Depression can exist alongside nearly any psychiatric disorder. Many of the mentally ill experience feelings of isolation and despair, which lead to depression. For other illnesses, such as borderline personality disorder, depression is actually one of several symptoms.

Many depression patients (around 70%) have noticeable anxiety problems, and in turn, many patients with anxiety disorders experience depression. The correlation between depression and anxiety is so great, that many of the newer anti-depressants provide some anxiety relief and were devised with that goal in mind (Serzone (Nefazodone)and some of the SSRIs fall into this category). Also, some anti-anxiety medications are used to treat depression.

There's also a strong correlation between addiction and depression. The relationship between them can vary from one individual to another. Some are depressed, and then abuse drugs and/or alcohol as a sort of self-medication, to make themselves feel better. Others, as a result of the addiction and its detrimental effects, become depressed over time. The same is true of eating disorders, such as anorexia nervosa or bulimia.

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UK laws regarding truancy and how the police can respond to truancy.

Police Power To Remove Truants

Section 16

This power enables a police officer to take truants back to school or other place designated by the local education authority. It is not a power of arrest or detention nor does it make truancy a criminal offence.

Full copy of the Government Guidelines Click Here

This extract from the Government Guidance document indicates that the police and other authorities should be aware that home educated children or children on fixed term or permanent exclussions are not truants.

Children being educated otherwise than at school

4.20 In planning for, and operating, a truancy initiative using the new power it is important to remember that not all children aged 5-16 are registered at school. Children educated outside the school system altogether (see paragraph 4.1), for example, by home tuition, might be out and about during the daytime for wholly legitimate reasons, for example visiting a library.

4.21 Local procedures should take account of possible contact with such home-educated children and it should be emphasised that they are not the target group for the new power. The power can only be exercised in relation to registered pupils of compulsory school age absent from school without authority; it does not apply to children who are lawfully educated at home. No further action should be taken where children indicate that they are home-educated - unless the constable has reason to doubt that this is the case.

Excluded pupils

4.22 Pupils excluded from school for breaches of discipline fall into two basic categories:

fixed period exclusions: a short term suspension, usually for a few days. Pupils on fixed period exclusions remain on roll and are absent from school with authority. If encountered during a truancy operation, the power does not apply to them and no further action should be taken, unless the police officer concerned has reasonable cause to suspect that they are not telling the truth.

permanent exclusions: once confirmed, permanent exclusion leads to a pupil being struck off the school roll. If a pupil claims to have been permanently excluded the constable should establish whether the pupil has yet found a place at another school (including a Pupil Referral Unit) or taken up provision made by the LEA (eg home tuition). Where alternative educational provision has been made for them at a school/PRU and they are absent from it without authority the power applies. If a pupil indicates that a permanent exclusion appeal is in progress, the power does not apply to them and no further action should be taken, unless the officer has reasonable cause to believe that the child is not telling the truth.

Other steps are being taken by the Government in conjunction with LEAs and schools, to reduce the numbers involved and the length of exclusions.

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We all long for true intimacy. Many people seek to fill that void by seeking sexual relationships, whether real or fantasized, that promise to provide the relief, acceptance, and fulfillment for which they long.

Sexual Conflicts Between Partners

Because we are evolving beings, our need or lack of need for sexual expression will flux and change. It may sometimes feel impossible for two people to remain harmonious in a mutual level of desire for any prolonged length of time. There is tremendous understanding available if we are able to listen deeply whenever a lack of harmony arises between us. We are gift bearers, bringing messages to ourselves and to one another through our sexual sharing. The ability to remain still enough to hear these messages requires tremendous discipline -- the discipline of not complaining, of not blaming, of not fearing or doubting or judging. It is, in fact, the ultimate discipline of unconditional love and curiosity.

There are many reasons why two people are drawn sexually to one another. There is the need to be reassured, to reassure the other, to forget separateness, to be safe, to feel alive and vibrant, to be united, to feel in communion with, to ward off loneliness, to feel valued, to be momentarily complete, to do our duty, to transcend the daily boredom, to touch the mysterious, to awaken the life force, to be consumed by a power greater than the mind, to heal misunderstandings, to claim our territory, to reinstate our affectionate hold, to give what we believe the other wants, to keep peace, to express tenderness, and on and on and on. All of the reasons are valid; all of them are part of a deep urge toward wholeness and love.

But each different reason carries with it a different energy field. Some of these fields are mutually compatible, and some are not. If, for example, we are longing to be reassured that we are loved and valued, and our partner is giving what he or she considers to be a duty, neither of us will be satisfied.

During times of disconnectedness, if we can intimately and with deep trust venture together into our most vulnerable honesties, we will begin to discover the understanding that can eventually lead to healing.

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We have been given few attributes as potent, volatile, and complex as our sexuality. For our sexuality often becomes a focal point where unacknowledged fears, hopes, expectations, and griefs rise to the surface.

It takes courage to go beyond our fear and actually acknowledge what is buried within us, but, when we do, we open the way for communion, joy, and profound discovery.

The more we can share about ourselves with our beloved, the more sexual harmony we will enjoy, and the greater will be our ability to discover and heal all the fears and misconceptions that keep us from our true capacity for intimacy, pleasure, and fulfillment.

Intimacy and Humility

We have been socialized in this culture to believe in a romantic fantasy in which two people meet, fall in love, live happily ever after, and never need anyone else.

This, we all eventually discover, is merely a fairy tale, and seeking it distracts us from the possibility of a more fulfilling voyage of discovery, a voyage that can lead us deeper into ourselves and into each other.

Inevitably, we bring not only our love to a relationship, but also our wounds and confusion. As the relationship begins to mature, we become a bit more willing to let go of the image that we believed we needed to maintain in order to love or to be loved. We become willing to risk showing more of ourselves, more of those places where we believe we are flawed.

Healing relationships give us the courage to face ourselves, to see those attitudes and behaviors that are not in keeping with our essential being. They show us the ways in which we distance ourselves from others, and enable us to see how we defend those habits and beliefs that compromise our well-being and the well-being of our relationships. As we acknowledge and share these patterns, they can become undone. Conflict, guilt, sorrow, and all the other fearful emotions can lead us to the place where the wounded child waits in hiding, so that what has been hurt can be brought to health.

When our heart's desire is to heal ourselves and each other, then every single moment can become an invitation to move toward love. When we open to ourselves and to our beloved with honor and total acceptance, something miraculous happens. In the full mingling of our spirits we are renewed, strengthened, and delivered to our highest possibilities. Our love has become a bridge not only to ourselves and to each other, but to life itself.

Criticism and Intimacy

There are times in every intimate relationship when we wish to express to the other person that he or she is doing something that we feel is not in alignment with his or her spirit.

This is a delicate moment. For when we share any kind of criticism, the attitude we hold toward the other and the manner in which we speak are an essential part of the message we convey. The communication becomes difficult to receive if we are relating out of a sense of separation or condescension, if we are bitter, judgmental, or angry or if we are needing the other person to change. There is a much greater possibility that our communication will be heard and received when we are embracing the other as essentially well and whole, and when we speak with acceptance and respect for who he or she already is.

We have all at times used our intimate relationships as a place to vent our frustrations. A healing relationship, however, calls for impeccable responsibility and infinite fairness and respect. For only then can enough trust develop so that trembling hearts can open deeply to each other and risk being known.

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This article was excerpted from the book The Awakened Heart : Meditations on Finding Harmony in a Changing World, © by John Robbins and Ann Mortifee. Reprinted with permission of the publisher HJ Kramer/New World Library, Novato, CA 94949.

A fear of intimacy will interfere with your capacity for intimacy.

next: Fear of Intimacy

"The phenomenal growth of AA and the success of the disease concept in the treatment of Alcoholism generated the founding of treatment centers in the late 1950s and early 1960s. These early treatment centers were based on what had been successful in early AA. They focused on getting the Alcoholic sober and paid very little attention to the families of Alcoholics.

As these treatment centers matured and evolved, they noticed that the families of Alcoholics seemed to have certain characteristics and patterns of behavior in common. So they started to pay some attention to the families.

A term was coined to describe the significant others of Alcoholics. That term was "co-alcoholic" - literally "alcoholic with."

The belief was that while the Alcoholic was addicted to alcohol, the co-alcoholic was addicted in certain ways to the Alcoholic. The belief was that the families of Alcoholics became sick because of the Alcoholic's drinking and behavior.

With the drug explosion of the sixties, Alcoholism treatment centers became chemical dependency treatment centers. Co-alcoholics became co-dependents. The meaning was still a literal "dependent with," and the philosophy was much the same.

In the mid-to-late seventies, however, certain pioneers in the field began to look more closely at the behavior patterns of families affected by addiction. Some researchers focused primarily on Alcoholic families, and then graduated to studying adults who had grown up in Alcoholic families. Other researchers started looking more closely at the phenomenon of Family Systems Dynamics.

Out of these studies came the defining of the Adult Child Syndrome, at first primarily in terms of Adult Children of Alcoholics and then expanding to other types of dysfunctional families.

Ironically this research was in a sense a rediscovery of the insight which in many ways was the birth of modern psychology. Sigmund Freud made his early fame as a teenager with his insight into the importance of early childhood trauma. (This was many years before he started shooting cocaine and decided that sex was the root of all psychology.)

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What the researchers were beginning to understand was how profoundly the emotional trauma of early childhood affects a person as an adult. They realized that if not healed, these early childhood emotional wounds, and the subconscious attitudes adopted because of them, would dictate the adult's reaction to, and path through, life. Thus we walk around looking like and trying to act like adults, while reacting to life out of the emotional wounds and attitudes of childhood. We keep repeating the patterns of abandonment, abuse, and deprivation that we experienced in childhood.

Psychoanalysis addressed these issues only on the intellectual level - not on the emotional healing level. As a result, a person could go to psychoanalysis weekly for twenty years and still be repeating the same behavior patterns.

As the Adult Child movement, the Family Systems Dynamics research, and the newly emerging "inner child" healing movement expanded and developed in the eighties, the term "Codependent" expanded. It became a term used as a description of certain types of behavior patterns. These were basically identified as "people-pleasing" behaviors. By the middle to late eighties the term "Codependent" was associated with people-pleasers who set themselves up to be victims and rescuers.

In other words, it was recognized that the Codependent was not sick because of the Alcoholic but rather was attracted to the Alcoholic because of his/her disease, because of her/his early childhood experience.

At that time Codependence was basically defined as a passive behavioral defense system, and its opposite, or aggressive counterpart was described as counter dependent. Then most Alcoholics and addicts were thought to be counter dependent.

The word changed and evolved further after the start of the modern Codependence movement in Arizona in the mid-eighties. Co-Dependents Anonymous had its first meeting in October of 1986, and books on Codependence as a disease in and of itself started appearing at about the same time. These Codependence books were the next generation evolved from the books on the Adult Child Syndrome of the early eighties.

The expanded usage of the term "Codependent" now includes counter dependent behavior. We have come to understand that both the passive and the aggressive behavioral defense systems are reactions to the same kinds of childhood trauma, to the same kinds of emotional wounds. The Family Systems Dynamics research shows that within the family system, children adopt certain roles according to their family dynamics. Some of these roles are more passive, some are more aggressive, because in the competition for attention and validation within a family system the children must adopt different types of behaviors in order to feel like an individual.

A large part of what we identify as our personality is in fact a distorted view of who we really are due to the type of behavioral defenses we adopted to fit the role or roles we were forced to assume according to the dynamics of our family system.

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Behavioral Defenses

I am now going to share with you some new descriptions that I came up with in regard to these behavioral defenses. We adopt different degrees and combinations of these various types of behavior as our personal defense system, and we swing from one extreme to the other within our own personal spectrum. I am going to share these with you because I find them enlightening and amusing - and to make a point.

The Aggressive-Aggressive defense, is what I call the "militant bulldozer." This person, basically the counter-dependent, is the one whose attitude is "I don't care what anyone thinks." This is someone who will run you down and then tell you that you deserved it. This is the "survival of the fittest," hard-driving capitalist, self-righteous religious fanatic, who feels superior to most everyone else in the world. This type of person despises the human "weakness" in others because he/she is so terrified and ashamed of her/his own humanity.

The Aggressive-Passive person, or "self-sacrificing bulldozer," will run you down and then tell you that they did it for your own good and that it hurt them more than it did you. These are the types of people who aggressively try to control you "for your own good" - because they think that they know what is "right" and what you "should" do and they feel obligated to inform you. This person is constantly setting him/herself up to be the perpetrator because other people do not do things the "right" way, that is, his/her way.

The Passive-Aggressive, or "militant martyr," is the person who smiles sweetly while cutting you to pieces emotionally with her/his innocent sounding, double-edged sword of a tongue. These people try to control you "for your own good" but do it in more covert, passive-aggressive ways. They "only want the best for you," and sabotage you every chance they get. They see themselves as wonderful people who are continually and unfairly being victimized by ungrateful loved ones - and this victimization is their main topic of conversation/focus in life because they are so self-absorbed that they are almost incapable of hearing what other people are saying.

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The Passive-Passive, or "self-sacrificing martyr," is the person who spends so much time and energy demeaning him/herself, and projecting the image that he/she is emotionally fragile, that anyone who even thinks of getting mad at this person feels guilty. They have incredibly accurate, long-range, stealth guilt torpedoes that are effective even long after their death. Guilt is to the self-sacrificing martyr what stink is to a skunk: the primary defense.

These are all defense systems adopted out of a necessity to survive. They are all defensive disguises whose purpose is to protect the wounded, terrified child within.

These are broad general categories, and individually we can combine various degrees and combinations of these types of behavioral defenses in order to protect ourselves.

In this society, in a general sense, the men have been traditionally taught to be primarily aggressive, the "John Wayne" syndrome, while women have been taught to be self-sacrificing and passive. But that is a generalization; it is entirely possible that you came from a home where your mother was John Wayne and your father was the self-sacrificing martyr.

Dysfunctional Culture

The point that I am making is that our understanding of Codependence has evolved to realizing that this is not just about some dysfunctional families - our very role models, our prototypes, are dysfunctional.

Our traditional cultural concepts of what a man is, of what a woman is, are twisted, distorted, almost comically bloated stereotypes of what masculine and feminine really are. A vital part of this healing process is finding some balance in our relationship with the masculine and feminine energy within us, and achieving some balance in our relationships with the masculine and feminine energy all around us. We cannot do that if we have twisted, distorted beliefs about the nature of masculine and feminine.

When the role model of what a man is does not allow a man to cry or express fear; when the role model for what a woman is does not allow a woman to be angry or aggressive - that is emotional dishonesty. When the standards of a society deny the full range of the emotional spectrum and label certain emotions as negative - that is not only emotionally dishonest, it creates emotional disease.

If a culture is based on emotional dishonesty, with role models that are dishonest emotionally, then that culture is also emotionally dysfunctional, because the people of that society are set up to be emotionally dishonest and dysfunctional in getting their emotional needs met.

What we traditionally have called normal parenting in this society is abusive because it is emotionally dishonest. Children learn who they are as emotional beings from the role modeling of their parents. "Do as I say - not as I do," does not work with children. Emotionally dishonest parents cannot be emotionally healthy role models, and cannot provide healthy parenting."

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In the popular science periodical put out by the New York Academy of Sciences and the newsletter of the addiction division of the American Psychological Association, Stanton turns Project MATCH and other NIAAA and mainstream research on their ears to show that alcoholism cannot be dealt with as a medical disease. Instead, such research shows, even highly dependent drinking is an interchange between drinker and environment, shifts considerably over time, allows for moderated drinking, does not particularly respond to treatment (and almost not at all to standard, overly-aggressive 12-step therapy that dominates the American treatment scene), and responds best to brief helping interactions in which the drinker is the principal actor.
In the APA Division 50 newsletter, the president of Division 50 states, "Project MATCH delivered what it was paid to do," while Richard Longabaugh, who commented on Stanton's paper, noted, "This response is undertaken with considerable apprehension as it has been my impression over the years that offering a view at variance with Dr. Peele's is rarely 'a day at the beach.'" Please note the remarkable points of concurrence between the views Stanton expresses and those expressed by William Miller in his David Archibald Lecture, (see Addiction, 93:163-172, 1998).

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The Addictions Newsletter (The American Psychological Association, Division 50), Spring, 1998 (Vol 5, No. 2), pp. 6; 17-19.

The National Institute on Alcohol and Alcoholism's (NIAAA) Project MATCH is the most elaborate clinical trial of psychotherapy ever conducted—in its ninth year, it has cost 30 million dollars and has involved most of this country's prominent clinical alcohol researchers. MATCH tested the hypothesis that alcohol treatment outcomes could be significantly improved by matching alcoholics on relevant dimensions with appropriate treatments. MATCH did not actually match alcoholics with treatments, but conducted a multivariate analysis on outcomes as predicted by a variety of traits in interaction with undergoing one of three types of treatment: Twelve-Step Facilitation (TSF), Cognitive-Behavioral Coping Skills Therapy (CBT), and Motivational Enhancement Therapy (MET).

MATCH results were reported in a long article by the collective Project MATCH Research Group (1997). None of the three treatments produced better outcomes overall, nor did any treatment produce better results for alcoholics with any given profile. Nearly all subjects were DSM-III-R alcohol dependent. Treatment was 12 weeks on an outpatient basis (for a purely outpatient group and a hospital treatment aftercare group), and patients were followed up for a year. Ten primary client characteristics were reported (e.g., motivation, psychiatric severity, gender). Outcomes were measured as days abstinent and drinks per drinking day. Among 64 tested interactions—16 proposed patient/treatment interactions by outpatient versus aftercare treatment by 2 outcome measures—one proved significant: in the outpatient group only, less psychiatrically severe subjects had 4 more abstinent days per month on average in TSF than in CBT treatment.

The idea of patient-treatment matching has for some time been regarded as the cutting edge in alcoholism treatment. The failure of MATCH's primary analysis to confirm the matching hypothesis revealed more than methodological oversights or the need for further analysis. It, along with other NIAAA and alcoholism research, shows that American conceptions of alcoholism and treatment policy are fundamentally wrong.

(1) The objectivist medical approach to alcoholism treatment does not work. Although psychologists were the primary movers in MATCH, MATCH typifies the modern medical approach to alcoholism which NIAAA director Enoch Gordis has promoted. In its aftermath, Gordis concluded, "Treatment matches may become apparent when we get to the core of the physiological and brain mechanisms underlying addiction and alcoholism." The idea underlying matching is often appropriate in medical treatment, but the failure to find benefit from matching contravenes the value of matching alcoholics to treatment based on their objective traits and symptoms. An alternate psychological approach is to allow alcoholics to select treatment types and goals based on their values and beliefs. Research by psychologists like Heather, Winton, and Rollnick (1982), Heather, Rollnick, and Winton (1983), Orford and Keddie (1986), Elal-Lawrence, Slade, and Dewey (1986), and Booth, Dale, Slade, and Dewey (1992), none American, has shown the superiority of subjective over objective matching, although this approach is not part of American alcoholism treatment.

(2) Individual and situational variables are more important for alcoholism outcomes than treatment variables. MATCH uncovered significant individual and setting factors including motivation and the drinking behavior of cohorts. In other words, MATCH found that outcomes of alcoholism were the results of who people are, what they want, where they reside, and who they spend time with. Alcoholism cannot productively be addressed like medical illnesses by relying on a strict diagnostic-treatment protocol.

This phenomenon is apparent in the overall results of MATCH. In several public presentations, MATCH researchers highlighted the overall improvement of patients, noting that subjects on average reduced drinking from 25 to 6 days per month and drank less on these days. However, this improvement occurred with alcoholics who were not typical of alcoholism patients in the United States. To start with, prospective subjects with simultaneous diagnosable drug problems were eliminated although, according to SAMHSA's (1997, February) national treatment admissions census (TEDS), "combined alcohol and drug abuse. . . [is] the most frequent problem at admission to substance abuse treatment."

Many additional filters were introduced by both the subjects and the researchers. Of 4,481 potential subjects identified, fewer than 1800 ultimately participated in MATCH. MATCH participants were volunteers, which places them at odds with the many coerced treatment referrals by the courts, employers, and social agencies. The MATCH team also eliminated potential subjects for reasons like "residential instability, legal or probation problems," etc. Another 459 potential subjects declined to participate because of the "inconvenience" of treatment. Subjects who actually participated in MATCH were more motivated, stable, noncriminal, and free of drug problems—all of which indicate greater likelihood of success. Thus overall MATCH results, like the MATCH analysis itself, illustrate that patients and their lives outside of treatment are more critical to alcoholism treatment results than the nature of their therapy.

(3) The characteristics of therapists and of interactions between patients and therapists are more important than type of treatment in alcoholism outcomes. While treatment type was not significant in MATCH, treatment site and site by treatment type effects were. In other words, the way particular therapists interacted with alcoholics had a substantial impact on patient outcomes whereas the label of the therapy they practiced did not.

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(4) Alcoholism treatment in the United States is not notable for its success. Gordis's fundamental summary of MATCH was that while its findings "challenge the notion that patient-treatment matching is necessary for alcoholism treatment, the good news is that treatment works" (emphasis added; Bower, 1997). But MATCH could make no categorical statements about the impact of treatment since it had no untreated control comparison. Moreover, so much about the MATCH clinical trial was unique that there is little reason to assume its results generalize to alcoholism treatment at large in the United States. On the other hand, the NIAAA has conducted a thorough assessment of treated and untreated remission rates as experienced in the general population—the National Longitudinal Alcohol Epidemiologic Survey (NLAES)—based on face-to-face interviews about drug and alcohol use and treatment and concurrent emotional problems.

The NIAAA's Deborah Dawson (1996) analyzed over 4,500 NLAES subjects whose drinking at some point in their lives qualified for a diagnosis for alcohol dependence (DSM-IV). Treated alcoholics were more heavily alcohol dependent on average than untreated alcoholics and, according to the NIAAA's Bridget Grant (1996) in the same journal volume, to also have a drug problem (thereby distinguishing these from MATCH subjects). NLAES found that a third of treated (and 26% of untreated) subjects were abusing or dependent on alcohol in the past year. Of those whose alcohol dependence appeared within the last five years, 70 percent who received treatment were drinking alcoholically in the past year. Although population differences color comparisons between treated and untreated outcomes in NLAES, the results nonetheless show that alcoholics undergoing treatment in the United States do not experience the reliable improvement rosily reported by NIAAA/MATCH officials (see Table).

Table
National Longitudinal Alcohol Epidemiologic
Survey Data on Alcohol Dependent Subjects

Drinking over prior year	Treated (n=1,233)	Untreated (n=3,309)	Total (n=4,585)
Total population
% drinking with abuse/dependence	33	26	28
% abstinent	39	16	22
% drinking w/o abuse/dependence	28	58	50
Less than 5 years since onset of dependence
% drinking with abuse/dependence	70	53	57
% abstinent	11	5	7
% drinking w/o abuse/dependence	19	41	36
Note. From "Correlates of past-year status among treated and untreated person with former alcohol dependence: United States, 1992" by D. A. Dawson (1996) Alcoholism: Clinical and Experimental Research, 20, p. 773. Adopted with permission.

(5) American twelve-step treatment is of limited usefulness. Any documented success of twelve-step treatment would reflect well on American alcoholism treatment, since Roman and Blum (1997), in their National Treatment Center Study, found that 93 percent of drug and alcohol programs follow the twelve-step program. Margaret Mattson (1997), a principal NIAAA MATCH coordinator, declared: "The results indicate that the Twelve Step model, . . . the most widely practiced . . . in the US, is beneficial." But this conclusion is not consistent with a meta-analysis of all available controlled alcoholism treatment studies reported by Miller et al. (1995). Unlike MATCH, Miller et al. found that alcoholism treatments were clearly differentiated in terms of their demonstrated effectiveness, with brief interventions ranked first, followed by social skills training and motivational enhancement. Ranked at the low end were confrontation and general alcoholism therapy. The two tests of AA found it inferior to other treatments or even no treatment but were not sufficient to rank AA reliably.

Remarkably, Miller et al. noted a strong inverse correlation between the popularity of treatments practiced in the US and the evidence that these treatments work, with the typical program comprising "a spiritual twelve-step (AA) philosophy . . . and . . . general alcoholism counseling, often of a confrontational nature," usually administered by former substance abusers. That this conventional treatment is not effective is consistent with NLAES results, although not with the impression created by MATCH.

(6) TSF in MATCH differed from standard twelve-step treatment, which is overly directive and otherwise poorly delivered. Treatment in MATCH was not the same as treatment in the field. Manuals were developed and counselors carefully selected and trained, each treatment session was videotaped, and the tapes were monitored by supervisors. Jon Morgenstern, as part of a Rutgers research project which has observed standard treatment providers, has noted that they offer very poor quality therapy. One way in which usual twelve-step therapy might differ from its MATCH version is that it is often highly directive (to the point of being abusive).

(7) The most cost-effective therapy for any severity alcohol problem is brief interventions/motivational interviewing—that is, short-term, nondirective treatment. In both brief interventions and motivational interviewing, therapies found most effective by Miller et al., patients and counselors jointly discuss the patient's drinking habits and consequences in a nonjudgmental way that focuses the patient on the value of reducing or quitting drinking. Meanwhile, Motivational Enhancement Therapy would be the recommended treatment based on MATCH because it produced equal results at far lower cost. TSF and CBT were designed to be 12 weekly sessions while MET was designed to be only four sessions. However, MATCH patients on average attended only two-thirds of their sessions, so that MET in MATCH approached brief interventions. That the briefest treatment in MATCH worked as well as more extensive treatments challenges conventional wisdom that brief interventions are inappropriate for alcohol-dependent patients.

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(8) Elaborate alcoholism treatment is not necessary for recovery; most alcoholics in the United States recover without treatment. MATCH indicated that people who seek to overcome alcoholism and have a supportive social environment can well do so with brief therapeutic interactions that focus their motivation and resources on improving their lives. The NLAES analysis of untreated alcoholics shows (a) that most alcoholics do not seek treatment and (b) that most of these stop abusing alcohol (Dawson, 1996).

(9) Nonabstinent remission is standard for American alcoholics. Not only do most alcoholics improve significantly without treatment, but they typically do so without quitting drinking. According to NLAES, from five years following a dependence diagnosis on, a majority of ever-alcohol-dependent people in the US are drinking without manifesting alcohol abuse/dependence. Untreated alcoholics are more likely to be in remission than treated alcoholics at all points since dependence onset because, although they are less likely to abstain, they are far more likely to drink without diagnosed problems.

On September 8, 1997, U.S. News/World Report ran a cover story on controlled drinking (Shute, 1997, September 8). Gordis responded in the magazine (September 29) that "current evidence supports abstinence as the appropriate goal for person with the medical disorder 'alcohol dependence' (alcoholism)." Yet Gordis touted MATCH's excellent outcomes consisting of a reduction in the frequency and intensity of drinking by alcoholics! NIAAA's MATCH and NLAES results defy the irrational claims this agency (and American alcoholism treatment) make about abstinence as the desired—if largely unobtainable—goal for all alcoholics.

(10) The clinical tool used for the medical diagnosis of alcoholism confounds those who most strongly endorse the medical treatment of alcoholism. Possible resolutions of Gordis's views on abstinence with NIAAA research are (a) that those diagnosed alcohol dependent by DSM (both III-R and IV) are not really alcohol dependent and/or (b) that those categorized in remission are not. Untreated alcoholics in NLAES have less severe drinking problems than treated alcoholics. Perhaps they are not fully alcoholic. But what then is the significance of a DSM alcohol dependence diagnosis on which so many treatment decisions are made?

At the other end of the spectrum, the criticism might be that DSM-IV too readily finds drinkers are not categorizable as alcohol abusers/dependent. Many formerly dependent alcoholics in NLAES who now drink without abuse or dependence would not qualify for standard outcome definitions of moderate/social drinking. This is because American alcoholism researchers have become extremely cautious, not to say paranoid, about claiming that former alcoholics are drinking moderately. Yet, as indicated by the results MATCH proudly proclaimed, such reductions are clinically important. The public health term for this clinical improvement without full remission is "harm reduction."

Summary. NIAAA research shows that a medicalized conception of alcoholism and treatment is not suited to the nature and course of drinking problems. Project MATCH represents a massive effort to shoehorn a large amorphous peg into a small square hole. That it fails in this impossible task does not bother the health care industry, however. This is because, whether or not it accounts for the behavior of alcoholics, the medicalization of alcoholism succeeds in justifying the mission and policies of government and treatment agencies and professionals.

References

Booth, P.G., Dale, B., Slade, P.D., and Dewey, M.E. (1992). A follow-up study of problem drinkers offered a goal choice option. Journal of Studies on Alcohol, 53, 594-600.

Bower, B. (1997, January 25). Alcoholics synonymous: Heavy drinkers of all stripes may get comparable help from a variety of therapies. Science News, 151, 62-63.

Dawson, D.A. (1996). Correlates of past-year status among treated and untreated persons with former alcohol dependence: United States, 1992. Alcoholism: Clinical and Experimental Research, 20, 771-779.

Elal-Lawrence, G., Slade, P.D., and Dewey, M.E. (1986). Predictors of outcome type in treated problem drinkers. Journal of Studies on Alcohol, 47, 41-47.

Grant, B.F. (1996). Toward an alcohol treatment model: A comparison of treated and untreated respondents with DSM-IV alcohol use disorders in the general population. Alcoholism: Clinical and Experimental Research, 20, 372-378.

Heather, N., Rollnick, S., and Winton, M. (1983). A comparison of objective and subjective measures of alcohol dependence as predictors of relapse following treatment. British Journal of Clinical Psychology, 22, 11-17.

Heather, N., Winton, M., and Rollnick, S. (1982). An empirical test of "a cultural delusion of alcoholics." Psychological Reports, 50, 379-382.

Kadden, R.M. (1996, June 25). Project MATCH: Treatment main effects and matching results. Meeting of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism, Washington, DC.

Leary, W.E. (1996, December 18). Responses of alcoholics to therapies seem similar. New York Times, p. A17.

Mattson, M.E. (1997, March). Treatment can even work without triage: Initial results from Project MATCH. EPIKRISIS, 8(3), 2-3.

Miller, W.R., Brown, J.M., Simpson, T.L., Handmaker, N.S., Bien, T.H., Luckie, L.F., Montgomery, H.A., Hester, R.K., and Tonigan, J.S. (1995). What works?: A methodological analysis of the alcohol treatment outcome literature. In R.K. Hester and W.R. Miller (Eds.), Handbook of alcoholism treatment approaches (2nd Ed., pp. 12-44). Boston: Allyn and Bacon.

Orford, J., and Keddie, A. (1986). Abstinence or controlled drinking: A test of the dependence and persuasion hypotheses. British Journal of Addiction, 81, 495-504.

Project MATCH Research Group. (1997). Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol, 58, 7-29.

Roman, P.M., and Blum, T.C. (1997). National treatment center study. Athens, GA: Institute of Behavioral Research, University of Georgia.

SAMHSA (1997, February). National admissions to substance abuse treatment services: The treatment episode data set (TEDS) 1992-1995 (Advance Report No. 12). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

Shute, N. (1997, September 8). The drinking dilemma. U.S. News and World Report, 54-65.

next: The Antidote to Alcohol Abuse: Sensible Drinking Messages
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Getting Off the Roller Coaster

Of all the profound concepts of awareness philosophy I have learnt, the one I continually keep on referring to, the one that is so simple in nature, is the one that seems to have it's beauty and value hidden by its own simplicity.

It is knowing that YOU, along with your reality, exist for just that instant we call the present.

When that instant ceases to exist, a new instant will then come into being. It is knowing that the past is only a shadow of what was. It is knowing that the future is but a dream, it is the unborn child.

In one respect, we could say that our lives are part of an infinite series of Instant Moments, and when they are all strung together it is then given a name. That name is time.

When the instant ceases to be the instant, it is called the past. The instants that are to come are labeled the future, but the past and future do not exist; they are an illusion and all that REALLY EXISTS--is the present.

All that really matters is "THE NOW".

ONLY THE MOMENT LIVES:

To understand the value of the Present when trying to obtain relief from sorrow, you must appreciate the link between the truth of the moment that you live in right now, and the illusion that there might be something good for your peace hiding in a mist of shadows and nothingness.

The reflections of clouds on a still pond are not clouds. Though they have beauty; if you were to reach out and touch them, you would disturb the stillness of the water and lose the peace and beauty you once had. The only reality was the water. The clouds you sought were an illusion; just an image.

This link between the present and the past can now be seen as some form of goodness, pleasure or beauty, and when you reach out to be with those qualities, you touch an illusion. From this, sorrow is then born.

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REGRET, THE TAUNTING LURE:

If we go through a painful experience, we tend to go through many and varied "If Only" scenarios.

"If only it had happened this way, I wouldn't have this pain."

"If only I had done this then, I'd be happier now."

"If only I had this yesterday, I'd have so much more of that tomorrow."

Among the many whirlwinds within the mind, there are two important areas of concern that you should understand are capable of manifesting pain. They are, a regret of what was, and a regret of what wasn't. I may have become aware of an opportunity that would have been good for me, but through fear, I could chose to remove myself from it. On the other hand, it may have been removed from me against my desire. In another example, I could come to the understanding that something I sought after and experienced has left me feeling shaken and miserable. In each case, I am open to experience pain if I choose to re-live the situation, or dream of how else it could've been.

To maintain...

"If only I HAD done this",

...is to invent a past that never was and attempt to live in it. Realities that once were can be bad enough, but to conjure up a past that never was, is to inflict nothing less than torment upon yourself. To say...

"If only I HAD NEVER done this,"

...is to deny the reality of a choice.

Through the acceptance of a choice that has brought pain, one can then appreciate that what was understood as truth, is just a reflection of what was, and all that is important is your peace in "THE NOW".

After my marriage broke up, a dear friend wrote to me and said in her letter:

"When the energies go back and forth between the past and the future, the healing process is delayed".

At the time, the effect was subtle, and my understanding of it was vague. Since my sorrow was not at its peak, the doors of meaning were not fully open, but planted within me was a seed that was being nurtured by the passage of time.

Slightly more than a year later, my life took another completely unexpected turn. A chance of happiness and friendship vanished with frightening brevity, and its effect was even more devastating than the first. With delayed grief and compounded sorrows, I found myself lost in an ocean of loneliness as the ground was literally washed from beneath me. Inwardly I was crushed, though outwardly I kept a smile on my face. Whether or not this was good, I don't bother with now, for I am what I am, and I do what I do. I react to things in only the way that I am capable of. I try my best. I am a good person.

This was when I truly began my journey to find peace and restoration and it was to lead me down a road that never in my wildest dreams did I ever think I would travel.

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PROJECTION:

Upon coming out of the event that had brought significant changes to my life, I found myself floundering in a new state of emptiness and insecurity. I would desperately try and find something to hang on to that would restore me to a former state of existence. My first natural reactions were to review my past and wonder where I went wrong; I would wonder what alternatives of living could have prevented my new circumstance. In looking backwards or forwards in time, I would PROJECT my thoughts out of the reality of the present and try to become a part of an illusion.

This very normal practice is called upon many times in every day of our lives. To refresh our memory after an absence of concentration is to project. To recall what we wore yesterday so we can wear clean clothes today is to project. To be able to understand this chapter, you will have to project so that your feelings can be compared in order to find understanding and meaning.

If we are happy, and we look at a photograph of happy times, our projection re-enforces our existing happiness. Likewise, if we are sad and we dwell on the events that have brought us pain, then our sorrow also shall be re-enforced.

I have found a simple source of Peace from the belief that in the present moment, I have everything that I need for that moment. I say this because I have always had and maintained a belief that no matter what the circumstance, I would always be able to find some aspect of a given situation that could be used for my own good.

This long time belief of mine has now been validated for me through the freedom I have obtained from adapting this philosophy when I most needed it. In trying times, such thinking is difficult to maintain, but for me, somehow this unshakeable belief would always be there for me when all else made no sense. When there is a need for a major adjustment to your life and you are experiencing deep emotions such as Grief, Anxiety, or Brokenness, within the pain of the moment you would think that such thinking would be the last thing you need, but if you yearn for someone or something that gave you Love or pleasure, then the situation that arose to remove those things from your life came about through circumstances that needed attention and a necessity to be resolved. Even when you experience the depths of grief and loneliness, the pain of a broken heart, or any other emotion which seizes upon you, such intensity is serving your personal development through the enforced activation of awareness to Yourself, your situation, and your Truth.

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I can now see the separation from someone who was once dear to me as a need. At the time I could not see this since my desires were not being fulfilled. Poets and Lovers say within their bitter sweet laments that ...

"You took a part of me when you left".

Within such words lies a subtle truth. When we are without peace, it can be said that we fragmented, and when we yearn for a part of our life that no longer exists; there is truly a part of us that is still attached to that aspect of the past. Indeed, that "part of me", that the poets write about, is in fact essentially somewhere else. Ironically, when we can truly let go of the object of our yearning, that "part of us", can then come back to unite us with ourselves and allow us to feel at Peace once again. We are then WHOLE once again.

Again in retrospect, since there was a particular aspect of my life that was not serving my ongoing need for Love and comfort, something had to happen in my life that could enable me to live the sort of life I have always wanted. In short... I had something to LEARN. When I felt pain in the separation, it was because I was associating with an illusion, I was not in the present, I was some where else.

Within such circumstances, knowledge can be a saviour that will help us regain our peace. This knowledge has it's roots in the word CHOICES. We do not need to be a slave to suffering, and we need not be at the mercy of lingering emotions. We can choose to stay within our sorrows, or we can choose to acknowledge the past as that which cannot serve us anymore. Here we can also choose to call on courage and begin a new start to life and a new self-respect.

To have been hurt by someone whilst we were being kind to them; then from a state of anguish we will project to the past to live in an old happiness, but agitation then develops in the search for answers. Those answers are never there, it's like trying to converse with the images we see on a television. Your answers are buried beneath your sorrow in a very serene place, and only in the stillness of "THE NOW" is when they can be revealed to you.

Take time out to be silent and go within. Lay aside your dramas and begin a process of contemplation of past actions. Identify areas in your life that are repetitive in nature, and the problems they bring you. Deep within you are the answers that can change your life.

Not only must you be willing to seek them, but you must also be willing to employ them. Contemplation is an ongoing process and the benefits are enormous.

Many times for myself, no matter how hard I tried, I was just drawn to my sorrows in an almost irresistible and magnetic way. I just couldn't seem to put them down no matter how bad they made me feel. I had no concentration and many times I was just unavailable to my work, my family, my friends and many other things that were important. The days seemed never-ending and my sleep would be broken from the recalling of memories that refused to leave me alone.

During that period, there was a tremendous source of energy within that needed to be released, and as difficult as it was, it had be expressed. This was the unavoidable time of my grieving process and it had to take its full path. When we are in this situation, all we can do is be kind to ourself as we experience our suffering. We can even comfort ourselves by wishing for Peace. For myself, I would say:

"Peace to Me. Things Will get better".

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There were times when I became so caught up in my sorrows that I became unaware of the reality of the present and ended up distancing myself from the world around me. Though I would desperately try to make the effort, the times that I was with my friends, I found that I may as well have not have been there at all. Through being so established in sorrow, I would have no concentration. To raise a smile would even bring sadness upon me as the aspect of happiness I would try to emulate would go on to remind me of better times. When I made plans and appointments, I would often overlook them if I was not prompted by family or friends. Sometimes, being with a certain group of people could prompt sadness, so I would end up avoiding their company. Though I still yearned to be a part of their lives, I would stay away so as to ease the pain.

It is the Ego which is guiding these actions through a fear of being sad. It fears revealing to other people what is deep within, what is hurting. It fears noone might understand the situation or the grief and only come forth to condemn us for our situation. In this circumstance, the best thing to do is to be patient and keep on trying. Though the friends I avoided continued to mean a lot me, I knew that I had to be patient with myself as I would eventually find a way to share with them what my heart really wished to. If you can link up with these thoughts, then take as much time as you want and know that, in time, things Will get Better.

Indeed, things are getting better right now as you read this book and others which have been written with the same intent. Your searching for a better way of living has now been Clearly Defined, and your Goodness and Love is now guiding you home. Affirm your Worthiness at this very moment to a life equal in the happiness and prosperity to that which you have always been dreaming of.

TIME TO RISE.

When sorrows eventually peak, it is then time to activate awareness philosophy. Understand the value of "THE NOW"; understand what it is you are searching for as you project and ask yourself:

"Will I really find what I am looking for in the past?

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Be daring enough to ask yourself:

"Are my answers already contained within me?"

"Am I willing to search deeply for my Truth?"

Remember that your pain is brought about by association with the past and an isolation from the truth. The beasts of the animal kingdom who live perfectly in "THE NOW" do not know of suffering a yearning heart, since they do not have the ability to make a comparison through contemplation of past events. Our pain is relative since we compare what is, against what was or what we would like to be. In the present moment, there is no association, there is only existence. So when we stop associating, we stop the pain.

Obviously, because of our humanity, a person would need attain great Skill, Knowledge, Discipline and Love to live Perfectly in the present. So until we come to live permanently in such a state, we will always be prone to experience the burden of pain and its seemingly never-ending quality. However, through knowledge that demystifies human behavior, we can give ourselves a chance to resolve grief in a much more effective way than we could have if we were to lack such knowledge.

If we give ourselves a chance to truly Experience our pain rather than Bare or Deny it, we will allow the feeling to become complete, and be complete in itself. It will have a birth, it will grow, but more importantly, in time, it will die. It is through blocking the development of any emotion by rationalizations or justifications, be they subtle or pronounced, that unresolved feelings are maintained and carried within. Uncried tears can then block our future vision in the quest for Love and happiness.

Bring yourself closer to your emotion by surrendering to it. Let go of the thinking side and become one with the feeling.

Identify exactly what it is you are feeling and be True to the feeling, then let it pass. I found that many times my sorrow would comes in waves. It was when I would try to go against this force by not fully going with it, that my sorrow would become incomplete and therefore prolonged.

I would try to find answers, but through the questions in my mind, I would only bring alive my original drama and rekindle the hurt. From these actions, it seemed like there was to be no end to the pain, as wave-after-wave of sadness would break over me.

When such experiences were peaking for me, I came across a few books which told of the Peace that can be found by knowing of and staying in the present. Now I can see that to have thoughts like:

"If only it were like it used to be,"

...is to sustain or prolong a part of my life that would eventually come to the same conclusion. To continue to think these "If only" thoughts, was to project myself into the past, and since the past is related to pain, I invariably brought that pain back into my reality. It is the Ego which seeks the ways to eliminate pain by wanting me to live the illusion of happier times. When I come back out of my dreaming into reality, I bring pain to myself. By remembering that the Ego operates through survival thinking, it will now conceive a way to eliminate the pain it has just caused. It is here that we could do a thing that might bring later regret. By learning to stop for a moment and recognise the projection of thoughts to an illusion, you give yourself a chance to remain within your reality where stillness is to be found.

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Unfortunately, or fortunately, this way of thinking is only ever really understood when we suffer something like a terrible grief; a broken heart, or an awakening to a very bad choice that may have brought terrible consequences upon us. Even in the moment of doing a thing that can bring us grief, we can most probably be in no pain at all. We could even enjoy it very much. The pain comes when we dwell on the past. So by staying in the present, you allow yourself the right to be peaceful. You allow yourself a chance to gain a reserve of strength to sustain you through any unresolved aspect of your situation.

If you are believing of the fact that your pain can truly help you in the process of finding a new direction, then the pain itself can then be seen to be serving you. From this, Despair can be transformed into Hope, so by acknowledging the need for change, we can let go of the past and concentrate on finding our peace. We will now be assured of finding that peace in "THE NOW".

PEACE WITHIN:

To stay available to the option of peace requires Courage since the Ego will try to take you away from any prompting of anxiety or pain you may be feeling. As you see that Ego thinking will only give you a choice for the immediate pain you are suffering, you will become aware that any option brought about to bring you external relief shall only be a temporary measure. Your greatest peace will be found within, and because it is YOUR peace, it is always available whenever you need it. It takes courage to find it, and it takes courage to call on it.

I have learnt to live my life as a continuing series of packets of time. Since through my humanness, I cannot live 'perfectly' in the moment, I have to live in time. Therefore, I choose to live with a limited past and a limited future. Some people manage to live a day at a time, and if your lifestyle can support it, that's good. For myself, and at the time of writing this book, my lifestyle concerns itself with about a week. A week for me is good. I have commitments and obligations and it works well for me. Beyond that, I must still. however. remain flexible and open to changing circumstances. I remain aware.

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Staying in "THE NOW" also helps to drop the emotional baggage that we cart around with us so much. By giving yourself the opportunity to experience the peace of the present, you will find yourself being able to gently release futile feelings the likes of blame and guilt. To do this, will then allow insights of understanding to filter into your mind to dissolve hurt, anxiety, and other crippling emotions which stop you acting to your truest feelings.

SOME EVERYDAY EXAMPLES:

In regard to projection outside the topic of sorrow, I offer this story to provide a balance to the concept of "THE NOW". The wife of a friend of mine was under threat of loosing her job through staff cuts in hard financial times. After reviews and recommendations, the outcome would eventually be known with some inevitable casualties. After the staff assessments, my friend came to tell me how his wife had been fortunate in keeping her job. However, his face still showed concern. I asked him why and he replied somberly that "her job was only safe for a year."

Even though the past few days had given him good reason to be concerned, he still managed to remove himself from being in a happy state from his wife's good news. He immediately projected, without awareness, a whole year ahead. He had leapt over 365 days of security to be with the pain of a retrenchment that might never eventuate. There was no awareness that his behavior was normal, justified, or otherwise. There was simply no awareness. His actions were sympathetic of his thinking, his thinking was guided by his Ego, and his choice brought him pain.

Once again, by looking at Ego thinking based on fear, it wanted him not to bear any pain of the job loss, so it projected him to the future in an attempt to find answers to a non-existent problem. It found none and brought him back with a burden.

The problem lies when we project without limitation, but what is even more devastating is to project without awareness. When we project and don't realise it, when we live in dream world, we are missing the healing peace of the present. To dream "If only" thoughts are a waste of energy since your thinking will not change the past. Similarly, when we worry over an event that we know is to come upon us, we tend to circulate the event around-and-around inside our minds without producing any positive output. We draw no conclusions and we make no plans; we end up waiting for the arrival of pain (which very often never eventuates) as we dwell on how we are going to cope. We, in effect, bring extra pain upon ourselves through our own choice of behavior.

How painful it would be to know what our future is. The past is bad enough as it lasciviously tries to keep the hurt alive through a constant re-staging of the original drama.

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FUTURE PROJECTION:

Sometimes we have an option to be involved in a future event but in the present moment, we may feel down in spirits or emotionally not available for what ever reason. It is here that a chance becomes available for the feelings you have in the present, to be projected into the future. To say:

"I'm feeling tired and rundown lately

and the thought of that trip to the country

next week doesn't appeal at all. I'll cancel."

...is to project low feelings into the future, and presume that you would still be feeling this way when the event comes around. If you don't have to make a decision in the present moment, forget about it entirely. Living in "THE NOW", is reality. If you're miserable, then acknowledge your feelings. It's O.K. to feel what comes from within regardless of the emotion. Stay with the truth of the emotion and don't attempt to rationalise or invalidate yourself or your feelings.

Simply experience what you feel and let it go after it has passed. Don't burden yourself with thoughts such as:

"I should be feeling this..." or "I shouldn't be feeling this..."

It's simply you expressing what is true and valid for you, and you know of your commitment to goodness.

MASTERY IN CHILDHOOD:

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Children are Masters of "THE NOW," and children are masters of unconditional Love. Since a child has its needs fully catered to, it does not concern itself with distant future or past events. They are able to freely express their desires and wants without limitations or restrictions. They are naturally Loving, and they seek and respond without reserve to the Love given to them by those in their care. They consider nothing about the next meal or whether there is enough food in the cupboard, and they are oblivious to the effort behind the care put in for their well-being. They simply sense a need, express it, and find themselves catered to. A child not having to fend for itself stays perfectly content in the present moment. As far as children are concerned, meals just happen, toys have always been in their room, and there is always a soft and cozy bed to sleep in.

As we leave childhood and pass through all the various stages that take us into adult life, the influences of people and events envelope us as we journey in life. To quote that much used cliché: "The Innocence of Childhood is lost." We grow up and experience the world. We come across disappointment and hardship, and we find there are times we have to take a back seat. People can let us down, and we build up a library of memories and feelings linked to experiences.

When profound circumstances in our Adult life make us stop and evaluate where we are going, (usually an event that demands change), we then have the potential to rediscover the gems of childhood which have always been within us. Through this discovery we can then have the best of both worlds. It is, in fact, when we are reborn through the fire of our pain, and find that there is much more to life than we could ever had imagined. Through a new Love, it is possible to see our link in Spirit. This is when a person is born again of an awakened spirit; discovering the link of Love and Life, and the true connection with life and what it has to offer. All this can come about if we unite ourselves with the wisdom of Adulthood, and the Love of a Child.

A CHANCE FOR PEACE:

To live with ongoing peace after understanding the concept of "THE NOW" will bring great freedom. Start to nurture this state by letting things unfold without your anxious yearnings and worrisome concerns. Deal with problems when its time to deal with them. Obviously one needs to put some attention to future events. The planning of financial budgets, shopping and preparation of meals, holidays, business ventures etc. The preparation of the future is a valid part of the present, but after these efforts have been fulfilled, simply continue on with what requires your present availability, your daily duty. Gather the moment and rest in yourself.

If you think there will be strong winds blowing your way soon, simply acknowledge that fact as your major preparation. Do what you have to do efficiently and peacefully, then go about your business in the meantime. Don't spread your energies around too much at one time. Prioritize your workload against your personal interests. Put your duties first and get them out of the way. When you're very keen to do something whilst at the same time other things demand your attention, there can be a temptation to do a bit of this and a bit of that. When your energies are distributed like this, you are prone to mistakes from frustration since each task is advancing slowly. You will be eager to see some positive output, but because the other duties are calling for your attention, you can tend to rush and end up doing less than your best efforts would otherwise allow.

If you project to the task that you would like to be doing rather than being available to the task at hand, your state of mind then becomes inappropriate to the job you are trying to do. An attitude is then maintained that the job is a drudgery and a chore. However, by staying in "THE NOW" with the reality of the job at hand, you will perform more efficiently and the job will just fly by. Concentration will shelter you and give you peace.

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Have you ever had a day where time just seems to whiz past?

What you were experiencing, were a combination of events and circumstances which had called for your present availability. You were, in fact, living and operating in "THE NOW" in a very refined way. Though you were unaware of it at the time, the scene eventually registered within you from your peaceful attitude. Your peace was highlighted by the lack of worries and concerns within. This type of feeling is available to you more often as you develop awareness and stop yourself from projecting and being concerned when you don't have to be.

The demands of the present are more than enough without added loads brought on by choice. To live in "THE NOW" is to finely tune your ability to manage the day-to-day problems that will always come your way.

When you become open and available to the flow of your worldly events, you will learn to see situations with greater clarity since fears and concerns shall be framed in a quite state of mind. Many times, fears can be seen as unrealistic. Genuine problems can also be tackled in the most appropriate ways since you are able to see into the truth of the situation. You shall see a problem and through your stillness and refined instinct, efficiently apply a solution. The problem is then no more and you then continue on with our business. Each time you act this way, the benefit that your actions bring you shall nurture your confidence as you learn that the potential for problems is no longer a problem.

Be available to your destiny.

Foster Stillness and Gentleness.

Love being peaceful.

Don't be too concerned or anxious about the direction of your life. As you change your outlook and learn to be guided by your goodness and instinct, good things will then begin to come your way. Opportunities will always present themselves when they can serve a need for your development. Believe this and get the strength to believe it by remembering your link with the Infinite.

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CONTEMPLATION:

Anxiety of the future makes us stumble in the present.

Anxiety of the past keeps us in chains.

Only within the Present, is where we will be Free and Peaceful.

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• Watch the video on Narcissists and the Possession of Objects

The Accumulator

This kind of narcissist jealously guards his possessions - his collections, his furniture, his cars, his children, his women, his money, his credit cards ... Objects comfort the narcissist. They remind him of his status. They are linked to gratifying events and, thus, constitute secondary sources of narcissistic supply. They attest to the narcissist's wealth, his connections, his achievements, his friendships, his conquests, and his glorious past. No wonder he is so attached to them. Objects connected with failures or embarrassments have no place in his abode. They get cast out.

Moreover, owning the right objects often guarantees the uninterrupted flow of narcissistic supply. A flashy car or an ostentatious house help the somatic narcissist attract sexual partners. Owning a high powered computer and a broadband connection, or a sizable and expensive library, facilitate the intellectual pursuits of the cerebral narcissist. Sporting a glamorous wife and politically correct kids is indispensable in the careers of the narcissistic politician, or diplomat.

The narcissist parades his objects, flaunts them, consumes them conspicuously, praises them vocally, draws attention to them compulsively, brags about them incessantly. When they fail to elicit narcissistic supply - admiration, adulation, marvel - the narcissist feels wounded, humiliated, deprived, discriminated against, the victim of a conspiracy, unloved.

Objects often make the accumulator-narcissist. They are an inseparable part of his pathology. This type of narcissist is possessive. He obsesses about his belongings and collects them compulsively. He "brands" them as his own. He infuses them with his spirit and his personality. He attributes to them his traits. He projects to them his thwarted emotions, his fears, his hopes. They are an integral part of him, inseparable, providing emotional succor.

Such a narcissist will say: "My car is daring and unstoppable", or "How clever is my computer!", or "My dog is cunning", or "My wife craves attention". He often compares people to the inanimate. Himself he sees as a computer or sex machine. His wife he regards as some kind of luxury good. The Narcissist loves objects and relates to them - things he fails to do with humans. This is why he objectifies people - it makes it easier for him to interact with them. Objects are predictable, reliable, always there, obedient, easy to control and manipulate, universally desired.

 

A long time ago I was asked if objects, or pets could serve as sources of narcissistic supply. I described in my response a second type of narcissist - the DISCARDER.

I responded thus.

The Discarder

Any thing can serve as a source of Narcissistic supply, providing that it has the potential to attract people' attention and be the subject of their admiration. This is why Narcissists are enamored of status symbols, i.e., objects, which comprehensively encapsulate and concisely convey a host of data regarding their owners. These data generate a reaction in people: they make them look, admire, envy, dream, compare, or aspire. In short: they elicit narcissistic supply.

But, generally, Discarder Narcissists do not like souvenirs and the memories they bring. They are afraid to get emotionally attached to them and then get hurt if the objects are lost or stolen or expropriated or taken by creditors. Narcissists are sad people. Almost anything can depress them: a tune, a photograph, a work of art, a book, a mental image, or a voice. Narcissists are people who divorced their emotions because their emotions are mostly negative and painful, coloured by their basic trauma, by the early abuses that they suffered.

Objects, situations, voices, sights, colours - can provoke and evoke unwanted memories. The Narcissist tries to avoid them. The Discarder-Narcissist callously discards or gives away hard-won objects, memorabilia, gifts, and property. This behaviour sustains his sense of control and lack of vulnerability. It also proves to him that he is unique, not like "other people" who are attached to their material belongings. He is above this.

 

Accumulators and Narcissistic Handles

Still, not all narcissists are like this. Accumulator narcissists take to objects and memorabilia, to voices and tunes, to sights and to works of art - as reminders of their past glory and of their potential future grandeur. Many Narcissists collect proofs and trophies of their sexual prowess, dramatic talent, past wealth, or intellectual achievements. They file them away almost compulsively. These are the "Narcissistic Handles".

The Narcissistic Handle operates through the mechanism of narcissistic branding. An example: objects, which belonged to former lovers, are "stamped" by them and become their full-fledged representations. They are fetishized. By interacting with these objects, the Narcissist recreates the narcissistic-supply-rich situation, within which the objects were introduced into his life in the first place. This is magical thinking. Some clairvoyants claim to be able to extract all the information regarding the present, past and future states of the owner of an object they hold. It is as though the object, the memory, or the sound carry the Narcissist back to where and when Narcissistic Supply was abundant.

This powerful combination of branding and evidencing is what gives rise to the "Narcissistic Contagion". This is the ability of the Narcissist to objectify people and to anthropomorphesize objects in order to derive the maximum narcissistic supply from them. The Narcissist is a pathogen. He transforms his human and non-human environments alike.

On the one hand, he invests as much affection and emotions in an inanimate object as healthier people do in human beings. On the other hand, he transforms people around him into functions, or objects.

In their effort to satisfy the needs of the Narcissist - his nearest or dearest very often neglect their own. They feel that something is sick and wrong in their lives. But they are so entrapped, so much part of the Narcissist's personal mythology that they cannot cut loose. Manipulated through guilt, leveraged through fear - they are but a shadow of their former selves. They have contracted the disease of Narcissism. They have been infected and poisoned. They have been branded.

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next: To Age with Grace

Thom Rutledge, Guest Author

Are you a fixer?

When someone tells you a problem they are having, do you immediately feel the need to offer advice? Is it difficult for you to just listen to someone who is in distress, to just be there for them without knowing precisely what to say or do? Are you uncomfortable with anything being in limbo? Are you addicted to certainties? Does your self-esteem depend on your ability to make things right for other people? If you're answering yes to some of these questions, you are probably a fixer.

Did you just now experience an impulse to "fix" the fact that you may be a fixer? If so, you are definitely a fixer.

I find it helpful when faced with a problem or a discomfort or a pain to ask this question:

Does this need to be fixed or healed?

Think about it. The two options are very different. When a pipe burst below my kitchen sink, I don't wrap a bandage around it and wait for it to heal. Similarly, when I cut my hand slicing tomatoes I don't imagine that I can simply "fix" the cut.

Certainly when something needs to heal, we still attend to it. I can apply pressure and bandage my cut. Or if I have the flu, I can go home, lie on the couch drinking juice and chicken soup. But I know that as much as I might try to convince myself otherwise, I cannot simply fix myself so that I don't have the flu anymore.

Consider relationship problems: do they need to be fixed or healed?

In this context the question is more difficult because both are often called for. If I have been dishonest with you causing damage to your ability to trust me, then I need to fix my behavior and allow there to be time for the relationship to heal. I suppose this is analogous to a broken bone needing to be set so that it can heal properly.

When something needs to be fixed, it calls for us to be proactive in identifying what needs to be done and then doing it. When something needs to heal, our job is to protect the space around the wound or injury, allowing in only what will contribute to the process of healing.

"Does this need to be fixed or healed?" is just one of those good questions to keep around. Sometimes the answers will be obvious, and other times the question may just get us thinking in a different direction. Certainly using the question will save some valuable energy when we can stop trying to fix what can only be healed, and stop waiting around for what needs fixing to heal.

Write the question down on an index card and put it in your pocket, your wallet, or your purse. Carry the question everywhere you go for the next week or so - test drive it.

See if it makes a difference.

Copyright © - Thom Rutledge. All rights reserved. Reprinted with Permission. - Thom Rutledge is a psychotherapist, speaker and author of several books, including Embracing Fear. For more information visit www.ThomRutledge.com.

Embracing Fear: And Finding the Courage to Live Your Life - Thom Rutledge - Fear takes many forms - dread, worry, panic, anxeity, self-consciousness, superstition, and negativity - and manifests itself in many ways - avoidance, procrastination, judgement, control, agitation and perfectionism, to name a few. As a recovering alcoholic and a therapy patient himself, as well as a syndicated columnist and national lecturer, Rutledge is uniquely qualified to give advice about overcoming fear and addiction.

Larry's Review: This book will challenge you to look fear in the face and walk right though it! On the other side of fear is Love. If you want more love in your life. . . read this book!

Chronos cannibalized his own sons. He devoured them and cast away their remains. This is often what I feel like doing to my more successful protégés. Young people - and not so young - tend to look up to me, stick to me, emulate me, admire me - in short: they are perfect sources of narcissistic supply. I reciprocate. I give them letters of introduction and recommendations suffused with unmitigated enthusiasm. I acquaint them with my business and academic contacts. I help them with their homework. I listen to their dilemmas and give direction to their life. I play the older brother, the friend, the confidant, and the sagacious teacher.

And it often works. They all succeed. They become ministers or bankers or authors or scholars. I then feel left behind, stuck in the proverbial mud that is my life, drowning in a grimy wave of envy and self-pity. I think to myself: I am better than they are - more intelligent and more experienced, more knowledgeable and more creative. Yet, they are there progressing inexorably - and I am here, regressing and decaying.

I consider the numerous chances I was given and how I blew them. The sponsors I eroded with my infantile indecisiveness and amateurish attitude. The businesses I drove to bankruptcy with my narcissistic temper tantrums and superiority contests. The clients and investors I lost to my procrastination, abuse, or treason. The friends who turned to enemies. The enemies who abandoned me in sheer revulsion. The fortunes I squandered, the disgrace of drunken speeches, my barren life - no love, no intimacy, no sex, no family, no children, no country, and no language. I disappointed my benefactors and lovers and well-wishers with glee. I cherished and reveled in my self-annihilation.

A central pillar in my thinking unravels as I age. My intellect is not enough. Not only is it not half as rare or as refined as I imagined it to be - it is simply insufficient. It cannot secure my happiness, or safety, or longevity, or health. It cannot buy me love or friendship. I eke out a living - but that is it. I don't have what it takes. And what it takes is a combination of intelligence with many other things: with empathy, with team work, perseverance, honesty, integrity, stamina, a modicum of optimism, true assessment of reality, sense of proportion, the ability to love, selflessness in measure. Intelligence without these is cold and sterile. It gives birth to nothing but recursive exercises.

To be fully human, it takes much more than memory and analytic skills. In the absence of emotions and empathy, there is only artificial intelligence - a lame and pitiable simulation of the real thing. Artificial intelligence can beat chess masters and memorize entire encyclopaedias. It can blaze a trail of written articles. It can add, subtract, and multiply.

But it can never enjoy another person. It can never intertwine, or care, or warm its heart, or hope. It can produce some poems but never poetry. It is even deprived of the ability to feel lonely. And though it may fully grasp its own deficiencies - try as it may, it can never change. For it is artificial and synthetic - a fiction, a two-dimensional creation, a part and not a whole. It is a narcissist.

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next: The Labors of the Narcissist

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next: The Use of Focus with Children and Young Teens with Attention Deficit Disorder
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