soteria movement, proven to be effective in curing psychosis, tells a wonderfully descriptive story. One young man with psychosis told the friendly but untrained Soteria support staff that Martians were arriving at Los Angeles airport at 4 a.m. the following morning. So they went. When the aliens failed to materialise, he said that they must have got the date wrong – I suggest this was the first time he had ever been taken seriously – his ‘consent’ mattered. He was, for the first time, getting relevant assistance for his mental stresses. Compare that with the appalling destruction of civil rights in today’s psychiatry, and you can see quite how bankrupt contemporary psychiatric has become. Human rights are therapeutic.
1) WHAT’S WRONG Before 1900, the ‘germ theory of disease’ struggled – microscopes were few, and bacteria remained invisible to the naked eye. Male midwives notoriously refused to wash their hands between deliveries. Psychiatry today is in a similarly profound and damaging state of ignorance. This time the cause of the trouble is not only invisible – it’s also that the customer (aka the patient) is unable to say what’s really gone wrong, as with Alistair above. This derails the standard medical expectations. Whereas medics are used to solving problems posed to them – here they are asked to solve problems which are determinedly tangential to the main pathology. Psychiatry is offered the wrong end of the stick, is presented with a plausible red-herring, and being unaware of the pathology of ‘denial’ the orthodox practitioner grabs it, with calamity all round.
2) WHAT’S RIGHT Sufferers from psychiatric symptoms decline to say what's wrong, simply because they don’t want to know. And the reason they don't want to know is equally simple – it’s because it’s too frightening. They wax voluble on the painful symptoms, while remaining resolutely mute (even violently combative) on where these really come from. The root of this paradox is childishly simple. It comes directly from the standard response of any infant to trauma or abuse – i.e. denial – “this isn’t happening to me”. They grow into adult life, and cannot say “this has stopped happening to me”. Often of course they can, and the problems evaporate – but for those that cannot, the symptoms they suffer – phobias, panics, hysteria, psychoses, bipolar, personality disorders of all types, anorexia, self harm, suicidality – all arise, and can be evaporated, by tracing their origin back to a ‘frozen terror’, an infantile seizure when the infant decided that the end had come, and they did not want to know reality anymore. Persuade them to ‘grow up emotionally’ and the cure is 100% guaranteed, provided they finish the course.
3) WHAT TO DO NOW. Restore dignity and respect to sufferers from emotional distress. They are adult human beings, with full human rights, except they are currently operating on infantile survival strategies. They need help to pull themselves together – they’ve done what they can, and now need help with the remainder. In other words, it is essential to enlist the determination of the sufferer to deal with the problem from the inside. This is Emotional Education or Cognitive Emotional Therapy. There is no danger that the individual does not wish to rid themselves of the painful symptoms – they just need help, support and guidance as to how to do this. Truth, Trust and Consent are essential ingredients, since the co-operation and determination of the sufferer is crucial to any re-evaluation of the ‘frozen terror’. Bring the emotional survival strategies up to date, and the symptoms evaporate. The key is to appreciate and convey that every emotional resource is being used by the customer to prevent the dreaded truth coming out – the process of denial is heaviest in the best endowed mentally. The customer is fooling themselves as to the true root of the pain – whence fooling inept medics is child’s play. You and I know that any and all infantile damage is well and truly over – but the sufferer does not. They still inhabit a nursery nightmare where abuse or trauma is going to happen ‘next’ and the only remedy they know is not to look – to deny. Reverse this, and the glories of adulthood blossom.
Dr Bob Johnson Consultant Psychiatrist,
P O Box 49, Ventnor, Isle of Wight, PO38 9AA UK Sunday, 26 October 2008
CAUSE AND CURE OF PSYCHOSIS
CAUSE AND CURE OF PSYCHOSIS
whether bipolar, mania, paranoia or any of the schizophrenias
The cause and cure of psychoses is simple, and would be obvious to all, were it not for the mountain of prejudice which so obscures our view. What is needed is to look with a clear unbiased eye at what actually happens in a psychosis. This is not possible in cold print, but on the clear assumption that what follows is well below 50% accurate, try this. Suppose you meet a person suffering a psychotic break, the conversation might perhaps go somewhat as follows. You say “hello”, they don't. You say “it’s a nice day” – they say nothing. They hear and see things you don't. They describe fears and terrors you cannot see and do not believe in. They talk in ways that make no sense to you, and about things you cannot possibly understand or follow. The dialogue is not really a dialogue, more two monologues. There is no meeting of minds – there is no consensus as to what you are talking about, or indeed about the reality you are both sharing at that moment. What usually happens in a conversation between two people – indeed the underlying purpose of any and every conversation – is the overlapping and mutual confirmation of what reality is like just then. But this simply doesn’t happen when one participant is labouring under a psychosis. That’s what a psychosis is, and that is all that a psychosis is. The rest is embroidery.
So the cure, obviously, would be to re-synchronise these two realities, yours and theirs. This requires establishing a common point, an agreed foundation or basis from which to start. Without this, you are running on parallel lines, your two versions of reality diverge. You are talking, not so much at cross-purposes, more at cross-realities. Psychotic thinking is unreal. And the origin of this unreality is fear, serious fear, best labelled terror. Psychosis does not occur unless the sufferer has been deflected from today’s reality – and the only thing powerful enough to deflect the human mind from finding out what is currently going on, is terror.
The remedy for all and every psychosis therefore, is abating the terror. This is why ‘the healing hand of kindness’ has proved so effective in the past, and will do so increasingly in the future. It forms the basis of the Therapeutic Community approach in which I was trained in 1963, as also of the Soteria movement today. And it obviously makes sense. There is a prodigious reason why the person you are talking to does not converse, does not share your interest in what's currently happening, in what is real. Remove that prodigious reason, and a commonality is again introduced, from which, since both are sociable human beings, both can benefit enormously. And the sovereign remedy for fear, is trust – whence the axiom: Truth, Trust and Consent, as discussed more fully elsewhere. Thus the cause of psychosis is terror which when removed leads invariably to cure.
overpowering prejudices
It is important here to uncover the overpowering prejudices, both medical and mythical, that so curdle our current view of psychosis. The first point to emphasise is that the orthodox medical approach is hamstrung by mental disease. No medical progress is possible without an understanding of what has gone wrong. The problem with all mental diseases however, is that the sufferer cannot tell you where the pain is coming from – and this is a particularly severe problem with the psychoses. The simple reason for this is that where the source of the agony is obvious, then the afflicted individual will already have taken all available steps to limit or expunge it. Where the origin of the pain is obscure – as here – then the sufferer can see no way through and therefore cannot help themselves. What they need most, is a clear, believable, and reliable pathway to stability – as do all those around them.
While it may be understandable that the intrinsic nature of mental disease hobbles standard medical practice, nothing can justify the nihilism that prevails in psychiatry today, nor the neglect of common human courtesy nor of Human Rights, which currently risks comparison with Soviet psychiatry. The desperate flailing of the medical mind in seeking underlying causative factors leads to bizarre and indeed inconsistent and irrational notions, some of which are downright toxic. To counter this – no psychiatric disorder is caused by genetic defects, chemical aberrations, enzyme shenanigans nor permanent damage of any kind. All available evidence supports this – there has never been any evidence to refute it, there is none now, and there are powerful philosophical reasons to suppose there never will be, however much some might wish for it. Blaming parents is equally futile – deliberate parental damage does occur, but the heart-rending suffering so often seen in parents of the severely mentally ill eliminates this factor from our enquiries. The problem is that the underlying terror is deliberately well hidden, and therefore challengingly hard to winkle out – but it’s there all right, and winkling it out is undoubtedly a realistic objective. Simple, but by no means easy.
The next point to emphasise is that every one of us can suffer psychotic breaks – we are none of us superman, or superwoman. Place any one of us under enough toxically-focussed stress, and we will all experience some or all of the following:– paranoia, inability to think straight, hallucinations, delusions, and invariably a loss of contact with today’s reality in which the rest of us live. A simpler illustration is the tantrum. Who among us can deny having at least one tantrum – the red mist descends, all other considerations are thrown to the wind, and contact with what is real is lost, temporarily for most, but longer for the psychotic sufferer. “I just went mad” is poignantly precise. The actual symptoms themselves as described by the psychotic sufferer are of no practical value whatsoever – their variability and fluidity being limited only by the imagination and creativity of that individual – another point which befuddles the standard medical mind. Their only clinical relevance is their severity, and less frequently their dangerousness. What they actually represent is the whirring of malperceptions – misperceptions of a malign hue. Once contact with reality – the common touchstone for all humanity – is lost, then there is simply no restraint on what can spout from a troubled mind.
The psychotic sufferer labours under a belief system which is no longer based on today’s reality and is therefore alien to what the rest of us believe. Most of us hold on to reality as best we can, sometimes with difficulty – so to have one of us stoutly declare that the world is full of unseen terrors, that there are voices and visions which the rest of us cannot hear or see – this shakes us to our core. In particular it challenges our own personal belief systems – and when we are threatened, we tend to react aggressively, even destructively, which explains (though it does not excuse) the appalling history of maltreatment meted out to victims of psychosis over the millennia through, inexcusably, to the present day.
the impact of terror
Since September 1986, I have been exploring the impact terror has on the human mind. In a word it induces something akin to a prolonged panic, and sometimes a prolonged tantrum. Its chief pathological defect is that it leads to a paralysis of thought – a major handicap in a thinking species like homo sapiens. If it occurs early enough in human development, it can leave an impact for the rest of that individual’s life – until resolved 100% through Emotional Education. Again, this is not easy to convey in cold print – video is better, but neither is a substitute for the real thing. In psychosis, the terror prevents access to today’s reality, which alone can demonstrate that the source of the trouble is past. And here we come to an intriguing notion. We all start remarkably small, and impotent. We need sound parental attachment to survive. We need help not only in learning language but also in determining what is real, and what is a fairy tale. And it is here that we have to look for the cure for psychosis.
For whatever reason (and the events can be legion) the sufferer from psychosis today has mislearnt the nature of human beings, of human reality. Instead of learning that human beings are born Lovable, Sociable and Non-Violent – the sufferer has picked up the message that reality is dangerous, that powerful human beings, including everyone else, are consistently malign. Such others may appear benign, they may say they are friendly – but the basic trust has been broken, and they are not to be believed. This disbelief is what needs countermanding – which explains not only what needs doing, but also that it is eminently doable, though only via inexhaustible supplies of the ‘healing hand of kindness’.
Those trying to assist sufferers from psychotic disease are at a fundamental disadvantage – the sufferer will not, indeed cannot, disclose precisely what the problem is, who it was that misinformed them as to the nature of reality, and who therefore must be contradicted in that person’s mind. Attempts to second guess the lesion, the trauma, the true source of the terror are doomed. Attempts to persuade that individual too strongly, or prematurely, will result only in re-traumatisation, and a gross aggravation of the psychotic condition. In my clinical experience, death of a mother, a ferocious outburst on the part of a father, a tantrum from either parent may hit a vulnerable individual, at the wrong moment, in the wrong way, and cause something to ‘break’ in that person’s developing mind, such that the world is thereafter viewed as just too dangerous to tolerate – “if that’s reality, I don't want to know”.
This may well sound like gobbledy-gook to those not familiar with psychotic thinking, and perhaps even more so to those that are. Bear in mind that the individual sufferer will insist that the incident in question was trivial, jocular, of no consequence. And this insistence is intense – as if on pain of death. Bear in mind further that such individuals cannot “live with the fact that my parent tried to kill me”. Since they cannot live with this “fact”, they hide it away as fiercely and as deeply as they can. Which is anomalous, since this “fact” has not been born out by the event – namely your death – a point in logic, reason and today’s reality which can assist (though invariably only with the sufferer’s explicit consent) as a verbal spanner in unpacking this deep-seated terror. The quantity of calumny that has been heaped on my head because of this ‘denial’ is legion, and not only from my bemused psychiatric colleagues. It is a matter of record that psychiatric drugs have proved no better than sedatives – indeed for 50 years the evidence is that they prolong psychoses, and should therefore be relabelled ‘pro-psychotics’, not anti-psychotics. The reason for this is simple – they add, and are misguidedly intended to add, a chemical barrier to reality, to supplement the existing mental one. Mandatory administration of such medical ‘treatment’ without consent, calls for urgent legal and indeed political review.
The root of psychosis
Here is the true root of psychosis. The afflicted individual builds a ‘safer’ world, and conjures up in their imagination a more benign ‘pretend’ reality which, en passant, does not include the abuser, or at least the abusive event. The tragedy is that when they grow up, they cannot then readily re-connect with the reality in which the rest of us live, or try to live. To do that entails confronting the remnant of the misguided parent or carer who inadvertently or otherwise broke that infantile trust. All abused children carry among their mental furniture a parental figment or image of their abuser, which it is the aim of treatment to expel. In psychoses the figment is even more potent, and comes to act as a lethal gatekeeper for reality – do not question or disbelieve what your carer taught you, or you will come to a sticky end. The human mind is quite up to this sort of challenge, and builds barriers against it, which are as thick and robust as the mental resources available to that individual allow. The point being that these barriers are built as life-savers – hence they remain insuperable, and ferociously well defended, until melted by benign external forces. The sole aim of Cognitive Emotional Therapy is to dispel them, with the sufferer’s explicit consent – a handy challenge at the best of times. Simple yes, but not necessarily easy.
There is thus a simple pattern to the cause and cure of psychosis. There is a simple logic to the picture just described. There are also vast fears and prejudices, medical and mythical, which belie this simplicity, and which strive to prevent it seeing the light of day. But there are also powerful and realistic forces pushing for a more humane approach to mental suffering. There is now even legal backing behind Human Rights, which are therapeutic. The foregoing is written in the hope and expectation that the more benign view will prevail. Those wishing to assist could contact us via our website www.JamesNaylerFoundation.org
whether bipolar, mania, paranoia or any of the schizophrenias
The cause and cure of psychoses is simple, and would be obvious to all, were it not for the mountain of prejudice which so obscures our view. What is needed is to look with a clear unbiased eye at what actually happens in a psychosis. This is not possible in cold print, but on the clear assumption that what follows is well below 50% accurate, try this. Suppose you meet a person suffering a psychotic break, the conversation might perhaps go somewhat as follows. You say “hello”, they don't. You say “it’s a nice day” – they say nothing. They hear and see things you don't. They describe fears and terrors you cannot see and do not believe in. They talk in ways that make no sense to you, and about things you cannot possibly understand or follow. The dialogue is not really a dialogue, more two monologues. There is no meeting of minds – there is no consensus as to what you are talking about, or indeed about the reality you are both sharing at that moment. What usually happens in a conversation between two people – indeed the underlying purpose of any and every conversation – is the overlapping and mutual confirmation of what reality is like just then. But this simply doesn’t happen when one participant is labouring under a psychosis. That’s what a psychosis is, and that is all that a psychosis is. The rest is embroidery.
So the cure, obviously, would be to re-synchronise these two realities, yours and theirs. This requires establishing a common point, an agreed foundation or basis from which to start. Without this, you are running on parallel lines, your two versions of reality diverge. You are talking, not so much at cross-purposes, more at cross-realities. Psychotic thinking is unreal. And the origin of this unreality is fear, serious fear, best labelled terror. Psychosis does not occur unless the sufferer has been deflected from today’s reality – and the only thing powerful enough to deflect the human mind from finding out what is currently going on, is terror.
The remedy for all and every psychosis therefore, is abating the terror. This is why ‘the healing hand of kindness’ has proved so effective in the past, and will do so increasingly in the future. It forms the basis of the Therapeutic Community approach in which I was trained in 1963, as also of the Soteria movement today. And it obviously makes sense. There is a prodigious reason why the person you are talking to does not converse, does not share your interest in what's currently happening, in what is real. Remove that prodigious reason, and a commonality is again introduced, from which, since both are sociable human beings, both can benefit enormously. And the sovereign remedy for fear, is trust – whence the axiom: Truth, Trust and Consent, as discussed more fully elsewhere. Thus the cause of psychosis is terror which when removed leads invariably to cure.
overpowering prejudices
It is important here to uncover the overpowering prejudices, both medical and mythical, that so curdle our current view of psychosis. The first point to emphasise is that the orthodox medical approach is hamstrung by mental disease. No medical progress is possible without an understanding of what has gone wrong. The problem with all mental diseases however, is that the sufferer cannot tell you where the pain is coming from – and this is a particularly severe problem with the psychoses. The simple reason for this is that where the source of the agony is obvious, then the afflicted individual will already have taken all available steps to limit or expunge it. Where the origin of the pain is obscure – as here – then the sufferer can see no way through and therefore cannot help themselves. What they need most, is a clear, believable, and reliable pathway to stability – as do all those around them.
While it may be understandable that the intrinsic nature of mental disease hobbles standard medical practice, nothing can justify the nihilism that prevails in psychiatry today, nor the neglect of common human courtesy nor of Human Rights, which currently risks comparison with Soviet psychiatry. The desperate flailing of the medical mind in seeking underlying causative factors leads to bizarre and indeed inconsistent and irrational notions, some of which are downright toxic. To counter this – no psychiatric disorder is caused by genetic defects, chemical aberrations, enzyme shenanigans nor permanent damage of any kind. All available evidence supports this – there has never been any evidence to refute it, there is none now, and there are powerful philosophical reasons to suppose there never will be, however much some might wish for it. Blaming parents is equally futile – deliberate parental damage does occur, but the heart-rending suffering so often seen in parents of the severely mentally ill eliminates this factor from our enquiries. The problem is that the underlying terror is deliberately well hidden, and therefore challengingly hard to winkle out – but it’s there all right, and winkling it out is undoubtedly a realistic objective. Simple, but by no means easy.
The next point to emphasise is that every one of us can suffer psychotic breaks – we are none of us superman, or superwoman. Place any one of us under enough toxically-focussed stress, and we will all experience some or all of the following:– paranoia, inability to think straight, hallucinations, delusions, and invariably a loss of contact with today’s reality in which the rest of us live. A simpler illustration is the tantrum. Who among us can deny having at least one tantrum – the red mist descends, all other considerations are thrown to the wind, and contact with what is real is lost, temporarily for most, but longer for the psychotic sufferer. “I just went mad” is poignantly precise. The actual symptoms themselves as described by the psychotic sufferer are of no practical value whatsoever – their variability and fluidity being limited only by the imagination and creativity of that individual – another point which befuddles the standard medical mind. Their only clinical relevance is their severity, and less frequently their dangerousness. What they actually represent is the whirring of malperceptions – misperceptions of a malign hue. Once contact with reality – the common touchstone for all humanity – is lost, then there is simply no restraint on what can spout from a troubled mind.
The psychotic sufferer labours under a belief system which is no longer based on today’s reality and is therefore alien to what the rest of us believe. Most of us hold on to reality as best we can, sometimes with difficulty – so to have one of us stoutly declare that the world is full of unseen terrors, that there are voices and visions which the rest of us cannot hear or see – this shakes us to our core. In particular it challenges our own personal belief systems – and when we are threatened, we tend to react aggressively, even destructively, which explains (though it does not excuse) the appalling history of maltreatment meted out to victims of psychosis over the millennia through, inexcusably, to the present day.
the impact of terror
Since September 1986, I have been exploring the impact terror has on the human mind. In a word it induces something akin to a prolonged panic, and sometimes a prolonged tantrum. Its chief pathological defect is that it leads to a paralysis of thought – a major handicap in a thinking species like homo sapiens. If it occurs early enough in human development, it can leave an impact for the rest of that individual’s life – until resolved 100% through Emotional Education. Again, this is not easy to convey in cold print – video is better, but neither is a substitute for the real thing. In psychosis, the terror prevents access to today’s reality, which alone can demonstrate that the source of the trouble is past. And here we come to an intriguing notion. We all start remarkably small, and impotent. We need sound parental attachment to survive. We need help not only in learning language but also in determining what is real, and what is a fairy tale. And it is here that we have to look for the cure for psychosis.
For whatever reason (and the events can be legion) the sufferer from psychosis today has mislearnt the nature of human beings, of human reality. Instead of learning that human beings are born Lovable, Sociable and Non-Violent – the sufferer has picked up the message that reality is dangerous, that powerful human beings, including everyone else, are consistently malign. Such others may appear benign, they may say they are friendly – but the basic trust has been broken, and they are not to be believed. This disbelief is what needs countermanding – which explains not only what needs doing, but also that it is eminently doable, though only via inexhaustible supplies of the ‘healing hand of kindness’.
Those trying to assist sufferers from psychotic disease are at a fundamental disadvantage – the sufferer will not, indeed cannot, disclose precisely what the problem is, who it was that misinformed them as to the nature of reality, and who therefore must be contradicted in that person’s mind. Attempts to second guess the lesion, the trauma, the true source of the terror are doomed. Attempts to persuade that individual too strongly, or prematurely, will result only in re-traumatisation, and a gross aggravation of the psychotic condition. In my clinical experience, death of a mother, a ferocious outburst on the part of a father, a tantrum from either parent may hit a vulnerable individual, at the wrong moment, in the wrong way, and cause something to ‘break’ in that person’s developing mind, such that the world is thereafter viewed as just too dangerous to tolerate – “if that’s reality, I don't want to know”.
This may well sound like gobbledy-gook to those not familiar with psychotic thinking, and perhaps even more so to those that are. Bear in mind that the individual sufferer will insist that the incident in question was trivial, jocular, of no consequence. And this insistence is intense – as if on pain of death. Bear in mind further that such individuals cannot “live with the fact that my parent tried to kill me”. Since they cannot live with this “fact”, they hide it away as fiercely and as deeply as they can. Which is anomalous, since this “fact” has not been born out by the event – namely your death – a point in logic, reason and today’s reality which can assist (though invariably only with the sufferer’s explicit consent) as a verbal spanner in unpacking this deep-seated terror. The quantity of calumny that has been heaped on my head because of this ‘denial’ is legion, and not only from my bemused psychiatric colleagues. It is a matter of record that psychiatric drugs have proved no better than sedatives – indeed for 50 years the evidence is that they prolong psychoses, and should therefore be relabelled ‘pro-psychotics’, not anti-psychotics. The reason for this is simple – they add, and are misguidedly intended to add, a chemical barrier to reality, to supplement the existing mental one. Mandatory administration of such medical ‘treatment’ without consent, calls for urgent legal and indeed political review.
The root of psychosis
Here is the true root of psychosis. The afflicted individual builds a ‘safer’ world, and conjures up in their imagination a more benign ‘pretend’ reality which, en passant, does not include the abuser, or at least the abusive event. The tragedy is that when they grow up, they cannot then readily re-connect with the reality in which the rest of us live, or try to live. To do that entails confronting the remnant of the misguided parent or carer who inadvertently or otherwise broke that infantile trust. All abused children carry among their mental furniture a parental figment or image of their abuser, which it is the aim of treatment to expel. In psychoses the figment is even more potent, and comes to act as a lethal gatekeeper for reality – do not question or disbelieve what your carer taught you, or you will come to a sticky end. The human mind is quite up to this sort of challenge, and builds barriers against it, which are as thick and robust as the mental resources available to that individual allow. The point being that these barriers are built as life-savers – hence they remain insuperable, and ferociously well defended, until melted by benign external forces. The sole aim of Cognitive Emotional Therapy is to dispel them, with the sufferer’s explicit consent – a handy challenge at the best of times. Simple yes, but not necessarily easy.
There is thus a simple pattern to the cause and cure of psychosis. There is a simple logic to the picture just described. There are also vast fears and prejudices, medical and mythical, which belie this simplicity, and which strive to prevent it seeing the light of day. But there are also powerful and realistic forces pushing for a more humane approach to mental suffering. There is now even legal backing behind Human Rights, which are therapeutic. The foregoing is written in the hope and expectation that the more benign view will prevail. Those wishing to assist could contact us via our website www.JamesNaylerFoundation.org
Dr Bob Johnson is a psychiatrist and an outspoken opponent of electroconvulsive therapy and psychosurgery in general.
Dr Bob Johnson is a psychiatrist and an outspoken opponent of electroconvulsive therapy and psychosurgery in general.
He currently acts as Consultant to the James Nayler Foundation, a charity set up to further research, education, training and treatment for all types of personality disorders, especially those involving violence to others or to self. A charismatic character with a strong magnetic personality, he is seen as a leader figure in the Foundation, which in turn is sometimes identified with him.
He trained at the University of Cambridge, the London Hospital, and at the renowned Claybury Hospital, Essex, where he obtained a grounding in group work and therapeutic community techniques. In 1964 he was appointed as a Senior Psychiatrist in Middletown State Hospital, New York, working in the Drug Addiction Unit and the acute wards.
His renown largely stems from his time as consultant psychiatrist in the Special Unit in HMP Parkhurst for dangerous prisoners. While there he devised his talking cure techniques around which the James Nayler Foundation and his personal crusade against psychosurgery and psychiatric medication. His work formed the basis of a documentary investigation by the BBC's flagship programme Panorama.
In 1997, he was consultant psychiatrist to The Retreat, and in 1998 he was invited to become Head of Therapy at Ashworth Special Hospital.
He has since set up an Emotional Support Centre on the Isle of Wight to assist and cure those with personality disorders.
[edit] Further reading
Emotional Health, Bob Johnson
Unsafe At Any Dose, Bob Johnson
He currently acts as Consultant to the James Nayler Foundation, a charity set up to further research, education, training and treatment for all types of personality disorders, especially those involving violence to others or to self. A charismatic character with a strong magnetic personality, he is seen as a leader figure in the Foundation, which in turn is sometimes identified with him.
He trained at the University of Cambridge, the London Hospital, and at the renowned Claybury Hospital, Essex, where he obtained a grounding in group work and therapeutic community techniques. In 1964 he was appointed as a Senior Psychiatrist in Middletown State Hospital, New York, working in the Drug Addiction Unit and the acute wards.
His renown largely stems from his time as consultant psychiatrist in the Special Unit in HMP Parkhurst for dangerous prisoners. While there he devised his talking cure techniques around which the James Nayler Foundation and his personal crusade against psychosurgery and psychiatric medication. His work formed the basis of a documentary investigation by the BBC's flagship programme Panorama.
In 1997, he was consultant psychiatrist to The Retreat, and in 1998 he was invited to become Head of Therapy at Ashworth Special Hospital.
He has since set up an Emotional Support Centre on the Isle of Wight to assist and cure those with personality disorders.
[edit] Further reading
Emotional Health, Bob Johnson
Unsafe At Any Dose, Bob Johnson
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD)
Post traumatic stress disorder is a condition where you have recurring distressing memories, 'flashbacks', and other symptoms after suffering a traumatic event. Treatment options include antidepressant medication and non-drug treatments such as cognitive behaviour therapy. .
What is post-traumatic stress disorder?.
PTSD is a condition which develops after you have been involved in, or witnessed, a serious trauma such as a life-threatening assault. During the trauma you feel intense fear, helplessness or horror. In some people PTSD develops soon after the trauma. However, in some cases the symptoms first develop several months, or even years, after the trauma..
Who gets post-traumatic stress disorder?.
The strict definition of PTSD is that the trauma you had or witnessed must be severe. For example: a severe accident, rape, a life-threatening assault, torture, seeing someone killed, etc. However, symptoms similar to PTSD develop in some people after less severe traumatic events..
It is estimated that up to 1 in 10 people may develop PTSD at some stage in life. It is much more common in certain groups of people. For example, some studies have found that PTSD develops in about:.
•1 in 5 fire-fighters.
•1 in 3 teenager survivors of car crashes.
•1 in 2 female rape victims.
•2 in 3 prisoners of war.
What are the symptoms of post-traumatic stress disorder?.
•Recurring thoughts, memories, images, dreams, or 'flashbacks' of the trauma which are distressing.
•You try to avoid thoughts, conversations, places, people, activities or anything which may trigger memories of the trauma as these make you distressed or anxious.
•Feeling emotionally 'numb' and feeling 'detached' from others. You may find it difficult to have loving feelings.
•Your outlook for the future is often pessimistic. You may lose interest in activities which you used to enjoy and find it difficult to plan for the future.
•Increased 'arousal' which you did not have before the trauma. This may include:
◦difficulty in getting off to sleep or staying asleep.
◦being irritable which may include outbursts of anger.
◦difficulty concentrating.
◦increased vigilance.
◦you may be 'startled' more easily than before.
Note: it is normal to feel upset straight after a traumatic event. But for many people the distress gradually eases. If you have PTSD the distressing feelings and symptoms persist. In some cases the symptoms last just a few months, and then ease or go. However, in many cases the symptoms persist long-term..
Up to 4 in 5 people with PTSD also have other mental health problems. For example, depression, persistent anxiety, panic attacks, phobias, drug or alcohol abuse. Having a mental health disorder before the trauma seems to increase your chance of developing PTSD. But also, having PTSD seems to increase your risk of developing other mental health disorders..
What is the treatment for post-traumatic stress disorder?.
Treatment can help to ease symptoms and help you to adjust following a trauma. However, no treatment will 'wipe the slate clean' and erase all memories of the event. (Note: some non-drug treatments mentioned below may not be available on the NHS in every area.).
Talking treatments and other non-drug treatments.
•Cognitive behaviour therapy (CBT) may be advised. Briefly, CBT is based on the idea that certain ways of thinking can trigger, or 'fuel', certain mental health problems such as PTSD. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful, and 'false' ideas or thoughts. The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful. It may help especially to counter recurring distressing thoughts, and 'avoidance' behaviour. Therapy is usually done in weekly sessions of about 50 minutes each, for several weeks. You have to take an active part, and are given 'homework' between sessions.
•Eye Movement Desensitization and Reprocessing (EMDR) is a treatment that seems to work quite well for PTSD. Briefly, during this treatment a therapist asks you to think of aspects of the traumatic event. Whilst you are thinking about this you follow the movement of the therapists moving fingers with your eyes. It is not clear how this works. It seems to 'desensitise' your thought patterns about the traumatic event. After a few sessions of therapy, you may find that the memories of the event do not upset you as much as before.
•Other forms of talking treatments such as anxiety management, counselling, group therapy, and learning to relax may be advised.
•Self help. Joining a group where members have similar symptoms can be useful. This does not appeal to everyone, but books and leaflets on understanding PTSD and how to combat it may help. A longer leaflet in this series called 'Post Traumatic Stress Disorder - a Self Help Guide' is a good start. See also the groups listed below.
Medication.
•Antidepressant medicines are often prescribed. These are commonly used to treat depression, but have been found to help reduce the main symptoms of PTSD even if you are not depressed. They work by interfering with brain chemicals (neurotransmitters) such as serotonin which may be involved in causing symptoms. Antidepressants take 2-4 weeks before their effect builds up, and can take up to three months. A common problem is that some people stop the medicine after a week or so as they feel that it is doing no good. You need to give an antidepressant time to work. If one does help, it is usual to stay on the medication for 6-12 months, sometimes longer.
There are several types of antidepressants. However, SSRI antidepressants (selective serotonin reuptake inhibitors) are the ones most commonly used for PTSD. There are various types and brands of SSRI.
•Benzodiazepines such as diazepam are sometimes prescribed for a short time to ease symptoms of anxiety, poor sleep, and irritability. The problem is, they are addictive and can lose their effect if you take them for more than a few weeks. They may also make you drowsy. Therefore, they are not used long-term. A short course of up to 2-3 weeks may be prescribed 'now and then' if you have a particularly bad spell of anxiety symptoms.
•Other medicines such as beta-blockers, mood stabilisers, and anticonvulsants are being studied. These are normally used to treat other conditions but there is some evidence that they may help some people with PTSD. Further research is needed to clarify their role.
A combination of treatments such as cognitive behaviour therapy and an SSRI antidepressant may work better in some cases than either treatment alone..
Can post-traumatic stress disorder be prevented?.
•'Debriefing' is now offered more and more to military personnel after a conflict, to people affected by natural disasters, etc. It involves discussing the event, expressing emotions, and examining your reactions to the event soon after it is over. Further research is needed as it is not clear whether debriefing reduces your chance of developing long-term PTSD. Some people even feel that one session of 'debriefing' may do more harm than good.
•Therapy soon after the traumatic event. Some evidence suggests that a type of cognitive therapy started within 14 days of the trauma can reduce the chance of long-term symptoms of PTSD developing.
•A short course of medication such as diazepam (a benzodiazepine) or a betablocker taken immediately after a traumatic event may possibly help to prevent long-term symptoms of PTSD from developing. Further research is needed to clarify if any medicines help.
Post traumatic stress disorder is a condition where you have recurring distressing memories, 'flashbacks', and other symptoms after suffering a traumatic event. Treatment options include antidepressant medication and non-drug treatments such as cognitive behaviour therapy. .
What is post-traumatic stress disorder?.
PTSD is a condition which develops after you have been involved in, or witnessed, a serious trauma such as a life-threatening assault. During the trauma you feel intense fear, helplessness or horror. In some people PTSD develops soon after the trauma. However, in some cases the symptoms first develop several months, or even years, after the trauma..
Who gets post-traumatic stress disorder?.
The strict definition of PTSD is that the trauma you had or witnessed must be severe. For example: a severe accident, rape, a life-threatening assault, torture, seeing someone killed, etc. However, symptoms similar to PTSD develop in some people after less severe traumatic events..
It is estimated that up to 1 in 10 people may develop PTSD at some stage in life. It is much more common in certain groups of people. For example, some studies have found that PTSD develops in about:.
•1 in 5 fire-fighters.
•1 in 3 teenager survivors of car crashes.
•1 in 2 female rape victims.
•2 in 3 prisoners of war.
What are the symptoms of post-traumatic stress disorder?.
•Recurring thoughts, memories, images, dreams, or 'flashbacks' of the trauma which are distressing.
•You try to avoid thoughts, conversations, places, people, activities or anything which may trigger memories of the trauma as these make you distressed or anxious.
•Feeling emotionally 'numb' and feeling 'detached' from others. You may find it difficult to have loving feelings.
•Your outlook for the future is often pessimistic. You may lose interest in activities which you used to enjoy and find it difficult to plan for the future.
•Increased 'arousal' which you did not have before the trauma. This may include:
◦difficulty in getting off to sleep or staying asleep.
◦being irritable which may include outbursts of anger.
◦difficulty concentrating.
◦increased vigilance.
◦you may be 'startled' more easily than before.
Note: it is normal to feel upset straight after a traumatic event. But for many people the distress gradually eases. If you have PTSD the distressing feelings and symptoms persist. In some cases the symptoms last just a few months, and then ease or go. However, in many cases the symptoms persist long-term..
Up to 4 in 5 people with PTSD also have other mental health problems. For example, depression, persistent anxiety, panic attacks, phobias, drug or alcohol abuse. Having a mental health disorder before the trauma seems to increase your chance of developing PTSD. But also, having PTSD seems to increase your risk of developing other mental health disorders..
What is the treatment for post-traumatic stress disorder?.
Treatment can help to ease symptoms and help you to adjust following a trauma. However, no treatment will 'wipe the slate clean' and erase all memories of the event. (Note: some non-drug treatments mentioned below may not be available on the NHS in every area.).
Talking treatments and other non-drug treatments.
•Cognitive behaviour therapy (CBT) may be advised. Briefly, CBT is based on the idea that certain ways of thinking can trigger, or 'fuel', certain mental health problems such as PTSD. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful, and 'false' ideas or thoughts. The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful. It may help especially to counter recurring distressing thoughts, and 'avoidance' behaviour. Therapy is usually done in weekly sessions of about 50 minutes each, for several weeks. You have to take an active part, and are given 'homework' between sessions.
•Eye Movement Desensitization and Reprocessing (EMDR) is a treatment that seems to work quite well for PTSD. Briefly, during this treatment a therapist asks you to think of aspects of the traumatic event. Whilst you are thinking about this you follow the movement of the therapists moving fingers with your eyes. It is not clear how this works. It seems to 'desensitise' your thought patterns about the traumatic event. After a few sessions of therapy, you may find that the memories of the event do not upset you as much as before.
•Other forms of talking treatments such as anxiety management, counselling, group therapy, and learning to relax may be advised.
•Self help. Joining a group where members have similar symptoms can be useful. This does not appeal to everyone, but books and leaflets on understanding PTSD and how to combat it may help. A longer leaflet in this series called 'Post Traumatic Stress Disorder - a Self Help Guide' is a good start. See also the groups listed below.
Medication.
•Antidepressant medicines are often prescribed. These are commonly used to treat depression, but have been found to help reduce the main symptoms of PTSD even if you are not depressed. They work by interfering with brain chemicals (neurotransmitters) such as serotonin which may be involved in causing symptoms. Antidepressants take 2-4 weeks before their effect builds up, and can take up to three months. A common problem is that some people stop the medicine after a week or so as they feel that it is doing no good. You need to give an antidepressant time to work. If one does help, it is usual to stay on the medication for 6-12 months, sometimes longer.
There are several types of antidepressants. However, SSRI antidepressants (selective serotonin reuptake inhibitors) are the ones most commonly used for PTSD. There are various types and brands of SSRI.
•Benzodiazepines such as diazepam are sometimes prescribed for a short time to ease symptoms of anxiety, poor sleep, and irritability. The problem is, they are addictive and can lose their effect if you take them for more than a few weeks. They may also make you drowsy. Therefore, they are not used long-term. A short course of up to 2-3 weeks may be prescribed 'now and then' if you have a particularly bad spell of anxiety symptoms.
•Other medicines such as beta-blockers, mood stabilisers, and anticonvulsants are being studied. These are normally used to treat other conditions but there is some evidence that they may help some people with PTSD. Further research is needed to clarify their role.
A combination of treatments such as cognitive behaviour therapy and an SSRI antidepressant may work better in some cases than either treatment alone..
Can post-traumatic stress disorder be prevented?.
•'Debriefing' is now offered more and more to military personnel after a conflict, to people affected by natural disasters, etc. It involves discussing the event, expressing emotions, and examining your reactions to the event soon after it is over. Further research is needed as it is not clear whether debriefing reduces your chance of developing long-term PTSD. Some people even feel that one session of 'debriefing' may do more harm than good.
•Therapy soon after the traumatic event. Some evidence suggests that a type of cognitive therapy started within 14 days of the trauma can reduce the chance of long-term symptoms of PTSD developing.
•A short course of medication such as diazepam (a benzodiazepine) or a betablocker taken immediately after a traumatic event may possibly help to prevent long-term symptoms of PTSD from developing. Further research is needed to clarify if any medicines help.
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