Excerpts from the Archives of the Narcissism List Part 24

1. The Restrained Narcissist
2. About Myself (what else?)
3. Myself as a Source of Narcissistic Supply to Others, or: The Existence of Others
4. Right Now I am Enraged
5. Is there an Ideal Source of Supply?
6. Destruction and Construction
7. Punishing Others
8. You are a Source of Supply
9. Narcissism
10. Addicted
11. False Self
12. Worth and Grandiosity

1. The Restrained Narcissist

The reason Ns are restrained is because they are terrified of their own suppressed violence. Ns are aggressive, rageful, uncontrollable. They fear the consequences. Their restraint is simultaneously an act of cowardice and self-denial.

2. About Myself (what else?)

I am looking to believe that narcissism can be unlearned.

I am sure that unlearning it is hardly the whole story. There is learning and growing to do. My narcissism is functional, adaptive, useful. It must be replaced with something if its breeding grounds (my needs) do not change.

I am tired, exhausted, depleted (the last word comes to mind more and more often). Today I am full of energy (by no means manic, just feeling good). But there is a another storm coming.

It sounds like a formula. As though I was writing it for publication, with an eye on posterity.

Then I said: it rings hollow and untrue.

Then I said: the fact the I wrote it must be of some import, the nature of which I do not know.

Today, I had the first good day after a month of impotent rage and raging envy. It often happens to me: inappropriate affect, incongruence, incoherence, lack of cohesion, no correlation. I feel one thing (let's say: I feel good) and I write another or people are convinced that it is my most horrible day.

I just read this "right now I am enraged". But I am not. I was not enraged all day.

Was I lying? No, I was not. It is simply that I occupy an inner world with very little relation to the outside. I WAS VERY ENRAGED yesterday. When writing it, I relived this rage in a semi-detached, semi-involved manner, as a baseball fan would when watching a game of his favourite group. Or like watching an especially engrossing movie, there and not there, without before or after. Movies are rather timeless ("it happened in the movie").

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3. Myself as a Source of Narcissistic Supply to Others, or: The Existence of Others

I never thought of myself as a source of supply, though I, in all probability, am very much so to many people. For instance: I hold a high ranking official position in the government and people name drop. Others regard me as "brilliant" and my affirmation and approval means a lot to them.

By stating that I am not a source to you - in some way you belittle me. But I am not reacting as I always do when belittled (or when I paranoidally think I am being belittled). I do not react to the THREAT. I react in a detached, amused and bemused way. I must get to the bottom of this. Perhaps you reflected me to myself and I find (that part of) myself pompous and unworthy of serious consideration.

By casting me in the role of a source of supply, you reminded me that others do exist.

The existence of others strikes me. It doesn't permeate the background, there constantly, a fixture, as I GUESS is the case with most people.

I am suddenly and intermittently struck by the lightning bolt of other people's existence (usually when they express their unmet needs).

It gives me pause. I slow down. I ponder this miraculous event, this curious fact, that others seem to have dimensions, to exist.

Then I shrug my shoulders and continue with whatever it was I was doing before. The other - whose existence I just became aware of - fades into the sort of two dimensional shadow which often inhabits my world.

It is the most peculiar thing this startling realization, but it is experienced by me exactly the way I just described it.

Imagine a movie character leaping out of the screen and you will grasp the effect.

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4. Right Now I am Enraged

Right now I am enraged. I hate and detest myself for my self hatred and the resulting self destructiveness. It's an old and worn out tale.

The unpleasant truth is that there is very little one can do about one's passions and that people like me have but one, over-riding, all-encompassing, all-pervasive, overpowering, irresistible passion: to annul themselves, to unravel through acts of death. Not suicide but slow disintegration. Time and again I judge myself and find me wanting and punish myself and find the punishment excessive and then punish myself for punishing myself so.

5. Is there an Ideal Source of Supply?

Of course there is (from the Narcissist's point of view). The ideal source of supply is sufficiently intelligent to qualify as such, sufficiently gullible, submissive, reasonably (but not overly) inferior to the narcissist, has a good memory (with which to regulate the flow of narcissistic supply), available but not imposing, not explicitly or overtly manipulative, interchangeable (not indispensable), not demanding (a fatalist to a degree), attractive (if the narcissist is somatic). In short: a Galathea-Pygmallion type.

6. Destruction and Construction

Destruction SHOULD precede construction.

But the narcissist dies of old age while still in the destruction phase, never getting anywhere near the reconstruction phase.

This is because construction can come ONLY with self-awareness and self-love. One does not re-build what one is unaware of and what one hates.

Few narcissists make it to self-awareness and none of them makes it to self-love.

7. Punishing Others

Some people are tormented by the very punishment they (however justly) inflict upon others.

Some people rush to the job with glee and jubilation (I LOVE punishing - it makes me feel so important, so potent, so GODLIKE !!!!)

Just punishment is the only proof we have that there is meaning and structure and order in the mayhem we call "our world". It must not be treated easily. It is a divine prerogative relegated and delegated to us mere mortals to make us feel at home.

8. You are a Source of Supply

You are a source of supply. If you cease to be a source of supply - as far as I am concerned, you cease to be. I do fight people furiously when they threaten my supply. I never judge (unless it is a show I put for public consumption, like in my articles). I never forget. I never forgive. I simply ignore those parts irrelevant to your function. Your function is to provide me with supply. My computer heats up. My cell phone radiates. My refrigerator hums. You act out. I cannot expect perfection.

9. Narcissism

Narcissism does has a strong compensatory component and is intended to offer a regulatory regime of the sense of self worth of the narcissist. It has other components, though (for instance: a reactive component - a reaction to past abuses or maltreatment). In general narcissism is the lack of a functioning ego. The individual then relies on others to perform his ego functions for him - the regulation of his sense of self worth being one of the more important ego functions.

Psychodynamic therapies aim to assist the narcissist to acquire, to "grow", a functioning ego and to break his dependence on others for the performance of his ego functions for him.

10. Addicted

I have been willingly addicted to information since the age of 4, when I began reading daily papers.

I LOVE information. It gives me a constant high. Why should I give up such sublime pleasure? (by "Information", I mean all manner of intellectual activity).

Why should I change my behaviour? What for?

I am not ego-dystonic. I am not depressed. Most of the day I am exhilarated as I absorb new data and write articles and listen to news and peruse my CD-ROM encyclopaedias...

It is heaven TEMPERED by humans.

The only thing I regret now and always regretted, ever since I was a kid, is the NECESSITY of dealing with humans and with my physical body.

But I am getting closer than ever to that perfect state of constant learning - manly thanks to the Internet.

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This is not Internet addiction. This is knowledge addiction. When I am off-line I read books, magazines, reprints, pre-prints, maps, labels. I am addicted to information, to reading, to writing - and I simply adore it. I am sorry I have to meet low-information-content-vehicles (=humans) from time to time or go to pee (as I must do now). It is a waste of valuable time. Time, time, data, data ... I am inebriated. It is the greatest time since my childhood and adolescence, since my army service and since prison - periods in which (with no computer in sight) I digested inhuman quantities of information, read, wrote and generally speaking enjoyed my dip in an ocean of knowledge.

To feel alive I must disappear and merge with information. Input, output. It is death but life at the same time. I am alive when I review the amount of data digested, the number of articles written. It has always been that way. This is the only stable feature of my life - the unrelenting, non-stoppable, obsessive, compulsive, hedonistic to the extreme, pursuit of the intellect and its fruits.

Humans are tiresome, exhausting, with low information content, unpredictable. In short: very boring.

11. False Self

The False Self (FS) does not have to be unconscious (mine is conscious, for instance). But it is a mask and, in this sense, a variant of the Jungian persona. FS is much more than a splitting defence mechanism. It incorporates splitting but it is much much more than that.

12. Worth and Grandiosity

One must not confuse WORTH with GRANDIOSITY.

The former exists (my IQ, my ability to convert abuse to learning, etc.)

The latter is a cancerous mutation of self worth.

That my True self is worthy of praise - I am sure.

That praise and adulation are not the same thing - I'm equally certain.

That my True Self is possessed of commendable qualities - is true.

That these qualities should not be confused with omnipotence and omniscience - is equally true.

Narcissism starts as a defence against abuse and ends up being a defence against the world (=the mundane). It is a drug. Few succeed to trade the magical world of drugs for the routine of daily life, no matter how hard they try.

To me, subjectively, the True/False schism appears real enough. I know that the False Self is a construct because I FEEL it this way: a transplanted, implanted, foreign entity, invoked by me, false (=not me) and alien.

What is this ME?

I don't have a clue. I just know that the True Self exists because I experience stirrings and counter-reactions when the False Self is active. At times I am ego-dystonic (something in me feels bad and it is distinct, it is NOT the False Self).

The False Self is a caricatured Jungian Persona. But it is so all-pervasive that the True Self at times appears to be a malfunction of the False self, a quirk, an idiosyncrasy.

The False Self is both a defence against the past and a break with it. It is a re-birth, the dawn of a new man (or, more rarely, woman) - omnipotent, omniscient, magical. This is why it is so difficult to divorce it. Who would willingly trade the magical for the quotidian?

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next: Excerpts from the Archives of the Narcissism List Part 25

Getting Off The Rollercoaster

There is only one true way to Love. It is without exception and without demands. It is accepting and forgiving. It is understanding of faults and mistakes, and finds no fault in being human. It is always kind, and is always willing to give what it has to offer. It does not expect anything in return, because its cup is never empty. It rejoices when a Truth is discovered, and shares in the Joy of another regardless of self. It is willing and free to help carry other peoples burdens, because with Love there is no burden to great. With Love, there are always answers to our problems. It sees the needs of others and recognises the things that can helpful in fulfilling those needs; for when those things have been discovered, there is always simplicity and joy associated with the giving.

Love enhances, Love advances. It is opened eyes and opened hearts, receptive and eager to please, and it is always willing to believe. Love is mutual, Love is harmony; just as the magnificence of a symphony comes into being through the individual tunes of individual instruments...they are alone yet together. Such is the harmony of a life centred on Love.

This is unconditional Love.

To Love someone truly is to Love all parts of that person. Unconditional Love simply exists. It is not expectant of certain conditions to be maintained. It just is... and all that it wants is for itself to be shared. If you want this type of Love, then it is yours. It will never be a burden or make demands, for it alone is free; it is centred from within and delights in giving.

SPECIAL LOVE:

When we Love all people, we are not IN LOVE with all people, but we are one with them as we journey together through life. If we are so blessed as to have someone in our life who gives us deep meaning and fulfilment, then to share such a Love like this is to share more than a life, it is to share a way of life. To have such a special Love in a lasting relationship based on unconditional Love is to possess a magnificent Love. For a woman and a man to be united in unconditional Love, is the kind of Love that poets have been writing of for centuries. It is not a dream Love, it does exist. It is a powerful Love, yet it is a simple and uncomplicated Love. It is a Love that endures, and it's available to all ... if you so choose.

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ACCEPTANCE THROUGH UNDERSTANDING:

Through learning to accept your past mistakes, you are in fact learning to forgive yourself. You are able to do this because you are the closest that anyone can be to you. You understand your situation more and more clearly as you grow in Love and awareness. With this concept in mind, you can be sure that there are people all over the world striving to be whole. They feel as you do, and they are searching for understanding and acceptance through Love.

But we cannot know all aspects of all such people, and we do not need to have such a deep knowledge. Part of loving unconditionally is related to living in the "THE NOW". As you may have forgiven someone else for a distant and past event, the same must hold true for mistakes that are with you now that remain unresolved. The past is gone and all that really matters is the time you are living right now. As long as you are ready to respond with first actions that are based on Love, then not only will you find your own continued peace, but you will also bring about a more thorough resolution to the problems of those who are close and dear to you, as well as those whose lives cross our paths from time to time.

YOUR WORTH IS AS EQUAL TO THE WORTH THAT YOU SEE IN OTHERS:

To Love yourself is a good thing. Old fashioned Ego thinking wants to guide our thoughts to the likes of...

"Don't be so conceited".

... but self Love is not associated with pride, it is associated with acceptance. It is linked to understanding as we continue to try our best. We are kind to ourselves, just as we are kind to others.

So often, we are sympathetic to the plight of others, but when it comes to ourselves we can be very intolerant of our own mistakes. It is the Ego which drags us down, telling us as a response to a foolish choice,...

"Never never do that thing again"

...yet after some time has passed, it would continue to chatter and say...

"Well; it really wasn't so bad.

it's really O.K., you're not hurting anyone".

But the truth in this thinking is that you are really hurting yourself.

The Ego can deliver strategies that might bring us to think that our place in life, our feelings, and the need for Love are unjustified. It would say...

"Stop thinking of yourself... Give your kindness to others

You're O.K... you've got enough..."

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Subtly, the ego is saying "you don't count", but you do count! and you are equal in worth to anyone else who lives and shares time on this earth. You cannot be selfish when you act with Love, for when you have learned to Love yourself, you are acting in accordance with nature.

Since the Ego does not operate out of Love, we can say that it does not know of Love. It only knows that it is a force that it must be responded to. Ego operates on physical realities, but the Inner Truth operates on Spiritual realities. Through an unknowing of Love, it cannot see the love in other people. As such, it will then relate other peoples behaviour to its own past experiences which are linked to fear. But!... Always keep in mind... Your Ego is simply trying to protect you.

As you would Love all people, you cannot exclude yourself or the other parts of yourself from that Love; even the parts which have brought about pain. Your choices, your thinking, your actions, and your desires have all come about through association and evaluation linked to all your past experiences. You are not bad or lacking because of past mistakes. There are no bad people, but there are people whose actions stem from lack of integration and the experience of kind Love. Inwardly they are sad and confused and their actions are associated with fear and survival brought about by a limited knowledge of the True concept of Love.

THE HIDDEN REASONS:

A child is born with unblemished Love and affection, and it's development is totally at the mercy of the parents or guardians. Children will learn about life from what they see in others, and when a child is raised by people who give Conditional Love, they will learn that this behaviour is how Love is supposed to be. But when children observe and learn from Unconditional Love, they are taught of the boundlessness that can exist in learning to live with understanding, forgiveness and tolerance.

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This tolerance is not one where we grit our teeth and fume within as people's unthinking behaviour clashes with our own world, we are tolerant because we know we are all learning from personal experiences. Our tolerance is then peaceful, and through it we continue to maintain our own peace.

Here is the principal reason why we should all Love each other unconditionally. We are all learning from what is available through our experiences and teachings. This is also why I believe that there are no bad people. Peoples behaviour is supported by valid and explainable reasons. (Please note my use of the word "Reasons", and not Excuses). Each of us has our own unique story, and only compassion and understanding for the circumstances of others will bring about that mass shift in consciousness that is inevitable as the world matures.

Continually acting with unconscious kindness to all people in all situations, will empower yourself and others as they inwardly respond to your Love based mode of living. It will help others in ways that they might not necessarily perceive since by your example, you bring into someone else's life aspects of behaviour that they may never have had the opportunity to witness. Even people with great Self Love who have minimal interaction with others are important, since there is a wind that carries the seeds of their inner kindness to other barren ground. This is part of the action of life. By simply living in Love, you contribute in ways that you may never know of. Be cautious not to operate purely with a "Be nice just in case attitude", but KNOW that your goodness attracts other goodness. Your Love will be exemplary as you lay seeds that silently take root in peoples hearts everywhere you go. Kindness is mimicked just as fear is.

Be good because it is good to be good.

UNIVERSAL GROWTH:

When you act with Love, the whole Universe grows that little bit more. When you grow in strength and Love, not only does it affect your own surrounding world, but equally your actions contribute to the overall advance of humanity. When a change is made within and that change becomes permanent, then the mirror action of Love and kindness will be available to others. They too shall learn and grow so that one day Love will permeate all things.

As we develop in our new Love, all people are seen in a different light. There are no longer veils and obstacles blocking our intuitive vision, for the Love we have now put in the forefront of our lives, sees the soul first, and then the body.

The sooner we begin our Love based way of living, the sooner the examples of goodness will then begin to settle in peoples minds to be seen as Alternatives of Being which will resonate within them as something good. When we get a taste for something, we may tend to pursue it whether it is good or bad, so by living a life that displays our inner goodness through practical example, we enable ourselves and the people around us to get a taste for kindness and Love. We can then work for Love, through Love, with Love.

Love based living does not necessarily imply the need to continually act like reverent and holy people, or even to be constantly searching out people in need. It means being available. It means asserting your worth. It means being bold enough to step out and follow your dreams. It means walking on a beach and feeling the sand grit underneath your feet and the biting chill as a wave washes around your toes. It means acknowledging the totality of your humanness with all its tears and joys. It means being free.

"Love thy neighbour". We were told this so long ago. It's such a hard lesson to get across. However, as hard as it may seem, don't let the required effort compromise the quality of the life you want for yourself. Remember that love is linked to an understanding that we are all in the same boat. Yes... we are learning... we are All learning.

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COMPLIMENTING VIRTUES:

To develop this way of living, we need to compliment it with other virtues. To Love fully, you must understand the value of Truth, as well as the value of Patience. By bringing these qualities into your life, you will see wonderful changes in your outlook on people and events as you grow to a restored unity of mind, body and soul.

TRUTH:

Never be afraid of the Truth. Never believe that the Truth is better left unspoken. Through loving discernment, we may have to delay the Truth while foundations of understanding are being built, but the Truth will eventually be delivered in its own way and in its own time. Never guide others blindly through your own unacceptance of what is right. Better to remain silent and go away to ponder the reasons that make you think that Truth is a lesser thing than your own judgment. We always know within our hearts when we feel that something is good and true. Sometimes we make mistakes, but through these mistakes, we come to a closer understanding of ourselves, of the world, and of an ability to clearly recognise truths from untruths.

When we always act to seek the Truth and to live the Truth, our mistakes turn into valuable teachings.

Always be receptive to these teachings. Turn your mistakes around by admitting and accepting them. See also that the admission of mistakes and errors is Truth unfolding; the Truth in you coming into the light. If you do something wrong, then own up to it. To act this way encourages a way of life that is able to foresee events which could lead you from the Truth. Get into the habit of being honest with yourself. Master this alone and you will be honest with all people; you will develop friendships which are strong, meaningful and lasting. They will be friends that really care and that will always support. Truthful people will always gravitate to each other since the Truth likes the Truth; the Truth seeks the Truth; and the Truth finds the Truth.

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This world has cheats and liars that take advantage of the ones who are honest and trustworthy, but the person with the highest acceptance of the Truth and what it stands for, will always know that these people never really succeed. Their moments of glory are transitory, but the Truthful person lives with the knowledge that nothing surpasses the Truth and that the Truthful way is always the best. It is not a perfect world we live in; this is not paradise, so we act in a way that brings us the strength we need to bring us peace of mind. It is so simple to be honest with yourself and with others.

PATIENCE:

To possess Patience, is to possess a great inner strength. The impatient person has no endurance, little hope, and with regard to important timely matters, little or no faith in oneself or others. Through fostering patience, a new peace is obtained. The Patient person is a positive person, for time is allowed to take a backseat since the end result is what matters. Though time is seemingly put aside as unimportant by living in THE NOW, it is only in the fullness of time that things happen; that things turn around; that tears are dried and sorrows are replaced by joys; that Love can blossom to great splendour.

Sometimes, time itself can seem to be your enemy, but in reality, time is your best friend. When you acquire Patience, you acquire a freedom from anxiety; and so often anxiety leads to failure. Patience will give you persistence and discipline, and the fruits of this virtue will ripen in many aspects of your life. The patience in doing a job properly. The patience in helping others through difficult times. The patience in waiting for Love... "Waiting for Love, with Love."

Patience is understanding. How often do we lack peace when we need to draw on it most, for as much as life will bring us good times, misfortune will also arise. When those difficult times arrive, we need a source of strength that must be available when needed. We can always call on the support of others, but we must be our own main support. Through our humanness, we have natural limitations, as such, we have limited Patience, but we can make it more enduring by acting with Love, kindness and understanding. To have such an understanding will then greatly increase our Patience. With such a degree of Patience, we can wait in peace for the things that matter and will bring joy to our lives. Patience is strength.

CONTEMPLATION:

To truly Love someone is all encompassing.

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next:Getting Off the Roller Coaster Affirming Your Right to Love

Article explores how we strive for wealth, power and struggle with issues inflicted upon us by our parents and how that leads to stress and a feeling of insuffiency.

We are not born, in essence, American, French, Japanese, Christian, Muslim, or Jew. These labels are attached to us according to where on the planet our births happen to take place, or these labels are imposed upon us because they indicate our families' belief systems.

We are not born with an innate sense of distrust of others. We do not enter life with the belief that God is external to us, watching us, judging us, loving us, or simply being indifferent to our plight. We do not suckle at the breast with shame about our bodies or with racial prejudice already brewing in our hearts. We do not emerge from our mothers' wombs believing that competition and domination are essential to survival. Nor are we born believing that somehow we must validate whatever our parents consider to be right and true.

How do children come to believe that they are indispensable to their parents' well-being, and that they therefore must become the champions of their parents' unfulfilled dreams, fulfilling them by becoming the good daughter or the responsible son? How many people revolt against their parents' relationships by condemning themselves to lives of cynicism about the possibility for real love? In how many ways will members of one generation after another efface their own true natures in order to be loved, successful, approved of, powerful, and safe, not because of who they are in essence, but because they have adapted themselves to others? And how many will become part of the detritus of the cultural norm, living in poverty, disenfranchisement, or alienation?

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We are not born anxious for our survival. How is it, then, that pure ambition and the accumulation of wealth and power are ideals in our culture, when to live for them is all too often a soulless pursuit that condemns one to a path of unending stress, which fails to address or heal the core, unconscious feeling of insufficiency?

All such internalized attitudes and belief systems have been cultivated in us. Others have modeled them for us and trained us in them. This indoctrination takes place both directly and indirectly. In our homes, schools, and religious institutions, we are explicitly told who we are, what life is about, and how we should perform. Indirect indoctrination occurs as we absorb subconsciously whatever is consistently emphasized or demonstrated by our parents and other caregivers when we are very young.

As children we are like fine crystal glasses that vibrate to a singer's voice. We resonate with the emotional energy that surrounds us, unable to be sure what part is us -- our own true feelings and likes or dislikes -- and what part is others. We are keen observers of our parents' and other adults' behavior toward us and toward each other. We experience how they communicate through their facial expressions, body language, tone of voice, actions, and so on, and we can recognize -- though not consciously when we are young -- when their expressions and their feelings are congruent or not. We are immediate barometers for emotional hypocrisy. When our parents are saying or doing one thing, but we perceive that they mean something else, it confuses and distresses us. Over time these emotional "disconnects" continue to threaten our developing sense of self, and we begin to devise our own strategies for psychological security in attempts to protect ourselves.

None of this is accompanied by our conscious understanding of what we are doing, but we quickly deduce what our parents value and what evokes their approval or disapproval. We readily learn which of our own behaviors they respond to in ways that make us feel loved or unloved, worthy or unworthy. We begin to adapt ourselves by acquiescence, rebellion, or withdrawal.

As children we do not initially approach our worlds with our parents' biases and prejudices about what is good or bad. We express our true selves spontaneously and naturally. But early on, this expression begins to collide with what our parents encourage or discourage in our self-expression. All of us become conscious of our earliest sense of self in the context of their fears, hopes, wounds, beliefs, resentments, and control issues and of their ways of nurturing, whether loving, suffocating, or neglecting. This mostly unconscious socializing process is as old as human history. When we are children and our parents view us through the lens of their own adaptations to life, we as unique individuals remain more or less invisible to them. We learn to become whatever helps make us visible to them, to be whatever brings us the most comfort and least discomfort. We adapt and survive as best we can in this emotional climate.

Our strategic response results in the formation of a survival personality that does not express much of our individual essence. We falsify who we are in order to maintain some level of connection to those whom we require in order to meet our needs for attention, nurturance, approval, and security.

Children are marvels of adaptation. They quickly learn that, if acquiescence produces the best response, then being supportive and agreeable provides the best chance for emotional survival. They grow up to be pleasers, excellent providers for the needs of others, and they see their loyalty as a virtue more important than their own needs. If rebellion seems to be the best path to diminishing discomfort while also gaining attention, then they become combative and build their identities by pushing their parents away. Their fight for autonomy may later make them nonconformists unable to accept the authority of others, or they may require conflict in order to feel alive. If withdrawal works best, then children become more introverted and escape into imaginary worlds. Later in life, this survival adaptation may cause them to live so deeply in their own beliefs that they are unable to make space for others to know them or to emotionally touch them.

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Because survival is at the root of the false self, fear is its true god. And because in the Now we cannot be in control of our situations, only in relationship with it, the survival personality is poorly suited to the Now. It tries to create the life it believes it should be living and, in so doing, does not fully experience the life it is living. Our survival personalities have identities to maintain that are rooted in the early childhood escape from threat. This threat comes from the disjunction between how we experience ourselves as children and what we learn to be, in response to our parents' mirroring and expectations.

Infancy and early childhood are governed by two primary drives: The first is the necessity to bond with our mothers or other important caregivers. The second is the drive to explore, to learn about and discover our worlds.

The physical and emotional bond between mother and baby is necessary not only for the child's survival but also because the mother is the first cultivator of the baby's sense of self. She cultivates it by how she holds and caresses her baby; by her tone of voice, her gaze, and her anxiety or calmness; and by how she reinforces or squelches her child's spontaneity. When the overall quality of her attention is loving, calm, supportive, and respectful, the baby knows that it is safe and all right in itself. As the child gets older, more of his or her true self emerges as the mother continues to express approval and set necessary boundaries without shaming or threatening the child. In this way her positive mirroring cultivates the child's essence and helps her child to trust itself.

In contrast, when a mother is frequently impatient, hurried, distracted, or even resentful of her child, the bonding process is more tentative and the child feels unsafe. When a mother's tone of voice is cold or harsh, her touch brusque, insensitive, or uncertain; when she is unresponsive to her child's needs or cries or cannot set aside her own psychology to make enough space for the child's unique personality, this is interpreted by the child as meaning that something must be wrong with him or her. Even when neglect is unintentional, as when a mother's own exhaustion prevents her from nurturing as well as she would like to, this unfortunate situation can still cause a child to feel unloved. As a result of any of these actions, children can begin to internalize a sense of their own insufficiency.

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Until recently, when many women have become working mothers, fathers have tended to transmit to us our sense of the world beyond the home. We wondered where Daddy was all day. We noticed whether he returned home tired, angry, and depressed or satisfied and enthusiastic. We absorbed his tone of voice as he spoke about his day; we felt the outside world through his energy, his complaints, worries, anger, or enthusiasm. Slowly we internalized his spoken or other representations of the world into which he so frequently disappeared, and all too often this world appeared to be threatening, unfair, "a jungle." If this impression of potential danger from the outside world combines with an emerging sense of being wrong and insufficient, then the child's core identity -- his or her earliest relationship to the self -- becomes one of fearfulness and distrust. As gender roles are changing, both men and working mothers perform aspects of the fathering function for their children, and some men perform aspects of mothering. We could say that in a psychological sense mothering cultivates our earliest sense of self, and how we mother ourselves throughout life strongly influences how we hold ourselves when faced with emotional pain. Fathering, on the other hand, has to do with our vision of the world and how empowered we believe ourselves to be as we implement our own personal visions in the world.

Day by day throughout childhood, we explore our worlds. As we move out into our environment, our parents' capacity to support our process of discovery and to mirror our attempts in ways that are neither overprotective nor neglectful depends on their own consciousness. Are they proud of us as we are? Or do they reserve their pride for the things we do that fit their image for us or that make them look like good parents? Do they encourage our own assertiveness, or interpret it as disobedience and quell it? When a parent delivers reprimands in a way that shames the child -- as so many generations of generally male authorities have recommended doing -- a confused and disturbed inner reality is generated in that child. No child can separate the frightful bodily intensity of shame from his or her own sense of self. So the child feels wrong, unlovable, or deficient. Even when parents have the best intentions, they frequently meet their child's tentative steps into the world with responses that seem anxious, critical, or punitive. More important, those responses are often perceived by the child as implicitly distrustful of who he or she is.

As children, we cannot differentiate our parents' psychological limitations from the effects they cause in us. We cannot protect ourselves by means of self-reflection so that we can arrive at compassion and understanding for them and ourselves, because we do not yet have the awareness to do so. We cannot know that our frustration, insecurity, anger, shame, neediness, and fear are just feelings, not the totality of our beings. Feelings seem simply good or bad to us, and we want more of the former and less of the latter. So gradually, within the context of our early environment, we wake up to our first conscious sense of self as if materializing out of a void, and without understanding the origins of our own confusion and insecurity about ourselves.

Each of us, in a certain sense, develops our earliest understanding of who we are within the emotional and psychological "fields" of our parents, much as iron filings on a sheet of paper become aligned in a pattern determined by a magnet underneath it. Some of our essence remains intact, but much of it has to be forfeited in order to ensure that, as we express ourselves and venture out to discover our worlds, we don't antagonize our parents and risk the loss of essential bonding. Our childhoods are like the proverbial Procrustean bed. We "lie down" in our parents' sense of reality, and if we are too "short" -- that is, too fearful, too needy, too weak, not smart enough, and so on, by their standards -- they "stretch" us. It can happen in a hundred ways. They might order us to stop crying or shame us by telling us to grow up. Alternatively, they might try to encourage us to stop crying by telling us everything is all right and how wonderful we are, which still indirectly suggests that how we are feeling is wrong. Of course, we also "stretch" ourselves -- by trying to meet their standards in order to maintain their love and approval. If, on the other hand, we are too "tall" -- that is, too assertive, too involved in our own interests, too curious, too boisterous, and so on -- they "shorten" us, using much the same tactics: criticism, scolding, shame, or warnings about problems we will have later in life. Even in the most loving families, in which parents have only the best intentions, a child may lose a significant measure of his or her innate spontaneous and authentic nature without either the parent or the child realizing what has happened.

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As a result of these circumstances, an environment of angst is unconsciously born within us, and, at the same time, we begin a lifetime of ambivalence about intimacy with others. This ambivalence is an internalized insecurity that can leave us forever dreading both the loss of intimacy that we fear would surely occur if we somehow dared to be authentic, and the suffocating sense of being dispossessed of our innate character and natural self-expression if we were to allow intimacy.

As children we begin to create a submerged reservoir of unacknowledged, nonintegrated feelings that pollute our earliest sense of who we are, feelings like being insufficient, unlovable, or unworthy. To compensate for these, we build up a coping strategy called, in psychoanalytic theory, the idealized self. It is the self we imagine we should be or can be. We soon start to believe we are this idealized self, and we compulsively continue to attempt to be it, while avoiding anything that brings us face to face with the distressing feelings we have buried.

Sooner or later, however, these buried and rejected feelings resurface, usually in the relationships that seem to promise the intimacy we so desperately crave. But while these close relationships initially offer great promise, eventually they also expose our insecurities and fears. Since we all carry the imprint of childhood wounding to some degree, and therefore bring a false, idealized self into the space of our relationships, we are not starting from our true selves. Inevitably, any close relationship we create will begin to unearth and amplify the very feelings that we, as children, managed to bury and temporarily escape.

Our parents' ability to support and encourage the expression of our true selves depends on how much of their attention comes to us from a place of authentic presence. When parents unconsciously live from their false and idealized senses of self, they cannot recognize that they are projecting their unexamined expectations for themselves onto their children. As a result, they cannot appreciate the spontaneous and authentic nature of a young child and allow it to remain intact. When parents inevitably become uncomfortable with their children because of the parents' own limitations, they attempt to change their children instead of themselves. Without recognizing what is happening, they provide a reality for their children that is hospitable to the children's essence only to the extent that the parents have been able to discover a home in themselves for their own essence.

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All of the above may help to explain why so many marriages fail and why much that is written about relationships in popular culture is idealized. As long as we protect our idealized selves, we are going to have to keep imagining ideal relationships. I doubt they exist. But what does exist is the possibility to start from whom we really are and to invite mature connections that bring us closer to psychological healing and true wholeness.

Copyright © 2007 Richard Moss, MD

About the author:
Richard Moss, MD, is an internationally respected teacher, visionary thinker, and author of five seminal books on transformation, self-healing, and the importance of living consciously. For thirty years he has guided people from diverse backgrounds and disciplines in the use of the power of awareness to realize their intrinsic wholeness and reclaim the wisdom of their true selves. He teaches a practical philosophy of consciousness that models how to integrate spiritual practice and psychological self-inquiry into a concrete and fundamental transformation of people's lives. Richard lives in Ojai, California, with his wife, Ariel.

For a calendar of future seminars and talks by the author, and for further information on CDs and other available material, please visit www.richardmoss.com.

Or contact Richard Moss Seminars:
Office: 805-640-0632
Fax: 805-640-0849
Email: 2miracle@sbcglobal.net

next: Articles: When Ordinary People Achieve Extraordinary Things

Valerian root is an alternative mental health treatment for the symptoms of insomnia, anxiety, and restlessness. Learn about the usage, dosage, side-effects of Valerian.

Botanical Name:Valeriana officinalis
Common Names:Valerian

• Overview
• Plant Description
• What's It Made Of?
• Available Forms
• How to Take It
• Precautions
• Possible Interactions
• References

Overview

Valerian, native to the Americas, Asia, and Europe has been used to ease insomnia, stress-related anxiety, and nervous restlessness for thousands of years, with particular popularity in Europe starting in the 17th century. Now, modern day research, mainly over the last decade, has begun to confirm the scientific validity of these historic uses. It may also ease menstrual and stomach cramps, irritable bowel syndrome, some of the restlessness that accompanies attention deficit/hyperactivity disorder (ADHD) and migraine symptoms. There have also been rare reports for use to treat convulsions from a seizure disorder. Its most well-researched use, however, is as a calmant to help people sleep.

Insomnia
Valerian is a popular alternative treatment to benzodiazepines (such as diazepam and alprazolam) and other commonly prescribed medications for sleep problems because it is considered to be both safe and gentle. In studies of animals and people, valerian has demonstrated mild sedative and tranquilizing activity, as well as the ability to relieve anxiety. Generally, studies have shown that valerian reduces the time it takes to fall asleep and improves the quality of sleep itself. Plus, unlike many prescription sleep aids, valerian may have fewer after effects the next day, such as morning drowsiness. In addition, although not studied scientifically, some experts use valerian for sleep disturbances related to feelings of depression.

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Plant Description

Valerian products are made from the root of a tall, wispy plant, which is grown to decorate gardens but also grows wild in damp grasslands. Its umbrella-like heads top grooved, erect, and hollow stems. Its dark green leaves are pointed at the tip and hairy underneath. Small, sweet-smelling white, light purple, or pink flowers bloom in June. The root is light grayish brown and has a pungent odor.

What's It Made Of?

The manufacture of medicinal valerian products begins with pressed fresh root or powdered freeze-dried root (frozen below 400°C). Valerian pressed-root juice added to alcohol or glycerite (sweet, nonalcohol liquid) bases become fluid extracts or tinctures; powdered root goes into capsules and tablets.

Available Forms

Valerian fluid extracts and tinctures are sold in alcohol or alcohol-free (glycerite) bases. Powdered valerian is available in capsule or tablet form, and also as a tea.

Valerian products are commonly added to formulas that contain other calming herbs, such as passionflower (Passiflora incarnata), hops (Humulus lupulus), lemon balm (Melissa officinalis), skullcap (Scutellaria lateriflora), and kava (Piper methysticum). (Note: reports linking kava with severe liver damage has prompted regulatory agencies in Europe and Canada to warn consumers of the potential risks associated with this herb and even remove kava-containing products from the market. Based on these and other reports in the United States, the Food and Drug Administration (FDA) also issued a consumer advisory in March of 2002 regarding the "rare," but potential risk of liver failure associated with kava-containing products.)

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How to Take It

Valerian products should be standardized to contain 0.8% valerenic or valeric acid; standardization helps to assure quality control in herbal products.

Pediatric
Adjust the recommended adult dose to account for the child's weight. Most herbal dosages for adults are calculated on the basis of a 150 lb (70 kg) adult. Therefore, if the child weighs 50 lb (20 to 25 kg), the appropriate dose of valerian for this child would be 1/3 of the adult dosage.

Adult
To help bring on sleep, reduce nervousness and anxiety, valerian may be taken in the following doses an hour or so before retiring, or up to three times in the course of the day, with the last dose near bedtime. It may take a few weeks before the effects are felt.

• Tea: Pour 1 C boiling water over 1 teaspoonful (2 to 3 g) of dried root, steep 5 to 10 minutes.
• Tincture (1:5): 1 to 1 1/2 tsp (4 to 6 mL)
• Fluid extract (1:1): 1/2 to 1 tsp (1 to 2 mL)
• Dry powdered extract (4:1): 250 to 500 mg
• Valerian extract, standardized to contain 0.8% valerenic acid: 150 to 300 mg.

Once sleep improves, valerian should be continued for two to four weeks. A total of four to six weeks is usually the length of treatment advised by herbalists. After six weeks, a two-week break is recommended to see if sleep has improved. (Note, however, that abruptly stopping valerian has, on very rare occasions, caused withdrawal symptoms; see Precautions. Therefore, it is important to follow the directions of a qualified practitioner when weaning off of valerian.) If there has been no improvement, another four-to-six week course of treatment may be started.

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Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.

The American Herbal Products Association (AHPA) gives valerian a class 1 safety rating, which indicates that it is a safe herb with a wide dosage range.

Nevertheless, some people have a "paradoxical reaction" to valerian. This means that instead of feeling calm or sleepy, they suddenly feel nervous, anxious, and restless after they take valerian and may experience palpitations (a feeling of a racing heart).

There is also some evidence that in cases where valerian has been used over a long period of time, serious withdrawal symptoms may occur when it is stopped abruptly.

Women who are pregnant or breastfeeding are advised against using valerian and, because of its tranquilizing effects, valerian should not be used while driving, operating heavy machinery, or engaging in other activities that require alertness. Also, some warn against use if you have liver disease because of a few reports of liver damage when valerian was used in combination with skullcap, another herb used for anxiety.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use valerian without first talking to your healthcare provider.

Anesthesia
For those facing surgery, it is important to note that valerian may increase the effects of anesthesia and, thus, it is important to discuss the use of valerian with your healthcare providers (particularly the surgeon and anesthesiologist) well in advance of your planned operation. The doctors may advise you on how to taper use of valerian prior to the surgery. Or, they may allow you to continue use up to the time of surgery, making any necessary adjustments to the anesthesia and giving you medication to avoid possible withdrawal symptoms from the valerian while in the hospital.

Sedatives and Anti-anxiety Medications
There are no reports in the scientific literature to suggest that valerian interacts with any conventional medications. However, valerian is a sedative herb that may increase the effects of alcohol and medications for anxiety and insomnia. Valerian should not be combined with barbiturates (medications, such as pentobarbital, prescribed for sleep disorders or seizures), and should be used with caution, if at all, by people taking benzodiazepines (anti-anxiety and sleep inducing medications including alprazolam, diazepam, and lorazepam) or other sedative medications (such as antihistamines).

back to: Herbal Treatments Homepage

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Supporting Research

Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. JAMA. 2001;286(2):208-216.

Attele AS, Xie JT, Yuan CS. Treatment of insomnia: an alternative approach.Altern Med Rev. 2000;5(3):249-259.

Balderer G, Borbely AA. Effect of valerian on human sleep. Psychopharmacology (Berl). 1985;87(4):406-409.

Barrett B, Kiefer D, Rabago D. Assessing the risks and benefits of herbal medicine: an overview of scientific evidence. Altern Ther Health Med. 1999;5(4):40-49.

Baumgaertel A. Alternative and controversial treatments for attention-deficit/hyperactivity disorder. Pediatr Clin of North Am. 1999;46(5):977-992.

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:394-400.

Briggs CJ, Briggs GL. Herbal products in depression therapy. CPJ/RPC. November 1998;40-44.

Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, Ore: Eclectic Medical; 1998:133-134.

Cauffield JS, Forbes HJ. Dietary supplements used in the treatment of depression, anxiety, and sleep disorders. Lippincotts Prim Care Pract. 1999;3(3):290-304.

Donath F, Quispe S, Diefenbach K, Maurer A, Fietze I, Roots FI. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry. 2000;33:47-53.

Ernst E, ed. The Desktop Guide to Complementary and Alternative Medicine: An Evidence-Based Approach. New York, NY: Mosby;2001:160-162.

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Ernst E. Herbal medications for common ailments in the elderly. Drugs Aging. 1999;15(6):423-428.

Foster S, Tyler VE. Tyler's Honest Herbal. New York, NY: The Haworth Herbal Press; 1999:377-379.

Fugh-Berman A, Cott JM. Dietary supplements and natural products as psychotherapeutic agents. Psychosom Med. 1999;61(5):712-728.

Gyllenhaal C, Merritt SL, Peterson SD, Block KI, Gochenour T. Efficacy and safety of herbal stimulants and sedatives in sleep disorders. Sleep Med Rev. 2000;4(2):229-251.

Heiligenstein E, Guenther G. Over-the-counter psychotropics: a review of melatonin, St John's wort, valerian, and kava-kava. J Am Coll Health. 1998;46(6):271-276.

Leatherwood PD, Chauffard F, Heck E, Munoz-Box R. Aqueous extract of valerian root (Valeriana officinalis L.) improves leep quality in man. Pharm Biochem Behavior. 1982;17(1):65-71.

McGuffin M, Hobbs C, Upton R, Goldberg A. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, Fla: CRC Press; 1997:120.

Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158(20):2200-2211.

Newall CA, Phillipson JD. Interactions of Herbs with Other Medicines. Kings Centre for Pharmacognosy, the School of Pharmacy, University of London. The European Phytojournal. 1998; 1. Available at: http://www.ex.ac.uk/phytonet/phytojournal/ .

O'Hara M, Kiefer D, Farrell K, Kemper K. A review of 12 commonly used medicinal herbs. Arch Fam Med. 1998;7(6):523-536.

Ottariano, SG. Medicinal Herbal Therapy: A Pharmacist's Viewpoint. Portsmouth, NH: Nicolin Fields Publishing; 1999.

Pizzorno JE, Murray MT. Textbook of Natural Medicine. New York: Churchill Livingstone; 1999:997-, 1355-1356.

Robbers JE, Tyler V. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: The Haworth Herbal Press; 1999: 154-157.

Rotblatt M, Ziment I. Evidence-Based Herbal Medicine. Philadelphia, Penn:Hanley & Belfus, Inc. 2002:355-359.

Shannon S. Attention deficit/hyperactivity disorder. Integrative Medicine Consult. 2000; 2(9):103-105.

Upton R. Valeriana officianlis photoessay. J Alt Comp Med. 2001;7(1):15-17.

Wagner J, Wagner ML, Hening WA. Beyond benzodiazepines: alternative pharmacologic agents for the treatment of insomnia. Ann Pharmacother. 1998;32(6):680-691.

White L, Mavor S. Kids, Herbs, Health. Loveland, Colo: Interweave Press; 1998:22, 42.

Wong AH, Smith M, Boon HS. Herbal remedies in psychiatric practice. Arch Gen Psychiatr. 1998;55(1):1033-1044.

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

back to: Herbal Treatments Homepage

Beauty, it is said, lies in the eye of the beholder.

But if the beholder has been bombarded by too much television and too many videos or reads too many fashion magazines, the eye may develop an unhealthy tunnel vision, experts say.

"Body image is not just appearance," said Karen Ritter, a licensed clinical social worker with 18 years' experience. "Your body image has to do with your health, your various talents, how able you are to be in tune with sensations in your body."

Ritter is the clinical director of the Oak Knolls Family Therapy Center in California, which specializes in treating eating disorders in both sexes.

Many of us grow up in families watching people be critical of their bodies, Ritter said. But everyone's body has strengths and weaknesses, and bodies are tied to a person's genetics.

"White American women have the worst body-image distortion," Ritter said. "Black American women have the best body image."

But comparing your body with someone else's doesn't work, nor does the mirror give an accurate picture of what you look like, she said. "You need to be active and doing things with your body that help your body," she said. "And resist the pressure to judge yourself and others based on weight, shape or size."

The Centers for Disease Control and Prevention in Atlanta conducted a survey that found more than a third of girls considered themselves overweight, compared with fewer than 15 percent of the boys.

Other studies say about half of teen girls are dieting, and elementary school students are already worrying about weight. The results lend new meaning to the term "trying to fit in."

"How you perceive your body is only one component of a complete self-image, but too often it becomes the sole factor in determining self-esteem," say experts.

"When 'how-I-look' becomes more important than 'who-I-am,' the groundwork is laid for crippling and life-threatening eating disorders."

According to information from the National Women's Health Resource Center, "Our society's 'ideal' body size for a woman has decreased, and the difference between the size of the average American woman and the size many women think they should be has grown tremendously. Twenty years ago, for example, the average fashion model weighed 8 percent less than the average woman; today's models weigh 23 percent less."

More than 43 percent of the girls in one study said they were on a diet. The most common methods used were" skipping meals, taking diet pills and inducing vomiting after eating," the study said. Experts agree that trying to achieve the "perfect" female body image seen on TV and magazines is leading an increasing number of teens to develop eating disorders such as bulimia and anorexia nervosa.

Men aren't Immune to Body Image Problems

Increasing numbers of men are joining the ranks of those who are unhappy with their bodies, and many are abusing steroids in an effort to look more muscular and powerful.

In a special report in the March 2001 edition of the Psychiatric Times, called "Unraveling the Adonis Complex," Dr. Harrison G. Pope Jr. wrote, "Steroids have shattered a million-year-old equilibrium of nature by making it possible to create men far leaner and more muscular than any naturally occurring man. The images of these steroid-pumped bodies have propagated into advertising, television soap operas, professional wrestling shows, movies and magazine covers. Even action figures ---- the little plastic heroes used by young boys in play ---- now sport huge muscles in comparison to their counterparts of a generation earlier."

Pope is professor of psychiatry at Harvard Medical School and chief of the biological psychiatry laboratory at the McLean Hospital Alcohol and Drug Abuse Research Center in Belmont, Mass. The "Adonis complex" is a term coined by the doctor and his colleagues for "male body obsession," which they say is on the rise.

"Today's men should recognize that many of these muscled bodies are products of steroids and other drugs; they should also recognize that large industries profit by nurturing male body obsessions, just as similar industries prey on women," Pope wrote.

"Men should remember that muscularity is not masculinity, and that self-esteem is not built on a six-pack of abdominal muscles. Perhaps if we can help boys and men to rise above the messages of contemporary society and the media, they can regain the simple comfort with their bodies that previous generations took for granted."

Karen Ritter suggested that people should practice being nice to their bodies and respect themselves and others for reasons other than appearance.

"The keys to having a good body image are to treat your body with respect, give it enough rest, fuel it with a variety of foods, exercise, and resist the pressure to judge yourself and others based on weight, shape or size."

Negative body Image is ...

• A distorted perception of your shape ---- you perceive parts of your body unlike they really are
• You are convinced that only other people are attractive and that your body size or shape is a sign of personal failure.
• You feel ashamed, self-conscious and anxious about your body.
• You feel uncomfortable and awkward in your body.

Positive body Image is ...

A clear, true perception of your shape ---- you see various parts of your body as they really are.

• You celebrate and appreciate your natural body shape and you understand that a person's physical appearance says very little about their character and value as a person.
• You feel proud and accepting of your unique body and refuse to spend an unreasonable amount of time worrying about food, weight and calories.
• You feel comfortable and confident in your body.

next: Distorted Body Image Can Have Tragic Results
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Learn about the characteristics of adults with ADHD, what causes ADHD, and the importance of adults with ADHD getting a diagnosis.

Diagnosis Is Critical: You Could Have Adult ADHD and Not Know It

ADHD has been recognized and treated in children for almost a century, but the realization that ADHD often persists into adulthood has only come over the last few decades.

The prevailing belief among professionals for many years was that children and adolescents would outgrow their symptoms of ADHD by puberty, and certainly by adulthood. However, contemporary research has shown that as many as 67 percent of children diagnosed with ADHD will continue to have symptoms of the disorder that significantly interfere with academic, vocational or social functioning in their adult lives. ¹

The core symptoms of ADHD: inattention, impulsivity and hyperactivity appear in childhood (usually by age seven) and result in a chronic and pervasive pattern of impairment for most. ADHD in adults is sometimes viewed as a "hidden disorder" because the symptoms of ADHD are often obscured by problems with relationships, organization, mood disorders, substance abuse, employment or other psychological difficulties. It is a complex and difficult disorder to diagnose, and should only be diagnosed by an experienced and qualified professional.

ADHD is first recognized in some adults because of problems with depression, anxiety, substance abuse or impulse control. Others recognize that they may have ADHD only after their child is diagnosed. Despite increased awareness and identification of the disorder in adults, many adults remain unidentified and untreated.

Characteristics of Adults with ADHD

The growth of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) and a renewed interest in research have contributed to the increased recognition of this disorder in both children and adults. Still, many adults grew up at a time when clinicians, educators, parents and the general public knew very little about ADHD or its diagnosis and treatment. Consequently, greater public awareness has led to an increased number of adults seeking evaluation and treatment for ADHD and its associated symptoms.

The current diagnostic criteria for ADHD (reworded slightly to be more appropriate for adults) according to the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are:

1. Fail to give close attention to details or make careless mistakes at work
2. Fidget with hands or feet or squirm in seat
3. Have difficulty sustaining attention in tasks or fun activities
4. Leave seat in situations where seating is expected
5. Don't listen when spoken to directly
6. Feel restless
7. Don't follow through on instructions and fail to finish work
8. Have difficulty engaging in leisure activities quietly
9. Have difficulty organizing tasks and activities
10. Feel "on the go" or "driven by a motor"
11. Avoid, dislike, or are reluctant to engage in work that requires sustained mental effort
12. Talk excessively
13. Lose things necessary for tasks and activities
14. Blurt out answers before questions have been completed
15. Easily distracted
16. Have difficulty awaiting turn (impatient)
17. Forgetful in daily duties
18. Interrupt or intrude on others

Although other symptom checklists are sometimes used in assessing adults for ADHD, the above DSM-IV criteria are currently considered the most empirically valid. These core symptoms of ADHD frequently lead to associated problems and consequences that often co-exist with adult ADHD. These may include:

1. Problems with self-control and regulating behavior
2. Poor working memory
3. Poor persistence of efforts toward tasks
4. Difficulties with regulation of emotions, motivation and arousal
5. Greater than normal variability in task or work performance
6. Chronic lateness and poor time perception
7. Easily bored
8. Low self-esteem
9. Anxiety
10. Depression
11. Mood swings
12. Employment difficulties
13. Relationship problems
14. Substance abuse
15. Risk-taking behaviors
16. Poor time management

The impairment from both the core symptoms and associated features of ADHD can range from mild to severe in its impact on academic, social and vocational domains, and in daily adaptive functioning. Since the symptoms of ADHD are common to many other psychiatric and medical conditions and some situational/environmental stressors, adults should never self-diagnose and should seek a comprehensive evaluation from a qualified professional.

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Who Receives an ADHD Diagnosis?

Research indicates that ADHD occurs in approximately three to five percent of school-age children and approximately two to four percent of adults. Among children, the gender ratio is approximately 3:1, with boys more likely to have the disorder than girls. Among adults, the gender ratio falls to 2:1 or lower. The disorder has been found to exist in every country in which it has been studied, including North America, South America, Great Britain, Scandinavia, Europe, Japan, China, Turkey and the Middle East. The disorder may not have the same name in these countries, and may be treated differently, but there is little doubt that the disorder is virtually universal among human populations.

What Causes ADHD?

There are no definitive answers as yet. To date, there are no biological, physiological or genetic markers that can reliably identify the disorder. However, research has demonstrated that ADHD has a very strong biological basis.

Although precise causes have not yet been identified, there is little question that heredity makes the largest contribution to the expression of the disorder in the population. In instances where heredity does not seem to be a factor, difficulties during pregnancy, prenatal exposure to alcohol and tobacco, premature delivery, significantly low birth weight, excessively high body lead levels, and postnatal injury to the prefrontal regions of the brain have all been found to contribute to the risk for ADHD to varying degrees.

Research does not support the popularly held views that ADHD arises from excessive sugar intake, food additives, excessive viewing of television, poor child management by parents, or social and environmental factors such as poverty or family chaos.

Diagnosis of ADHD in Adults

A clinician or a team of clinicians who have experience and expertise in ADHD and related conditions should make a comprehensive evaluation. This team may include a behavioral neurologist or psychiatrist, a clinical psychologist or an educational psychologist.

Evaluation for ADHD should include a comprehensive clinical interview surveying past and present ADHD symptomatology, developmental and medical history, school history, work history, psychiatric history; including any medications prescribed, social adjustment and general day-to-day adaptive functioning (i.e., ability to meet the demands of daily life).

The interview is intended first to identify evidence of core ADHD symptoms (hyperactivity, distractibility, impulsivity) and then to ensure that the history of these symptoms is both chronic and pervasive. This should not simply be a brief, surface-level exam. It usually requires one or two hours at minimum. Ideally, the interview should rely on several informants (a parent if possible, or a significant other,) and survey behavior from multiple settings (i.e., school, work, home). It is also imperative that the clinician attempt to rule in or rule out other psychiatric diagnoses that may better explain presenting symptoms.

An adult evaluation should also use the DSM-IV ADHD symptom rating scales, review any available past objective records such as report cards, transcripts or prior testing/evaluation reports, and in some cases use psychological testing to determine any cognitive or learning weaknesses that may underlie functional impairment.

A comprehensive evaluation is needed for three reasons:

1. to establish an accurate diagnosis
2. to evaluate for the presence of co-existing medical or educationally disabling conditions
3. to rule out alternative explanations for behaviors and/or relationship, occupational or academic difficulties.

Why Identify ADHD in Adults?

Growing up with undiagnosed ADHD can have devastating effects on the adult. For some, the diagnosis and education that follows an evaluation can be a profoundly healing experience. Proper diagnosis can help adults put difficulties in perspective and better understand the reasons for many lifelong symptoms.

Adults with ADHD have often developed negative perceptions of themselves as "lazy," "stupid," or even "crazy." Proper diagnosis and effective treatment can help improve self-esteem, work performance and skills, educational attainment and social competencies.

Many adults with ADHD are offered protection under the Americans with Disabilities Act of l990, which prohibits discrimination in employment and public accommodations against any individual who has a physical or mental impairment that substantially limits one or more major life activities, including learning and working, or who has a record of such impairment.

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After Adult ADHD Diagnosis, What Then?

Although there is no cure for ADHD, many treatments can effectively assist in managing its symptoms. Chief among these treatments is the education of adults with ADHD and their family members about the disorder's nature and management.

However, well-controlled research comparing different types of treatment has found overwhelmingly that the greatest improvement in the symptoms of ADHD results from treatment with stimulant medication combined with counseling. Evidence shows that some tricyclic antidepressants may also be effective in managing symptoms of ADHD as well as co-existing symptoms of mood disorder and anxiety.

Just as there is no single test to diagnose ADHD, no single treatment approach is appropriate for everyone. Treatment needs to be tailored to the individual and should address all areas of need. There may be a variety of behavioral, social, academic, vocational or relationship concerns for the adult with ADHD. For some, just getting the diagnosis and understanding that there was a reason for many past difficulties can be extremely helpful.

Adults with ADHD may also benefit from counseling about the condition, vocational assessment and guidance to find the most suitable work environment, time management and organizational assistance, coaching, academic or workplace accommodations, and behavior management strategies.

In summary, some common components of treatment plans for adult ADHD include:

1. Consultation with appropriate medical professionals
2. Education about ADHD
3. Medication
4. Support groups
5. Behavior skill-building such as list-making, day planners, filing
6. systems and other routines
7. Supportive individual and/or marital counseling
8. Coaching
9. Vocational counseling
10. Assistance with making appropriate educational and vocational choices
11. Perseverance and hard work
12. Appropriate academic or workplace accommodations

A multimodal treatment plan combining medication, education, behavioral and psychosocial treatments is thought to be the most effective approach. Although there has yet to be a large volume of research on psychosocial treatment of adult ADHD, several studies suggest that counseling which offers support and education can be effective in treating adults with ADHD. A combined treatment approach, maintained over a long period of time, can assist in the ongoing management of the disorder and help these adults lead more satisfactory and productive lives.

This article first appeared as CHADD Fact Sheet No. 7, Spring 2000. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) is a national organization with local support groups in many communities..

Suggested Reading

Barkley, R.A. (1998). Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment.New York: Guilford Press.

Goldstein, S. (1997). Managing Attention and Learning Disorders in Late Adolescence and Adulthood. A Guide for Practitioners. New York: John Wiley & Sons, Inc.

Nadeau, K.G. (1995). A Comprehensive Guide to Attention Deficit Disorder in Adults: Research Diagnosis and Treatment. Brunner/Mazel.

Hallowell, E.M., and Ratey, J. (1994). Driven to Distraction. New York: Pantheon.

Murphy, K.R., and LeVert, S. (1995). Out of the Fog: Treatment Options and Coping Strategies for Adult Attention Deficit Disorder. New York: Hyperion.

Solden, S. (1995). Women with Attention Deficit Disorder. Grass Valley, CA: Underwood Books.

1. Barkley, RA, Fischer, M., Fletcher, K., & Smallish, L. (2001) Young adult outcome of hyperactive children as a function of severity of childhood conduct problems, I: Psychiatric status and mental health treatment. Submitted for publication.

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next: Impact of ADHD on Adults
~ adhd library articles
~ all add/adhd articles

sexual fantasies

New York Times

Therapists who once viewed perverse sexual fantasies as the furtive compulsions of a lonely minority are seeing them in a new light, as more and more "normal" people report them in therapy and new studies suggest that even violent fantasies are surprisingly common.

...30 percent of men are sexually aroused by watching portrayals of physical violence against women, leading researchers to assume they fantasize about such violence... A study of college-age men found 12 percent had sexual fantasies involving children...

The new research is focusing on fantasies involving what most experts would call aberrant sexual acts, like bondage or cross-dressing, rather than more prosaic fantasies such as making love in an exotic locale or, perhaps the most popular fantasy among men and women alike, making love to someone other than one's partner.

The new approach may be most controversial in seeing perverse fantasies as commonplace and in suggesting that this form of "perversion" is as common in women as in men.

Simply being aroused by a given fantasy is not necessarily a sign of perversion. Indeed, experts disagree on where normal sexuality ends and perversion begins.

But the hallmark of all perverse fantasies, said Dr. Arnold Cooper, a Cornell University psychiatrist, is that the sexual partner is treated as "a nonperson, someone with no feelings."

Most experts on sexuality see nothing wrong with sex fantasies. Standard clinical wisdom holds that, so long as fantasy does not harm anyone, it is not a problem and, indeed, can even enhance a couple's sex life.

But many influential psychoanalysts are focusing on the sometimes subtle difficulties in intimate relationships that such fantasies can create, and on the range of purposes they serve, from filling empty relationships and allaying depression to bolstering self-esteem.

The new thinking holds that deep within such adult fantasies as having an obedient harem of love slaves or an urge for sexual humiliation lurk infantile longings such as for an attentive love or the need to overcome a profound sense of powerlessness.

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But the fantasies cannot help repair such emotional traumas, the psychoanalysts say, in part because they make those who rely on them emotionally unavailable to their partners.

The new view was summed up by Dr. Gerald Fogel, a psychoanalyst at Columbia University, who said that virtually everyone has aberrant sex fantasies, but that they are not always conscious of them. "Even so, they usually emerge over the course of psychoanalysis in almost everyone," he said.

Many sex therapists disagree. For example, though agreeing that a surprisingly high proportion of ordinary people sometimes have perverse fantasies, Dr. Gene Abel, a psychiatrist at Emory University in Atlanta, said, "People in psychoanalysis, or people who volunteer for studies of sexuality, just are not a representative sample. No one yet knows the true prevalence of perversion in the normal population.

Another major area of controversy is the contention of some psychoanalysts that women are as prone to perverse fantasies as men.

Many studies have found that most officially diagnosed perversions, such as pedophilia or fetishes, are extremely rare or non-existent in women, leading sex researchers to assume that perverse fantasies are rarer in women than in men.

But the new approach says the forms they take in women often are more subtle and so have escaped psychiatric notice.

Indeed, a study of the fantasies that arouse women, published last month, found that a surprising number have what psychoanalysts would describe as perverse fantasies and that the fantasies are highly arousing.

For example, fantasies of being watched while having sex, watching someone else have sex and being forced to have sex were among the most common and the most arousing fantasies, the study found.

The women read written descriptions of 112 fantasies, rated how arousing they were and reported how often they had had such fantasies in the past year.

The study of 119 women, which measured the genital blood flow of some of the women during these fantasies, were published in Behavioral Research and Therapy.

The study, done by psychologists in Australia, corroborates other recent studies of the content of women's fantasies, and is the first to use direct measures of sexual arousal to establish how powerful the fantasies are.

More troubling, though, are some of the data for men. A study of college-age men found 12 percent had sexual fantasies involving children, according to Abel, who has just completed the research.

And an earlier study, at the University of California at Los Angeles, found that 30 percent of men are sexually aroused by watching portrayals of physical violence against women, leading researchers to assume they fantasize about such violence.

Some people have concern and confusion over having an intensely sexual and repetitive fantasy. You can read more about that here.

next: Perverse Fantasies - You're Not Alone

Ending relationships can be very painful. As a culture, we have no clear-cut rituals for ending relationships or saying good bye to valued others. We are often unprepared for the variety of feelings we experience in the process.

Some common reactions as a relationship ends:

Denial - It can be hard to believe that the relationship is over.

Anger - We are angry and often enraged at our partner or lover for shaking our world to it's core.

Fear - We are frightened by the intensity of our feelings. We are frightened that we may never love or be loved again.

Self-blame - We blame ourselves for what went wrong. We replay our relationship over and over, saying to ourselves, "If only I had done this. If only I had done that".

Sadness - We are sad about what we have lost in the relationship and what we hoped the relationship would be for us in the future.

Guilt - We feel guilty, particularly if we choose to end a relationship. We don't want to hurt our partner.

Confusion - We may have some uncertainty about ourselves and our future.

Hope - Initially we may fantasize that there will be a reconciliation, that the parting is only temporary, and that our partner will come back to us. As we heal and accept the reality of the ending, we may hope for a better world for ourselves.

Relief - We can be relieved that there is an ending to the pain, the fighting, the torment, and the lifelessness of the relationship.

While some of these feelings may seem overwhelming, they are all "normal" reactions. They are necessary to the process of healing so that we can eventually move on and engage in other relationships.

Here are some ways many people find helpful for coping with a breakup:

• Allow yourself to feel the sadness, anger, fear, and pain associated with an ending. It is o.k. to validate the importance of the relationship that you have lost.
• Connect with others. It is crucial at this time to remember the caring and supportive relationships that remain in your life. Ask others for support at this time and tell them how they can be helpful to you. Share with supportive others how you are reacting to the ending of the relationship.
• Recognize that guilt, self-blame, and bargaining can be defenses against feeling out of control and being unable to stop the other person from leaving us. There are some endings we can't control because we can't control another person's behavior.
• Give yourself time to heal. Be kind to yourself and patient with yourself following the breakup. Follow your usual routine as much as possible. As a general guideline, don't make any large life decisions immediately following the breakup. Take some time to pamper yourself. Attend to your overall health—eat well, exercise, get enough sleep, and cut down on addictive behaviors (e.g., drinking excessively).
• Use this time of transition in your life to rediscover yourself, to reevaluate your life priorities, and to expand new interests.
• Consider how you have grown personally and what you have learned as a result of being in the relationship and coping with the ending of the relationship. Imagine how this personal growth will be a benefit to you in future relationships.
• Spend some time focusing outside of yourself. For example, do something to help others.
• Reaffirm your beliefs about life and relationships. Nourish your spiritual side in whatever way fits your beliefs, such as spending time alone in nature, attending a religious service, or meditating.
• Get the help you need. If you feel "stuck" in a pattern and unable to change it or if your reaction to the ending of the relationship is interfering negatively with positive areas of your life over a period of time, talking to a professional counselor may help.

Source: Counseling Services, State University of New York at Buffalo

sexual fantasies

Robert W. Birch, Ph.D. Sexologist & Adult Sexuality Educator

Have you ever given any thought to the differences between the sexual fantasies typically conjured up by man and women. Men tend to have more sexual fantasies than women and are more likely to pair them with masturbation. Men, being visual beings, are likely create a visual image of a woman's sexual body and imagine watching her or seducing her or, quite often, being seduced by her. Women, on the other hand, are typically less visual in their sexual fantasies, are usually less focused on genitals, and usually focus more on the emotional feelings of a romantic encounter. Women also tend to involve more olfactory and auditory memories... memories of smells and sounds.

Many women have difficulty imagining an explicit sexual encounter, but readily acknowledge the stirring of sexual feelings while engrossed in a romantic novel or movie. Erotic fantasies, PG-13 through the X rated ones, can serve several sexual functions. Fantasies can induce sexual desire, maintain sexual arousal, enhance the sexual experience, trigger an orgasm, and preserve a memory.

The desire to be sexual is not controlled by a switch that can be turned on following the eleven o'clock news. Many people, particularly as they age or as a relationship matures, find that the easy turn ons are less and less likely to occur, particularly late at night. At times when time is limited, fantasies can serve to focus attention on the anticipated erotic event and help induce a desire for sexual intimacy.

More than one person has told me, "I'm not able to get excited on a moment's notice - I need time to psych myself up." To induce desire, you can think ahead about what you would like to experience and what you wish to both give and receive. Imagine the sexual encounter is your very first, but without those initial anxieties, and let it be, in your mind, a new and exciting adventure. Recall the good sexual feelings you have experienced and mentally reminisce about memorable past encounters. Conjure up the memory of a partner's warmth, softness, and gentle touch. See your partner's face in your mind's eye and recall that person's sounds of pleasure and the aroma of their excitement.

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Desire can be induced mutually throughout the day, with, for example, a phone call to say, "I've been thinking of your wonderful body." The mid-day message, "You won't believe what I want to do to you tonight," can stir the imagination of both partners, spending the day thinking of the possibilities in store for that night.

For those without a partner, fantasies during the day can become the prelude for an episode of self-loving that evening. Self-stimulation, the normal, natural way of experiencing solitary pleasure, is a healthy outlet for many who are alone. Fantasy during the day can certainly prepare you for the quiet celebration of your own sexual response.

Most of us have had the experience of beginning a sexual encounter, only to find our minds wandering off to the worries of the day or the pressing issues of tomorrow. By pushing away the intrusive nonsexual thoughts, erotic fantasy can maintain arousal. When distractions hit, we need only focus on a pleasant sexual memory or project an exciting visual image on our mental movie screen. Fantasies can be of our current sexual partner, but often they will revolve around persons from the past, coworkers, movie stars, or attractive strangers. Bringing others into fantasies is normal and is justified if it serves the current relationship by eliminating distractions that would otherwise dampen or destroy the passion. Obviously, if someone feels guilty about including others in his or her fantasy script, they should be left out. Some people like a cast of thousands, while others want to focus exclusively on their current partner.

Many people worry about their fantasies being "kinky", but such fantasies are common. Unusual fantasies can help maintain arousal and are harmless if there is no compulsion to actually experience an act that would be emotionally or physically harmful to oneself or to others. Whereas honesty is usually the best policy, discretion must be used in the sharing of some unusual fantasies or fantasies involving other people. It is rare that a couple can share such private thoughts without, at best, a little discomfort. Too often the reaction to hearing a partner's most kinky fantasy is one of jealousy and distrust, if not anger and disgust.

One woman playfully imagined that her partner's penis was enormous, and reported how she would visualize engulfing this gigantic imaginary erection into her body... and she would privately marveled at her vagina's ability to swallow up this massive tool. She quickly acknowledged, however, that she had no desire to experience anything that large in real life, but she did enjoy embellishing her fantasy with the thoughts of dressing this impressive male member in doll's clothing and taking it for walks in the park. During her sexual encounters, this fantasy helped rivet her attention on the pleasure she was feeling from the very adequate reasonably-sized penis of her partner.

One night, this woman decided that it would be fun to share her fantasy with her partner. To her utter surprise, the man was devastated upon hearing her playful musings! He began worrying that she had been with men who had larger penises than his, fearing that these well-endowed men must have please her more than he could ever hope to. He erroneously assumed that she could not enjoy his average-sized penis, and began to feel totally inadequate as her lover. Fearing he could not satisfy this woman, he backed off sexually. When he did try, he felt self-conscious and, as a result, often failed to become erect. This, of course, led to more avoidance and self-degradation.

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In couples therapy, this man worked on understanding that his partner's fantasy had nothing to do with his genital size or sexual performance, but made their shared intimacy more exciting for her. In our last therapy session he began laughing and, when questioned, shared his own "pet" fantasy. He had for many years fantasized he was making love to a virgin and that her vagina was the town's tightest. Both agreed that they loved each other, loved the sexuality they shared, and would never again ask about the private fantasies each used to dispel the occasional intruding distractions. The also learned that virginity and penis size are immaterial when there is love.

The consequences of disclosure were more serious for another couple. The man fantasized about having sex with his wife's younger married sister. While he found the sister attractive, he had no illusions about her commitment to her husband and would never, in reality, make a pass at her. When he shared his fantasy, however, his wife expressed anger and disbelief. She became extremely uncomfortable whenever her sister was around and believed that she had to watch them both closely for any signs of subtle flirtation. Angry that she now felt distrusting, not only of her husband, but of her sister as well, she chose to end her marriage with the man rather than further damaging her relationship with her sister. The fantasy proved to be too close, too personal, and too threatening.

Many shared fantasies, however, enhance desire and maintain arousal. One night a man entered a singles bar, propped himself up on a bar stool and slowly rotated, carefully surveying the women around him. Apparently no one caught his eye, so he turned his back on the scene and sipped quietly on his drink. About fifteen minutes later, a woman walked in. As her eyes adjusted to the darkened room, she also scrutinized the crowd. She wandered around a bit, being careful not to make eye contact with any of the men scattered around the room. After a few minutes of aimless wandering, she moved up beside the man who was seemingly intent on nursing his drink. Sliding between him and the person sitting next to him, she leaned toward the bar to catch the bartender's attention. As she did, the man felt her breast brush lightly across his arm, but he did not look her way.

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After being served, the woman stepped back, drink in hand, and stood behind the man. Aware of her presence, the man turned and looked into her eyes. His unoriginal inquiry, "Do you come her very often?" was met with an abrupt, "No!" As he turned toward her, his leg came to rest against her thigh. She made no attempt to avoid the contact, but waited for him to continue his attempt to initiate conversation. Awkwardly he asked, "What do you do for fun?" Both grinned at her response, "I pick up strange men in singles bars." At this point the drink he had been nursing so patiently was gulped down in record time and he asked her to dance. She played at being reluctant, but allowed him to convince her. On the dance floor, they danced as though each was covered by porcupine quills and a large man on a Harley-Davidson could have driven between them. As they continued to dance, however, they moved closer until, from a distance, it looked as though their bodies had blended into one.

As they left together he asked, "Shall we take your car or mine?" Again giggling, they took his car to the nearest motel, where he produced a bottle of wine from an ice bucket on the back seat. Ralph and Mary, who had been married for three years, were acting out their shared fantasy. Once in the room, Mary enticed Ralph into seducing her slowly, pretending uncertainty "I really don't know if I should!" as he pretended clumsiness, fumbling to unbutton her blouse and acting bewildered by the complexities of the one-handed unsnapping of a push-up bra.

During their lovemaking, Mary intentionally cried out, "Oh Bill, you make me feel so good," and in the morning, Ralph pretended to have completely forgotten her name. It was a night not soon forgotten, providing the erotic content for many fantasies that followed.

Novelty can get lost in long-term relationships. When a couple becomes comfortable and familiar with each other sexually, they often forget to be romantic. The entire sexual scenario might become routine, taking place at the same time of the day and in the same location - and all too often hurried. While it might be impractical for most of us to make love on a beach, in fantasy we can imagine the sound of the ocean, the warmth of the sand beneath our body, and the excitement of making love under the stars. Perhaps yours will be a fantasy of making love in the woods, or in an old barn, or in the backseat of a car you had as a teenager.

Some fantasies can be acted out, e.g., a pick up in a grocery store. But most fantasies are just private thoughts that need not have a complex storyline, or a cast of hundreds. Working too hard at building a sexual fantasy can become a distraction, defeating one of its purposes. The best fantasies are often quite simple and tied in with pleasant memories. Often it is visual, creating a mental image of a part of the partner's body that is pleasing to look at, but impossible to see in the dark or in a particular position. At times words can be added to the fantasy while forming the mental image "I love your buns."

Special fantasies can be saved for those times when an orgasm is a bit elusive. These favorites can often add the final bit of excitement needed to trigger a powerful climax.

Fantasies serve many functions from getting started to getting finished. Remember, sexual fantasies before, during and after a sexual encounter are normal, natural and often helpful in changing a routine experience into a new and exciting event.

Robert W. Birch, Ph.D. is retired after 35 years of clinical experience, university teaching and public lecturing in the specialized area of relationships and sexuality. No longer a sex therapist, he now identifies himself as a sexologist and an adult sexuality educator, and lives and writes in rural Ohio with Susan and their four dogs. For much more on this topic, read Dr. Birch's illustrated book titled Male Sexual Endurance: A Man's Book About Ejaculatory Control. A shorter bare-bones outline of the start-start exercises are available in his manual titled Introduction To The Management Of Premature Ejaculation: A Short Book About Lasting Longer. For a short illustrated brochure on the use of vibrators, including their use during intercourse, read Dr. Birch's Your Vibrator: Using It, Enjoying It, and Sharing It. Men wanting to learn more about orally satisfying a woman should read the book written by Dr. Birch titled Oral Caress: A Loving Guide to Exciting a Woman. All these books and much more can be found on his website at http://www.oralcaress.com/.

next: Understanding Male and Female Sexual Fantasies

Excerpts from the Archives of the Narcissism List Part 23

1. Interview at Amazon UK
2. Vindictive Narcissists
3. Narcissistic Thoughts about Humanity
4. The Good Enough Mother
5. Vindicating One's Self-Loathing
6. The Narcissist as a Meaningful Other
7. On the Irrelevance of Labelling

1. Interview at Amazon UK

Amazon.co.uk talks to Sam Vaknin

Amazon.co.uk: Where are you from? How--if at all--has your sense of place coloured your writing?

S.V.: I was born in Israel to Jewish immigrants from Turkey and Morocco. We belonged to a socially and economically backward minority - which might explain what led to my interest in Narcissistic defence mechanisms. Israel is an aggressive, militaristic, power-driven, intolerant, religious and conservative society. Enclaves of liberal thinking do exist but they are outweighed and diluted by the general populace. It is an odd admixture of the Western indulgence of the individual (Lasch's narcissistic society) coupled with strong compensatory mechanisms employed in an effort to counter-balance a national inferiority complex and survival anxiety. This coalesces into the clinical picture known as "pathological narcissism" - which is the subject of my book.

Amazon.co.uk: When and why did you begin writing? When did you first consider yourself an author?

S.V.: I wrote all my life. It was my preferred venue of escape. I published short fiction, works of reference and columns in periodicals. Writing sits well with my personality disorder. It provides me with narcissistic supply. It is magical in that symbols lead to action. It provides the twin illusions of eternity and sagaciousness. I have never thought of myself as anything but an author.

Amazon.co.uk: Who or what has influenced your writing, and in what way? What books have most influenced your life?

S.V.: I have always been drawn to short fiction - although most of my published work (in Hebrew, Macedonian, other languages) is non-fiction. There is an essence in short fiction, distilled and aromatic which is missing in the homeopathic equivalent of the longer genres (such as the novel). I have thus found myself enamoured with A.A.Poe on one end of the spectrum - and Francoise Sagan on the other. The last two decades have been a revelation to me in that they provided me with legitimacy. My short fiction deals with amoral characters, making amoral decisions about emotionally harrowing (to them, emotionally neutral) situations. Post modernism liberated me and allowed me to pursue this line of writing.

Amazon.co.uk: What is the most romantic book you've ever read? The scariest? The funniest?

S.V.: I try to abstain from romantic literature and am pretty successful at doing so. The scariest book I ever read is the Amityville Horror. It took a whole sleepless night to wear off. The funniest book I read is "Three Men in a Boat" by Jerome K. Jerome. I love wry, marginally vicious humour.

Amazon.co.uk: What music, if any, most inspires you to write? What do you like to listen to while writing?

S.V.: I hate music. All types of music. It makes me intolerably sad. It osmotically infiltrates me, cell-level, and drowns me. Short of breath I barely make it to the gramophone (I prefer vinyl records) and turn it off.

Amazon.co.uk: What are you reading now? What CD is currently in your stereo?

S.V.: I am reading David Deutsch's "The Fabric of Reality". To me, it is a funeral. The death of science. When highly qualified physicists engage in metaphysics, even mysticism - both disciplines emerge the lesser for their efforts.

Amazon.co.uk: What are you working on?

S.V.: I have just finished writing my second book of short stories (in Hebrew) and submitted it. I am augmenting "Malignant Self Love - Narcissism Revisited" with additional chapter (available online and to the book purchasers via email). And I am columnizing ferociously on the Kosovo crisis. I used to live in Yugoslavia and Macedonia until 1998, so I know the area and its inhabitants first hand.

Amazon.co.uk: Use this space to write about whatever you wish.

S.V.: Malignant Self Love - Narcissism Re-Visited was written under extreme conditions of duress. It was composed in jail as I was trying to understand what had hit me. My nine years old marriage dissolved, my finances were in a shocking condition, my family estranged, my reputation ruined, my personal freedom severely curtailed. Slowly, the realization that it was all my fault, that I was sick and needed help penetrated the decades old defences that I erected around me. This book is the documentation of a road of self-discovery. It was a painful process, which led to nowhere. I am no different - and no healthier - today than I was when I wrote this book. My disorder is here to stay, the prognosis is poor and alarming.

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2. Vindictive Narcissists

Basically, there are only two ways of coping with such people:

(a) Frighten them

Narcissists live in a state of constant rage, repressed aggression, envy, and hatred. They firmly believe that everyone is like them. As a result, they are paranoid, suspicious, scared, and erratic. Frightening the narcissist is a powerful tool for the modification of his behaviour. If sufficiently deterred - the narcissist will promptly disengage, give up everything he was been fighting for and sometimes make amends.

To act effectively, one has to identify the vulnerabilities and susceptibilities of the narcissist and strike repeated, escalating blows at them - until the narcissist lets go and vanishes.

Example:

One should threaten a narcissist with public disclosure of misdeeds, misbehaviur, or unfavourable traits. One should drop cryptic hints that there are mysterious witnesses and recently revealed evidence. The narcissist has a very vivid imagination. Let his imagination do the rest.

If the narcissist has been involved in tax evasion, in malpractice, in child abuse, in infidelity - these are so many fields which offer a rich vein of attack. If done cleverly, noncommittally, gradually, in an escalating manner - the narcissist will crumble, disengage and disappear. He will lower his profile thoroughly in the hope of avoiding hurt and pain. Most narcissists have been known to disown and abandon a whole PNS (pathological narcissistic space) in response to a well focussed campaign by their victims. Thus, a narcissist may leave town, change a job, desert a field of professional interest, avoid friends and acquaintances - only to secure a cessation of the unrelenting pressure exerted on him by his victim.

I repeat: most of the drama takes place in the confined recesses of the paranoid mind of the narcissist. His imagination runs amok with him. He finds himself snarled by horrifying scenarios, pursued by the most vile "certainties". The narcissist is his own worst persecutor and prosecutor.

You don't have to do much except utter a vague reference, make an ominous allusion, delineate a possible turn of events. The narcissist will do the rest for you. He is like a little child in the dark, generating the very monsters that paralyse him with fear.

Needless to add that all these activities have to be pursued legally, preferably through the good services of law offices and in broad daylight.

Otherwise, if done privately and in the wrong way - it might constitute extortion, blackmail, harassment, and a host of other criminal offences.

(b) Lure them

The other way to neutralize a vindictive narcissist is to offer him continued narcissistic supply until the war is over and won by you. Dazzled by the drug of narcissistic supply - the narcissist will immediately become tamed, forget his vindictiveness and triumphantly take over his "property" and "territory". Under the influence of narcissistic supply, the narcissist is unable to tell when he is being manipulated. He is blind, dumb, and deaf to all but the song of the NS sirens. You can make a narcissist do ANYTHING by offering, withholding, or threatening to withhold narcissistic supply (adulation, admiration, attention, sex, awe, subservience, etc.).

3. Narcissistic Thoughts about Humanity

What is different today is the DEATH OF CURIOSITY.

Curiosity is the result of SCARCITY of information. It is like thirst - it is so much stronger when water is scarce. Or like hunger - it is so accentuated after a long fast.

But when there is a glut - too much of something - our hunger for it, our cravings, die.

There is too much information, data, knowledge. We have been desensitized. No one wants to know more than he ABSOLUTELY needs to know. This is the world of the absolute minimum. People are becoming more and more narrow minded, less open to the world, more isolated. The more TELEcommunication - the more the distance (=tele) between people. There is no more "professional pride" because people value their leisure more than their work, change workplaces and professions very often, and are flooded by superfluous information. So, no one knows anything about anything. What we fail to understand is that too much information results in insufficient knowledge and pervasive ignorance. People are dumbed down. Television, newspapers, books, films - I remember another era. Today, these are mass products for intellectually passive consumers. The education system disintegrated. Publishers refuse to publish books, or articles, with a vocabulary "too extensive". Collective idiocy replaced collective intelligence.

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For someone like me - this is an impossible world to live in. I am intelligent, forever curious to learn more about seemingly unnecessary things. I am intolerant of ignorance and stupidity in all its forms. While in the 1960's I could have survived somehow - today it is very difficult to even breathe. EVERYONE is stupid. University professors don't read books. Authors don't spell correctly. Freight forwarders know little about customs procedures.

Soldiers are too afraid to fight (hence "smart bombs" to replace soldiers). It is a total degeneration of all civilization.

Every time I come across a reminder of this - I MUCH PREFER my computer and books to ANY human. This is why I LOVED it in jail. Together with the army (another kind of jail) - it was the best period of my life. I didn't have to deal with humans.

4. The Good Enough Mother

The critical question is, of course, not whether she can be a good mother to her teen off-spring, but whether (to use Winnicott's phrase) she has been a "good enough mother" to her children when they were younger. Most theoreticians agree that the critical ages are 4 months to 6 years. It is then that most (not all, but most) of the long term damage is done.

She is crying for help the only way she knows how. She is playing on the fact that her father feels threatened by her exploding sexuality. She maximizes this threat by behaving promiscuously or by seeming to do so. It is her way of saying: "Daddy, I am hurting so terribly! Please help me!".

The FIRST thing he must do is VALIDATE this pain of hers. Ignoring it, denying it, belittling it, transforming, it, redirecting it, projecting it - is WRONG. It will (and does) have adverse effects.

The SOURCE of the pain, at least at this stage, is IMMATERIAL.

She must know that there is one place - ONE place - in this ominous, dangerous, capricious, arbitrary universe - one place where she is accepted and loved unconditionally AS SHE IS. One place where she DOES NOT have to play slut or gay or strip herself to gain attention, credence and an ear. She must be listened to and believed. She is in pain. If someone is bleeding - will a doctor postpone all treatment until he finds the instrument that wounded the patient?

5. Vindicating One's Self-Loathing

She is looking to victimize herself and thus validate the judgement instilled in her that she is worthless, lowly scum.

BUT

She is also testing the world to see: is it really as bad? Are all people vicious exploiters, devoid of conscience?

In psychological parlance: is everyone a "bad object"?

She is employing Projective Identification (PI) and Splitting (S).

These are two primitive defence mechanisms (defence against pain usually inflicted by a mother).

PI is when she tries to force people to conform to her view of them. If she thinks someone is a bad object she does her damnedest to provoke him, invoke anger, and a sense of threat and danger in him, motivate him to BE a bad object. Finally, when the inevitable reaction comes, she feels vindicated ("you see, I was right all along, everyone IS rotten, including my Daddy").

Splitting is the separation of the good aspects of an object (a person) from his bad aspects. If the person is seen as bad - the good aspects are tossed aside and often attributed to someone else (projection). Then the person remains "all bad".

She does not need things one can measure or count (time, money, possessions). She needs love, caring, sharing and support. Some of us are less gifted at giving these to others - because we never received them ourselves. This is the tragedy of mental disorders. Like some genetic curse, they are handed from one generation to the other, oblivious to all good intentions and fervent promises made.

6. The Narcissist as a Meaningful Other

The child modifies his behaviour in order to secure the Narcissist's continued love, so as not to be abandoned.

This is the root of the perniciousness of this phenomenon:

The narcissist IS a meaningful, crucially significant figure ("object") in the Inverted Narcissist's (IN) life.

This is the narcissist's leverage over the IN. And since the IN is usually very young when she makes the adaptation to the N - it all boils down to fear of abandonment and death in the absence of care and sustenance.

I don't think inverted narcissism is as much a wish to gratify one's narcissist (parent) - as the sheer terror of forever withholding gratification from one's self.

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7. On the Irrelevance of Labelling

Whether a poison is strychnine or cyanide is of very little consequence once one is poisoned.

It does not really matter whether he is a narcissist or not.

What matters is that loving this man and taking care of yourself are NOT COMPATIBLE goals. They are mutually exclusive behaviours. EITHER you are with him - OR you take good care of yourself.

A decision that only you can make, a matter of priorities. I don't know how long you have been together but I do not think that your husband is going to abandon you. This is because you accept him back. Not many women would - and he knows it.

Read FAQ 66

Think about his escapades as VACATIONS.

Perhaps you SHOULD establish a formal schedule of such "vacations" - or at least establish a procedure for your husband to take these vacations.

It will reduce your abandonment issues and provide him with the respite that he need. His escapes are obsessive-compulsive in nature, the result of mounting anxiety. There are many very effective cognitive-behavioural techniques to treat such behaviours. Did you try marital or couple therapy?

Accept that which you cannot change - formalize it, enshrine it, even encourage it.

Do not be afraid to lose him. The more freedom you allow him - the more attached to you he will become, knowing that such leeway is not to be found elsewhere.

The Persian poet Omar Al-Khayam wrote in the Rubaayat: "When you want the bird, set it free".

 

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next: Excerpts from the Archives of the Narcissism List Part 24