Self-Injury is known by many names, including self-abuse, self-mutilation, deliberate self-harm, parasuicidal behavior. It may be referred to by specific methods of self-injury such as "delicate" or "coarse" cutting, burning, or hair pulling.

Self-Injury transcends gender, age, religion, educational and income level. It may be accompanied by depression, and/or a range of psychiatric problems such as other mood disorders, obsessive-compulsive disorder, addictions, eating disorders or psychotic disorders. The longer it goes unrecognized and untreated the more disruptive it is to the sufferer's life and relationships and the more treatment-resistant it may become.

More information about the relationship between self-injury and clinical depression

• Study of Patients Who Exhibited Cutting Behavior and Suicidality

• Depression: Suicide and Self Injury

• Psychological Characteristics Common in Self-Injurers

• Depression is Common in People Who Self-Injure: Therapist's Comments

• Cutting: Self Mutilating to Release Emotional Stress

• Self Mutilation: Self-Injurers Often Suffered Sexual or Emotional Abuse

Treatment

• Teen-Depression Treatment Teaches Kids to Handle Anxiety

• Can Caviar Cure Depression? Fishing for Health

• Eye Movement Desensitization Reprocessing to Treat PTSD

• Coping with Feelings and Thoughts of Suicide - Transcript

Psychologists encourage parents to help teens find healthy ways to deal with frustration. Many teens feel like there's something wrong with them and don't understand why they're depressed. Doctors say parents should tell teens feelings like that are natural and consider counseling to help them.

Some doctors call it the new anorexia nervosa -- a dangerous addiction that's catching on with large groups of local teens. It's called Cutting. Teens taking blades to their bodies trying desperately to take their minds off emotional stress. Kids First reporter Kendall Tenney talked with one teen who almost lost her life because she was trying to cut away the pain.

Warning: graphic/disturbing description follows

"I was with that razor in the bathroom cutting and slicing away."

"I had these feelings and depression and I didn't know how to deal with it."

"I needed a release and that's what it was."

A release that almost took Marie's life last September when she cut too deeply and almost bled to death. "When you're cutting and you go into that trance you don't feel the pain you don't realize how deep you're going."

"How often were you doing this?"

"Once every other month I'd hit bottom for myself and I'd break out the razor."

"It helps take their mind away from the fact that they're depressed."

Doctor Mark Chambers has treated several local teen cutters. "It's almost always the result of depression and very often these kids don't know how to deal with it."

It's something they discover on their own. It might start with just the scratching of the skin and then they realize hey that feels better than what I'm feeling and then it tends to build and magnify from there.

"There can be cases where the cutting is done multiple times, every day."

"How were you able to hide this from people?"

"I did it in places where they couldn't see it like my upper arms."

That lasted 3 years until Marie's boyfriend told her mother what was going on.

"I was just devastated because I couldn't understand why she would do something like that."

"You feel remorse, you feel guilt, you feel like a freak, you're not supposed to be doing this."

Twice a week, the 23-year-old goes to support groups at her church and mental health facilities to control those urges. "I've had setbacks. I'm still going through it, I still cut."

"The thoughts go through my head. This isn't working out... go and cut yourself. You can't deal, go and cut yourself. I don't want to go through life with all these scars on my body."

Marie and her mom are trying to start a local support group for cutters. "Kids First" logged on to teen cutting websites. We found several teens in Nevada admitting to self-mutilation -- all looking for help to stop their addiction.

Psychologists encourage parents to help teens find healthy ways to deal with frustration. Many teens feel like there's something wrong with them and don't understand why they're depressed. Doctors say parents should tell teens feelings like that are natural and consider counseling to help them.

Excerpts from the Archives of the Narcissism List Part 22

1. Narcissists and Sexual Perversions
2. I Hate Birthdays
3. Hysteroid Disphoria
4. Narcissists and Control
5. Meaningful to Who?
6. Is Narcissism Learned? Can it be Unlearned?

1. Narcissists and Sexual Perversions

Graphic descriptions aside, Narcissism has long been thought to be a form of paraphilia (sexual deviation or perversion). It has been closely associated with incest (research supports this) and paedophilia (which research does not, as yet, support).

I raised the possibility that incest was AUTO-EROTIC and, therefore, narcissistic in: The Offspring of Aeolus On the Incest Taboo

In other words:

When a father makes love to his daughter - he is making love to himself because she IS 50% himself. It is a form of masturbation and reassertion of control over oneself.

Homosexuality is NOT a sexual perversion. I analyzed the relationship between narcissism and homosexuality in FAQ 19.

2. I Hate Birthdays

I hate holidays and birthdays, including my birthday. It is because I hate it when other people are happy if I am not the cause of it. I have to be the prime mover and shaker of EVERYONE's moods. And no one will tell me HOW I should feel. I am my own master.

I feel that their happiness is false, fake, forced. I feel that they are hypocrites, dissimulating joy where there is none. I feel envious, humiliated by my envy, and enraged by my humiliation. I feel that they are the recipients of a gift I will never have: the ability to enjoy life and to feel joy.

And then I do my best to destroy their mood:

I bring bad news.
Provoke a fight.
Make a disparaging remark.
Project a dire future.
Sow uncertainty in the relationship.

And when the other person is sour and sad, I feel relieved.

It's back to normal.

My mood improves dramatically and I try to cheer her up.

Now if she does cheer up - it is REAL. It is my doing. I controlled it.

And I controlled HER.

3. Hysteroid Disphoria

XXX: Sam, you're describing here what the empirical-descriptive folks have called "hysteroid dysphoria" (among other things).

Sam: No, I am not.
I am describing the narcissist's pattern of reaction to deficient narcissistic supply.
A personality disorder is a COMPLEX of hundreds of separate behaviours.
Surely, each behaviour pattern taken separately can be labeled out of context.
Moreover, the same behaviour pattern can (and often does) occur in a few mental health disorders.
For instance, "hysteroid dysphoria" (I am not a fan of this "definition") is also a part of the cyclothimic disorder.
But, in the CONTEXT of the narcissistic personality disorder what I describe in FAQ 28 is one of a group of recurrent dysphorias identified as early as 1960.
Additionally, do not forget that the Narcissistic PD has finally crystallized as a mental health diagnostic category only in 1980. "Discoveries" from 1969 - preceding Kohut, Kernberg and even early Millon - are absolutely irrelevant in view of today's understanding of narcissism.
Below, I outlines the differences based on the text you chose:

XXX: It's atypical depression (a specific subtype of non-melancholic depression) with narcissistic/histrionic/borderline "personality" features. A characterization (from "Atypical Depression" (Quitkin et al) in "Clinical Advances in Monoamine Oxidase Inhibitor Therapies", Kennedy ed.):
"In 1969, Klein and Davis described a group of patients referred to as `hysteroid dysphorics.' These patients were characterized by strong desire for attention and applause, positive response to amphetamines, and a marked rejection sensitivity (especially in romantic contexts)"

Sam: Narcissists do not react only to rejection.
They react to any input - verbal, nonverbal, social, implied, real or imagined - which is deemed by them to be incommensurate with their inflated self-image.

Often, narcissists react badly to ACCEPTANCE and LOVE rather than to rejection because they have a self-image as being mean, vicious, frightening, etc.

XXX (still quoting): "leading to frequent depressive episodes."

Sam: The narcissist is highly ego-syntonic (this is why treatment fails in most cases).
His dysphorias are so rare and "reactive" (I don't find this term particularly instructive either) that they have been classified and characterized with great ease.
The narcissist is more likely to react with narcissistic rage to rejection of the type described above.

XXX: "Features of these depressive episodes frequently included loss of ability to anticipate but not experience pleasure."

Sam: One of the major differentiating factors. 
Narcissists do not experience serious, prolonged anhedonia.
They immediately distort cognitive input to fit their self image (It was discovered that they enhance positive inputs rather than reject negative ones).

XXX: "hyperphagia or craving for sweets"

Sam: Never noted in narcissists - but research is rather lacking, I admit.

XXX: "Hypersomnolence, lethargy or inertia, and marked reactivity of mood."

Sam: These are classic depressive signs. They describe well a major depressive episode, cyclothimia, dysthimia and about a dozen other types of depressions.

XXX: Onset frequently occurred in adolescence without a history of adequate premorbid functioning.

Sam: Onset of narcissism AND its dyphorias is at age 2-4. Klein talks about age 6 months and she has a depressive construct (see FAQ 67).
True, the PD itself sets on in early adolescence.

XXX: Another interesting feature is, in addition to the general hyperphagia, specific cravings for chocolate (and amphetamines). There is a link to family history of alcoholism (not necessarily in the family of origin). It's thought to be related to a dysregulation in the systems governing reward.

Sam: No such connections have been discovered in research. Narcissists are often prone to substance abuse, though (dual diagnosis).

XXX: Personally I don't think it's useful to label these folks as personality-disordered (*especially* narcissistic), as it tends to stigmatize them, as well as depriving them of potentially useful medical interventions (response rates to MAOIs, for example, are comparable to those of melancholic depressives). I'm sure that a lot of them do have chaotic childhoods, but then again, a lot of people with chaotic childhoods *don't* grow up to become hysteroid dysphorics, so there has to be more to it than just that, even if it does play some role. The use of the word "hysteroid" emphasizes this - it *looks* like what we assume is a "personality" disorder, but it isn't safe to assume that it *is* a PD.

Sam: No one diagnoses someone as a narcissist just because he is sad.
FAQ 28 that you are referring to is one of 82 FAQs. Narcissism is a hypercomplex phenomenon.
I didn't suggest that if one matches FAQ 28 one is a narcissist (=didn't label and stigmatize them, though I do not regard a mental health diagnosis as a stigma).
I suggested that many narcissists match FAQ 28.
FIRST, one is diagnosed as a narcissist and THEN this particular type of dysphoria fits into the diagnosis. By ITSELF - of course it is insufficient to establish the existence of the NPD.

4. Narcissists and Control

Narcissists - above absolutely all else - are control freaks.

This, for instance, is why they precipitate their own abandonment. By bringing abandonment upon themselves - they feel that they control it.

To the narcissist, lack of control results in excruciating pain.

Control means alleviation, amelioration, or even annihilation of pain.

Narcissists cannot face loss of control coupled with loss of a major source of supply.

This is why they commit incest - so disproprtionately that it was once thought that narcissism is a sexual paraphilia (disorder). Through sexual union with their off spring they seek to merge with him or her and to transform him or her to be the narcissist's extension, thus never to abandon them.

This is why they sometimes stalk their ex-spouses. This is why they cripple their loved ones (always emotionally, in extreme cases physically). They thrive on the dependence and neediness of their sources of supply.

5. Meaningful to Who?

It is impossible to have a relationship with a narcissist that is meaningful to the narcissist.

It is, of course, possible to have a relationship with a narcissist that is meaningful to you (see FAQ 66).

6. Is Narcissism Learned? Can it be Unlearned?

Is narcissism LEARNED?

It is often a reactive formation, a result of unbalanced (overly negative or overly positive) reinforcements. It is some form of conditioning. It is an adaptive strategy and an amalgam of defense mechanisms.

It is all learned. Maybe not consciously - but it IS learned (it is not of genetic origin, or not predominantly so).

So, can it be UNLEARNED?

For instance, by behaving UN-narcissistically?

Some say: No, on the contrary, such an effort will REINFORCE the narcissism.

Others hold the opposite view.

Who knows?

next: Excerpts from the Archives of the Narcissism List Part 23

Excerpts from the Archives of the Narcissism List Part 21

1. Narcissistic Healing - through LOVE or through PAIN?
2. The Narcissist in Court
3. Being IN LOVE and LOVING
4. Inverted Narcissists ARE Narcissists
5. Masochism and Narcissism
6. Fulfilling Others' Dreams
7. Not to Feel Anything
8. The Presumption of Understanding the Narcissist - A Piece of Irony

1. Narcissistic Healing - through LOVE or through PAIN?

Narcissism is a continuum. I am referring to the personality disorder, not to narcissistic traits. I believe that the only way an NPD can heal is if he experiences a severe narcissistic injury, a LIFE crisis. Forced to shed his malfunctioning defences - a window of vulnerability is formed through which therapeutic intervention can try and sneak in. This window is very brief.

This window CANNOT COEXIST with the availability of narcissistic supply. The narcissist is susceptible to treatment ONLY when his defences are down because they FAIL to secure a steady stream of narcissistic supply.

Narcissistic supply should be clearly distinguished from an emotional connection. Narcissistic supply has to do with the functioning of primitive defence mechanisms in the narcissist. The affective component of the narcissist has been repressed to oblivion. It does not permeate the conscious level. The narcissist obtains narcissistic supply as a junkie obtains drugs.

Junkies can have emotional "connections" but they are always subordinated to their habit. Their connections are the victims of their habits. Ask children or spouses of alcoholics, or drug addicts.

I do not believe in the possibility of having any real, meaningful, or lasting emotional relationship with a narcissist - until his primitive defence mechanisms are discarded. Perturbed to non-existent interpersonal relationships are one of the criteria of most personality disorders.

So, the right order, to my mind, is:

1. Cut the narcissist from his sources of supply and thus precipitate a narcissistic crisis or injury
2. Utilize the window of opportunity to treat the narcissist, to help him mature emotionally
3. Encourage him in his baby steps in the emotional field.

Emotional connections which co-exist with the narcissistic defence mechanisms are part of the narcissistic theatrical repertoire, fake and doomed.

The narcissist does not employ his defence mechanisms because he needs them - but because he knows no better.

His defence mechanisms were useful in his infancy. They were adaptive in an abusive environment. Old tricks and old habits die hard.

The narcissist is a primitive person with a disorganized personality (Kernberg). He is likely to heal simply to avoid the pain of narcissistic injury. No place is safe. No one is to be trusted. Avoidance of pain is a powerful tool. Narcissists come to therapy in the first place to try and alleviate some of what has become an intolerable pain. None of them goes to therapy because he wants to improve his lot in life or to better interact with his loving significant other. This is why I am not in therapy. I am usually very successful in what I do (before I invariably demolish it). Thus, my agony is not great enough, not sustained, it is insufficient to motivate me to heal.

2. The Narcissist in Court

A clear distinction has to be made between the FACTUAL pillar and the PSYCHOLOGICAL pillar of any cross-examination or deposition of a narcissist.

It is essential to be equipped with absolutely unequivocal, first rate, thoroughly authenticated and vouched for information. The reason is that narcissists are superhuman in their capacity to distort reality by offering highly "plausible" alternative scenarios which fit all the facts.

It is very easy to break a narcissist - even a well trained and prepared one.

Here are a few of the things the narcissist finds irresistible:

1. Any statement or fact which seems to contradict his inflated perception of his grandiose self. Any criticism, disagreement, exposure of fake achievements, belittling of "talents and skills" which the narcissist fantasizes that he possesses, any hint that he is subordinated, subjugated, controlled, owned, or dependent upon a third party. Any positioning of the narcissist as average and common, indistinguishable from many others. Any intimation that the narcissist is weak, needy, dependent, deficient, slow, not intelligent, naive, gullible, susceptible, not in the know, manipulated, a victim.
2. The narcissist is likely to react with rage to all these and, in an effort to re-establish his fantastic grandiosity, he is likely to expose facts and stratagems he had no conscious intention of exposing.
3. The narcissist reacts with narcissistic rage, hatred, aggression, or violence to an infringement of what he perceives to be his entitlement.
4. Narcissists believe that they are so unique and that their lives are so cosmically significant that others should defer to their needs and cater to their every whim without ado. The narcissist feels entitled to special treatment by unique individuals, over and above the regular "bloke".
5. Any insinuation, hint, intimation, or direct declaration that the narcissist is not special at all, that he is average, common, not even sufficiently idiosyncratic to warrant a fleeting interest will inflame the narcissist.

Add to this a negation of the narcissist's sense of entitlement - and the combustion is inevitable. Tell the narcissist that he does not deserve the best treatment, that his demands are not everyone's priority, that he is boring, that his needs can be catered to by an average practitioner (medical doctor, accountant, lawyer, psychiatrist), that he and his motives are transparent and can be easily gauged, that he will do what he is told, that his temper tantrums will not be tolerated, that no special concessions will be made to accommodate his inflated sense of self, etc. - and the narcissist will lose control.

The narcissist believes that he is the cleverest, far above the madding crowd. If contradicted, exposed, humiliated, berated ("You are not as intelligent as you think you are", "Who is really behind all this? It takes sophistication which you don't seem to have", "So, you have no formal education", "You are (mistake his age, make him much older)... sorry, you are ...old" "What did you do in your life? did you study? Do you have a degree? Did you ever establish or run a business?" "Would your children share your view that you are a good father?" "You were last seen with a Mrs. ... who is (suppressed grin) a DOMESTIC (in demeaning disbelief))". I know that many of these questions cannot be asked outright in a court of law. But you CAN hurl these sentences at him during the breaks, inadvertently during the examination, or deposition phase, etc.

3. Being IN LOVE and LOVING

I am attracted to my inferiors (in money, stature, education, intelligence, physical looks, alternatives in life, career). This way I feel superior and assured of my narcissistic supply (adulation, attention, etc.).

The choice is unconscious. I am simply strongly incensed and repelled by my superiors or equals.

A clear and vigorous distinction has to be made between being "in love" and being in "love". The first is a catch phrase describing a set of physiological and biochemical interactions provoked and evoked by subliminal cues which, to my mind, ARE the result of childhood "imprinting". It involves flirting, courting, infatuation, arousal and other rather basic (primitive) behaviours and emotions. Primitive defence mechanisms are activated in this phase. Splitting (the object of infatuation is all good and, if you are rejected, all bad), projection (you see in him what you always fantasized), projective identification (you try to force the object to behave in a manner conforming with your fantasies) and so on.

There is very strong transference (you emotionally interact with your object as though he were someone else - your father, for instance).

Then, there is love. It is a whole different ballgame. It involves companionship, mutual compatibility, reciprocity, interaction on several planes (emotional, sexual, intellectual). It grows with common experiences.

It is fed by both hardships and successes. It gives rise to creativity (children, doing thing together). It is more profound, quieter, deeper, more stable, all-pervasive, reliable. It is more adult. I think that here childhood imprinting plays a smaller role. Adult considerations determine the choice, the process, and the outcome. I think it is very difficult to "control" our behaviour when it comes to whom we fall "in love" with. I think it is possible - spontaneously or through therapy - to develop a capacity for LOVING in the right, rewarding manner.

4. Inverted Narcissists ARE Narcissists

Inverted Narcissists ARE narcissists with a unique source of narcissistic supply (their narcissists). Their methods for extracting narcissistic supply from their source (from their narcissist) are unique.

Sufficiently unique in fact to warrant a special mental health category (which was already suggested a few decades ago under the name of "covert narcissism").

5. Masochism and Narcissism

The main issue, the differentiating factor is: WHY did the child say what it did (the last word)?

Is it because it craved punishment - or because it asserted itself?

And isn't seeking punishment a form of assertiveness and self-affirmation if one is a masochist"?

Author: Cheryl Glickauf-Hughes, in American Journal of Psychoanalysis, June 97, 57:2, pp 141-148):

"Masochists tend to defiantly assert themselves to the narcissistic parent in the face of criticism and even abuse. For example, one masochistic patient's narcissistic father told him as a child that if he said "one more word that he would hit him with a belt" and the patient defiantly responded to his father by saying "One more word!" Thus, what may appear, at times, to be masochistic or self-defeating behaviour may also be viewed as self-affirming behaviour on the part of the child toward the narcissistic parent."

6. Fulfilling Others' Dreams

Did you really want to do it or were you fulfilling someone's else's wishes (probably your parents)?

The biggest source of pain is when we are forced to live someone else's dream. It is through OUR dreams that we assuage our pain. If deprived of our dreams - our self is amputated and we have these phantom pains that we mistake for emotional pain. We grieve. We mourn ourselves, what we could have been, what we will never be. We become angry at the injustice of it all. Unable to punish the real culprits - we gang upon our inadequate selves.

I made millions and deliberately ruined my businesses many times in 20 years. Until I finally got the message: I DO NOT BELONG IN BUSINESS.

I want to read and write and learn. I HATE business. So, what I once used to interpret as self defeating or self destructive behaviour - I now know was an effort to salvage myself.

7. Not to Feel Anything

I have no emotions of any kind at all (consciously, of course). Very very rarely do I apprehend flickers of emotion and I know that a great fire is burning underneath the firmament. But it's a split second thing and it's over. I am numb and dumb as usual.

Narcissism is a defence mechanism. An integral and important part of it is the inability to feel anything. Because emotions come in lumps (good and bad agglomerated) - the narcissist learns to DENY ALL his emotions, good and bad alike.

8. The Presumption of Understanding the Narcissist - A Piece of Irony

HOW can YOU understand something as divinely unique, as stupendously complex, as cosmically significant, as unprecedented - as your Narcissist?

How dare you compare your AVERAGE self to HIM?

If you understand him - this means that you have something in COMMON.

COMMON.

AVERAGE.

(Narcissistic shivers)

Moreover, by now you surely know all this.

So, you must be doing it on purpose. You are trying to drag him to YOUR level, to "equalize" him, to level him, to make him indistinguishable from the grey mass that is others - and you.

You are nefarious and pernicious. Your behaviour PROVES that you HATE him.

You are a cunning, malevolent housewife who tries to reduce him to your default option of incompetence, inaptitude and inadequacy.

"I UNDERSTAND YOU"

How presumptuous.

How false.

How malicious.

next: Excerpts from the Archives of the Narcissism List Part 22

Past trauma/invalidation as an antecedent
Van der Kolk, Perry, and Herman (1991) conducted a study of patients who exhibited cutting behavior and suicidality. They found that exposure to physical abuse or sexual abuse, physical or emotional neglect, and chaotic family conditions during childhood, latency and adolescence were reliable predictors of the amount and severity of cutting. The earlier the abuse began, the more likely the subjects were to cut and the more severe their cutting was. Sexual abuse victims were most likely of all to cut. They summarize,... neglect [was] the most powerful predictor of self-destructive behavior. This implies that although childhood trauma contributes heavily to the initiation of self-destructive behavior, lack of secure attachments maintains it. Those ... who could not remember feeling special or loved by anyone as children were least able to ...control their self-destructive behavior.

In this same paper, van der Kolk et al. note that dissociation and frequency of dissociative experiences appear to be related to the presence of self-injurious behavior. Dissociation in adulthood has also been positively linked to abuse, neglect, or trauma as a child.

More support for the theory that physical or sexual abuse or trauma is an important antecedent to this behavior comes from a 1989 article in the American Journal of Psychiatry. Greenspan and Samuel present three cases in which women who seemed to have no prior psychopathology presented as self-cutters following a traumatic rape.

Invalidation independent of abuse
Although sexual and physical abuse and neglect can seemingly precipitate self-injurious behavior, the converse does not hold: many of those who hurt themselves have suffered no childhood abuse. A 1994 study by Zweig-Frank et al. showed no relationship at all between abuse, dissociation, and self-injury among patients diagnosed with borderline personality disorder. A follow-up study by Brodsky, et al. (1995) also showed that abuse as a child is not a marker for dissociation and self-injury as an adult. Because of these and other studies as well as personal observations, it's become obvious to me that there is some basic characteristic present in people who self-injure that is not present in those who don't, and that the factor is something more subtle than abuse as a child. Reading Linehan's work provides a good idea of what the factor is.

Linehan (1993a) talks about people who SI having grown up in "invalidating environments." While an abusive home certainly qualifies as invalidating, so do other, "normal," situations. She says:

An invalidating environment is one in which communication of private experiences is met by erratic, inappropriate, or extreme responses. In other words, the expression of private experiences is not validated; instead it is often punished and/or trivialized. the experience of painful emotions [is] disregarded. The individual's interpretations of her own behavior, including the experience of the intents and motivations of the behavior, are dismissed...

Invalidation has two primary characteristics. First, it tells the individual that she is wrong in both her description and her analyses of her own experiences, particularly in her views of what is causing her own emotions, beliefs, and actions. Second, it attributes her experiences to socially unacceptable characteristics or personality traits.

This invalidation can take many forms:

• "You're angry but you just won't admit it."
• "You say no but you mean yes, i know."
• "You really did do (something you in truth hadn't). Stop lying."
• "You're being hypersensitive."
• "You're just lazy." "
• I won't let you manipulate me like that."
• "Cheer up. Snap out of it. You can get over this."
• "If you'd just look on the bright side and stop being a pessimist..."
• "You're just not trying hard enough."
• "I'll give you something to cry about!"

Everyone experiences invalidations like these at some time or another, but for people brought up in invalidating environments, these messages are constantly received. Parents may mean well but be too uncomfortable with negative emotion to allow their children to express it, and the result is unintentional invalidation. Chronic invalidation can lead to almost subconscious self-invalidation and self-distrust, and to the "I never mattered" feelings van der Kolk et al. describe.

Biological Considerations and Neurochemistry
It has been demonstrated (Carlson, 1986) that reduced levels of serotonin lead to increased aggressive behavior in mice. In this study, serotonin inhibitors produced increased aggression and serotonin exciters decreased aggression in mice. Since serotonin levels have also been linked to depression, and depression has been positively identified as one of the long-term consequences of childhood physical abuse (Malinosky-Rummell and Hansen, 1993), this could explain why self-injurious behaviors are seen more frequently among those abused as children than among the general population (Malinosky-Rummel and Hansen, 1993). Apparently, the most promising line of investigation in this area is the hypothesis that self-harm may result from decreases in necessary brain neurotransmitters.

This view is supported by evidence presented in Winchel and Stanley (1991) that although the opiate and dopaminergic systems don't seem to be implicated in self-harm, the serotonin system does. Drugs that are serotonin precursors or that block the reuptake of serotonin (thus making more available to the brain) seem to have some effect on self-harming behavior. Winchel and Staley hypothesize a relationship between this fact and the clinical similarities between obsessive- compulsive disorder (known to be helped by serotonin-enhancing drugs) and self-injuring behavior. They also note that some mood-stabilizing drugs can stabilize this sort of behavior.

Serotonin
Coccaro and colleagues have done much to advance the hypothesis that a deficit in the serotonin system is implicated in self-injurious behavior. They found (1997c) that irritability is the core behavioral correlate of serotonin function, and the exact type of aggressive behavior shown in response to irritation seems to be dependent on levels of serotonin -- if they are normal, irritability may be expressed by screaming, throwing things, etc. If serotonin levels are low, aggression increases and responses to irritation escalate into self-injury, suicide, and/or attacks on others.

Simeon et al. (1992) found that self-injurious behavior was significantly negatively correlated with number of platelet imipramine binding sites self-injurers have fewer platelet imipramine binding sites, a level of serotonin activity) and note that this "may reflect central serotonergic dysfunction with reduced presynaptic serotonin release. . . . Serotonergic dysfunction may facilitate self-mutilation."

When these results are considered in light of work such as that by Stoff et al. (1987) and Birmaher et al. (1990), which links reduced numbers of platelet imipramine binding sites to impulsivity and aggression, it appears that the most appropriate classification for self-injurious behavior might be as an impulse-control disorder similar to trichotillomania, kleptomania, or compulsive gambling.

Herpertz (Herpertz et al, 1995; Herpertz and Favazza, 1997) has investigated how blood levels of prolactin respond to doses of d-fenfluramine in self-injuring and control subjects. The prolactin response in self-injuring subjects was blunted, which is "suggestive of a deficit in overall and primarily pre-synaptic central 5-HT (serotonin) function." Stein et al.(1996) found a similar blunting of prolactin response on fenfluramine challenge in subjects with compulsive personality disorder, and Coccaro et al. (1997c) found prolactin response varied inversely with scores on the Life History of Aggression scale.

It is not clear whether these abnormalities are caused by the trauma/abuse/invalidating experiences or whether some individuals with these kinds of brain abnormalities have traumatic life experiences that prevent their learning effective ways to cope with distress and that cause them to feel they have little control over what happens in their lives and subsequently resort to self-injury as a way of coping.

Knowing when to stop -- pain doesn't seem to be a factor
Most of those who self-mutilate can't quite explain it, but they know when to stop a session. After a certain amount of injury, the need is somehow satisfied and the abuser feels peaceful, calm, soothed. Only 10% of respondents to Conterio and Favazza's 1986 survey reported feeling "great pain"; 23 percent reported moderate pain and 67% reported feeling little or no pain at all. Naloxone, a drug that reverses the effects of opiods (including endorphins, the body's natural painkillers), was given to self-mutilators in one study but did not prove effective (see Richardson and Zaleski, 1986). These findings are intriguing in light of Haines et al.(1995), a study that found that reduction of psychophysiological tension may be the primary purpose of self-injury. It may be that when a certain level of physiological calm is reached, the self-injurer no longer feels an urgent need to inflict harm on his/her body. The lack of pain may be due to dissociation in some self-injurers, and to the way in which self-injury serves as a focusing behavior for others.

Behavioralist explanations
NOTE: most of this applies mainly to stereotypical self-injury, such as that seen in retarded and autistic clients.

Much work has been done in behavioral psychology in an attempt to explain the etiology of self-injurious behavior. In a 1990 review, Belfiore and Dattilio examine three possible explanations. They quote Phillips and Muzaffer (1961) in describing self-injury as "measures carried out by an individual upon him/herself which tend to 'cut off, to remove, to maim, to destroy, to render imperfect' some part of the body." This study also found that frequency of self-injury was higher in females but severity tended to be more extreme in males. Belfiore and Dattilio also point out that the terms "self-injury" and "self-mutilation" are deceiving; the description given above does not speak to the intent of the behavior.

Operant Conditioning
It should be noted that explanations involving operant conditioning are generally more useful when dealing with stereotypic self-injury and less useful with episodic/repetitive behavior.

Two paradigms are put forth by those who wish to explain self-injury in terms of operant conditioning. One is that individuals who self-injure are positively reinforced by getting attention and thus tend to repeat the self-harming acts. Another implication of this theory is that the sensory stimulation associated with self-harm could serve as a positive reinforcer and thus a stimulus for further self-abuse.

The other posits that individuals self-injure in order to remove some aversive stimulus or unpleasant condition (emotional, physical, whatever). This negative reinforcement paradigm is supported by research showing that intensity of self-injury can be increased by increasing the "demand" of a situation. In effect, self-harm is a way to escape otherwise intolerable emotional pain.

Sensory Contingencies
One hypothesis long held has been that self-injurers are attempting to mediate levels of sensory arousal. Self-injury can increase sensory arousal (many respondents to the internet survey said it made them feel more real) or decrease it by masking sensory input that is even more distressing than the self-harm. This seems related to what Haines and Williams (1997) found: self-injury provides a quick and dramatic release of physiological tension/arousal. Cataldo and Harris (1982) concluded that theories of arousal, though satisfying in their parsimony, need to take into consideration biological bases of these factors.

Excerpts from the Archives of the Narcissism List Part 20

1. There is no Gaol
2. Inverted Narcissists Once More
3. Losing Control
4. The Borderline Narcissist - A Psychotic?
5. How to Assuage a Narcissist
6. Don't Kiss Me without Permission
7. The Root of Evil
8. Love as Domination
9. My Guardian Angel
10. The Pleasures of the Somatic Narcissist

1. There is no Gaol

There is no gaol more monstrous than our mind.

The Narcissist is a child. He is so curious and frightened and cruel and passionate and tender and impetuous and obdurate and loveable and enraging - all the things kids are.

He is in constant search of a lost mother.

And when he finds her, he holds onto her apron and won't let go.

The narcissist is screaming constantly, transmitting agony to a world without receivers.

Except the inverted narcissists. They have receivers. And his pain blinds them and they cannot resist or desist. Insist, they persist and fight, trying to recapture the narcissist's soul, doing battle with his demons.

2. Inverted Narcissists Once More

Inverted narcissism is a term that we invented here, in this list - BUT we did not invent the condition.

It was previously called "covert" narcissist and Lowen and Golomb describe it in great detail.

Without a narcissist - the Inverted Narcissist's (IN) life is grey and motionless.

An IN would feel threatened in a relationship with another IN. First, they would both be competing for narcissists (not for narcissistic supply but for a supply of narcissists). Second, they would feel that the relationship is unstable and not built to endure.

I think that the IN is a co-dependent who latches on EXCLUSIVELY to narcissists. He uses what little empathy he does have to secure his supply from his narcissist.

3. Losing Control

The narcissist is mortally terrified of losing control - or of not having it to start with. Lack of control negates his deeply embedded feeling of omnipotence - a pillar of his False Self.

Thus, when faced with death, illness, grief, fear, natural catastrophe, accident, war - anything he knows he cannot control - he becomes frustrated and rageful.

4. The Borderline Narcissist - A Psychotic?

This is why Kernberg came up with the "Borderline" invention - a diagnostician's paradise. Something between psychotic and neurotic (actually between psychotic and the personality disordered). The differentiation is this:

• Neurotic - autoplastic defenses (something's wrong with me)
• Personality disordered - alloplastic defenses (something's wrong with the world)
• Psychotics - something's wrong with those who say that something's wrong with me

ALL personality disorders have a clear psychotic streak. Borderlines have psychotic episodes. Narcissists react with psychosis to life crises and in treatment ("psychotic microepisodes" which can last for days!!!).

Paranoids are paranoids. Schizoids are low intensity psychotics. And so on.

So, why the distinction between personality disorders and psychoses?

In one words, insurance. Money and medications. The pharmaceutical industry is the biggest one in the world. Much bigger than the armaments, media, and computer industries combined. There is big money here. The DSM is a money allocation mechanism. Taxonomies and classifications are mechanisms to allocate money amongst the guilds. The commissions on anti-psychotic drugs go exclusively to psychiatrists. Psychiatrists get rich on prescribing the4m because they get bribed to over-subscribe.

5. How to Assuage a Narcissist

1. Apologize profusely in the same way you attacked him (publicly, etc.) and ASSUME the blame (you had your period, women are irrational, you are too ignorant or stupid to fully understand him, you are contrite, it will never happen again, etc.)

1. Invent a project which will keep him physically out of the premises AND cater to his special, unequalled abilities which the company is in "dire" need of (client interfacing? PR? an ad campaign? media exposure? political lobbying? running for the presidency?)

6. Don't Kiss Me without Permission

When I am treated this way I feel humiliated, objectified and demeaned. Just because someone wants to give me a kiss or a hug doesn't mean that he has the right to give me a kiss or a hug. To want is not to have a right to. We often want things to which we are not entitled. We often want to behave in ways which are forbidden by social custom or by the personal predilections of the person in the receiving end of our wishes.

I mean if someone gave ME a hug, or a kiss, or a birthday party or called me to wish me a happy birthday WITHOUT my prior consent - I would consider this to be an invasion of my privacy, an intrusion, being treated as an object, and an uncivil imposition. Nothing I hate more than being imposed upon (this is why I constantly clash with authority figures and the law).

7. The Root of Evil

Pathological narcissism is considered by many authorities to be the phenomenon underlying most mental disorders. I describe how pathological narcissism develops into various personality disorders in FAQ 40

The Excerpts pages contain many references to the artificiality of the DSM and its distinctions between personality disorders. All personality disorders are either variations on a theme or appear intermingled. Thus, a SINGLE mental health category with different axes and intensities would have been a more appropriate ("process-orientated") approach, to my mind.

I think that all Cluster B personality disorders (being mean is called "Antisocial Personality Disorder") are arbitrary points in a continuum.

8. Love as Domination

Sometimes we mistake guilt and self-assumed blame for love.

Committing suicide for someone else's sake is not love.

Sacrificing yourself for someone else is not love.

It is domination.

You control her by your giving as much as she controls you through her pathology.

Your generosity prevents her from facing her true self and from healing.

9. My Guardian Angel

I rarely stroll in parks or anywhere else for that matter.

Which makes my story all the more incredible.

Because today, in torrential rain, I did. I strolled.

Mindful of my infirmities, I dressed well, collapsible umbrella in hand and the disdainful look that I reserve to others, a fixture on my face.

I did regard the weather as a personal slight, it running contrary to my plans and aspirations in this particular eve. But I was determined to demonstrate my mettle by defying this divine impropriety.

As I passed the winged lions which keep a mossy vigil at the entrance to the park, the weather cleared and my gait acquired a more cheerful countenance.

From the corner of my eye (I never stare directly, a sign of lowly upbringing) I spotted an immaculately clad gentleman, poised rigidly on the edge of a metal bench.

I approached him and venturing forth my most civil voice I enquired: "May I, Sir?"

Not deigning so much as to look at me, he replied (if reply it was): "Certainly not, Sir. Can't you tell it is occupied?"

Taken aback, I measured him, head (or rather, Panama hat) to toes (or rather a pair of lewd leathery Italian shoes). "Sire" - I insisted - "this is a publick domain. If you find my company so reprehensive, pray find another place to rest yourself".

And with these resolute words, I sat myself near him, though maintaining a proper distance between me and his cheap perfume.

He curled a thin moustache with a gloved hand and half turned around as though not decided whether to fully face what he surely must have regarded to be an insolence of the highest degree.

"I see that you are as opinionated as you are young and the desires or needs of others matter but little to you" - he said, his voice harsh.

"'Tis so" - I agreed with him, slumping in my seat, shutting my eyes and abandoning my face to a more agreeable dialogue with the sun rays.

"And to be so callous and impertinent" - he pressed ahead, disavowing my clear reluctance to pursue the matter - "one must be assured of some immunity and of one's own superiority".

"Sir" - I said, still half awake, but rather intoxicated with the nectar of the sun dripping through my eyelids - "you seem to have a penchant for the obvious and to be enamoured with the easily discernible."

His voice climbed an octave in his excitement: "And what, in heavens name, do you rest these outrageous suppositions on?"

"They haven't been disproved as yet" - I said, bored to the core.

"Perhaps they have not been tried sufficiently".

"Oh, they have and more" - I heartily disagreed knowing full well the rage this will provoke in him - "Simply I AM superior. I am cerebral and handsome to behold and not without means. I move in the right company of men and place women where they belong and where their wiles can have the least effect. I'm pretty content with myself".

"You are a narcissist" - he raged as I expected - "You are a selfish, heartless, blind narcissist."

"I bid you go to hell" - I said, as nonchalantly as I could - "no one dares talk to me like this and no one dares take his leave of me lest I permit it. So, here is my permission: go to hell".

"I am going" - said the man, to my surprise. The thunderous, echoing quality of his speech awoke me full. I gazed at him in daze, for he was brilliant and outshone the sun.

"I am going there, whence I came. You know not what you said. I am your guardian angel and I am waiting for you there among the cauldrons and the sulphur".

"Who are you?" - I exclaimed, suddenly alarmed but he has vanished. And on the bench he abandoned a fiery calling card, strange lettering that left a lot to be desired inasmuch as good taste is concerned.

"Samael" - I read his name - "Samael Van Knin"

10. The Pleasures of the Somatic Narcissist

The somatic narcissist derives his narcissistic supply from sexual exploits and conquests, OR from the cultivation of his body, OR from seductive acts (which do not culminate in sex and are not otherwise consummated), OR from any combination of the above. Thus, a celibate somatic narcissist is a possibility. Such a somatic will tend to be an hypochondriac, for instance, or a body builder. Additionally, many narcissists are fetishists, latent homosexuals (there is a strong auto-erotic element in HOMOsexuality) AND misogynists (or misnadrogenists if they are female narcissists). This is not very conducive to healthy, consistent patterns of sexual behaviour.

next: Excerpts from the Archives of the Narcissism List Part 21

Self-Therapy For People Who ENJOY Learning About Themselves

PROFESSIONAL QUALIFICATIONS

I work, here, in Milwaukee at the Midwest Center for Human Services, a state-certified mental health clinic. We also have a sister office in Madison, Wisconsin. Here's a bit more about me, professionally:

TONY SCHIRTZINGER, MSSW, CICSW

Almost thirty five years as a psychotherapist and trainer of therapists and counselors. Certified Transactional Analyst. Extensively trained in a remarkably wide range of clinical areas due to ten years as training director for counselors and therapists in a large state agency. Does not specialize, but prefers a wide variety of clients. Especially experienced at working with individuals regarding depression, anxiety, physical and sexual abuse in childhood, delinquency and criminality, parenting, teenagers, and dissociation. Also works with couples on relationship issues.

next: How to Use These Pages

The UK Disability Discrimination Act and how it applies to children with learning disabilities and schools.

From September 2002, it is unlawful for schools in England and Wales to discriminate against pupils with a learning disability.

The Disability Discrimination Act now applies to all schools and covers all aspects of school life. This covers mainstream schools, special schools and independent schools. There are new duties for all these schools to avoid discriminating against disabled pupils.

What does this mean for children with a learning disability?

It means protection from discrimination and new ways to challenge discrimination on the grounds of disability. Alongside other changes that came into force with the Special Educational Needs and Disability Act, it means that attending a mainstream school will become possible for many more pupils in the coming years.

The changes do not affect your child's rights to have support to meet their special educational needs. For children who need a lot of support at school Statements of Special Educational Needs are still available.

My child has special educational needs does this mean she is disabled?

Most children with a learning disability will be seen as disabled under this new Act. Pupils are disabled if their impairment has a substantial and long-term adverse effect on their day to day life. There will be some pupils with special educational needs who do not fit this definition of disability and are notcovered by the new Act.

My child needs his own communication aid, is this covered?

The new Act does not cover aids that are provided especially for your child, for example a specially adapted computer keyboard. These aids are covered by the special educational needs framework and should be stated on your child's Statement. The use of aids is covered under the new Act, so that if a teacher refused to let your child use their special keyboard this could be unlawful.

Are school trips and school clubs covered by the new Act?

Yes, they are when the school arranges these activities. It is now unlawful to discriminate against disabled pupils when schools arrange trips and clubs. This does not mean that everyone will go on exactly the same trip or attend the same club. It does mean when organising these activities schools have to make sure that they are not overall putting disabled pupils at a disadvantage.

What does the Act mean for schools?

It becomes unlawful to discriminate against disabled pupils when the school is aware that the child has a disability. Schools will need to make sure that all their polices, (eg admission policy) practices (eg timetabling) and procedures (eg medication) do not discriminate against disabled pupils.

Schools are now not able to refuse a place to a child with a learning disability unless they can prove that the education of other children would be adversely affected or that they are not able to take reasonable steps to educate the disabled pupil.

Who at the school is responsible for these new disability discrimination duties?

It is the Governing Body of the school that is responsible for making sure that the school is not acting in a discriminatory way. You can find out from the headteacher or the LEA, the name of the Chair of Governors and the name of the Special Educational Needs Governor. They will be able to give more detailed information about the school is working to avoid discriminating against disabled pupils. The will have a written policy on inclusion and by April 2003 have to publish plans on how they will extend access to all pupils in the coming years.

In the case of independent schools it is the proprietor or the management group of the school and they have the same duties to avoid discrimination as all other schools.

The school I really want for my child says that they are not able to meet their needs. Isn't this discrimination?

The new law makes it clear to schools that they have to take reasonable steps to admit and educate your child. They may not be able to do this within time for your child. If, for example, all the school staff needed to learn sign language it would take time for the school to manage this.

I think the school could take reasonable steps to help my child what can I do about this?

In the first instance it would be best to discuss this with the headteacher and consider writing to the Chair of Governors. The school Governors will need to check that the school has taken all reasonable steps and that disabled children are not at a substantial disadvantage. The school is allowed to take into account:-

• The need to maintain academic standards
• The costs of taking reasonable steps
• Whether it is practical to make changes
• The health and safety of all the pupils
• The interests of other pupils

You may want to use the school's complaints procedure and you can do this at the same time as making a claim to the Tribunal or using the conciliation service.

What help outside the school is there for me and my child?

All Local Education Authorities have to provide information and advice to parents of children with special educational needs. This information and advice is available through the Parent Partnership Service and your local council office would be able to give you contact details.

There are also independent disagreement resolution (mediation) services available to parents in every local area and these may be able to help resolve a dispute about discrimination. The Parent Partnership Service or the independent mediation service may also be able to help you use the school complaints procedure and give you information about conciliation and about the Tribunal.

Parents can make a claim that their child has experienced unlawful discrimination through the Special Educational Needs and Disability Tribunal. This Tribunal can order any remedy except financial compensation. Parents must make a claim to the Tribunal within 6 months of the alleged discrimination.

The Disability Rights Commission runs an independent conciliation service to promote settlement of claims without going to the Tribunal. Both you and the Governing Body (or proprietors of an independent school) have to agree if the conciliation service is to be used. Agreeing to use either mediation or conciliation does not affect your right to take your claim of discrimination to the Tribunal. If you use the conciliation service this means that you have 8 months from the decision or discriminatory incident to take your claim the Tribunal.

How can I find out more?

The Disability Rights Commission can be contacted on 08457-622-633. On their website www.drc-gb.org there is a leaflet for parents and further information.

The Special Educational Needs and Disability Tribunal can be contacted on 0207-925-6902. They have a useful booklet and video that explain about making a claim.

next: Disability Rights UK
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"We are all carrying around repressed pain, terror, shame, and rage energy from our childhoods, whether it was twenty years ago or fifty years ago. We have this grief energy within us even if we came from a relatively healthy family, because this society is emotionally dishonest and dysfunctional.

When someone "pushes your buttons," he/she is activating that stored, pressurized grief energy. She/he is gouging the old wounds, and all of the newer wounds that are piled on top of those original wounds by our repeating behavior patterns."

Codependence: The Dance of Wounded Souls by Robert Burney

When I first got into recovery one of the things that I was told was that 'all I had to change was everything'. I had no idea what that meant back then. Now I know that it means that I needed to change my attitudes, beliefs, and definitions about myself and everything in my life. I needed to start surrendering my way of seeing things, of doing life.

One of the first surrenders that I had to make was to let go of doing things 'my way.' (I used to sit in bars and get tears in my eyes over Frank Sinatra's recording because I was also doing it 'My way.') I had to start listening to those weird people who were telling me that I could live without alcohol. Then I had to start letting go of my belief that life was impossible without drugs and alcohol.

Every time I go through a surrender in my recovery I am letting go of some of the ego definitions that have defined my relationship with myself and life. I have to let go of the attitudes and beliefs that I adapted because of the emotional trauma that I suffered as a child (which are still buried in my subconscious until I became willing to look at them.)

There is an old AA saying that, "AA doesn't open up the gates of heaven and let us in it opens up the gates of hell and lets us out". What we are let out into is life. The only way that I had known how to deal with life up to that time was to drink and use. The Twelve Steps are a formula for learning how to deal with life in a Spiritual way, and they saved my life.

Unfortunately, the Twelve Steps as practiced in AA are not always enough. Not because the Twelve Step process is not enough - but because the way it is practiced in AA leaves out a vitally important level of healing. That is the level of healing the emotional wounds. We can deal with our grave emotional and mental disorders by having the capacity to be honest with ourselves. That includes being emotionally honest with ourselves. And the only way to achieve emotional honesty is by releasing the grief energy that we are carrying around - the pain, terror, shame, and rage from our childhoods.

Until we deal with our emotional wounds, we do not have the ability to be emotionally honest in the moment. Until we change our relationship with our own emotions it is impossible to be comfortable in our own skins.

Emotional energy manifests in the body. Our attitudes, definitions, and beliefs (subconscious and conscious) dictate our perspective of life and our expectations of ourselves, others, and life. Those perspectives and expectations set us up to react emotionally to life events. If we have not dealt with the old wounds then we will live life in reaction - overreacting (or under reacting to keep from overreacting) - when our 'buttons are pushed.' Our fear of our own reactions determines the quality of our relationships. Until we go back and heal our childhood emotional wounds we cannot successfully change the old tapes we cannot achieve a healthy, emotionally honest relationship with ourselves and others.

Grave emotional and mental disorders is AA language for Codependence. Codependence is all about having a dysfunctional relationship with self: with our own bodies, minds, emotions, and spirits; with our own gender and sexuality; with being human. Because we have dysfunctional relationships internally we have dysfunctional relationships externally. Because we cannot be emotionally honest with ourselves we aren't really being totally honest with anyone ever.

Bill Wilson would have loved to have had the tools we have available to us today. He would have run to an ACA or CoDA meeting because that is where he could have found the roots of the depression which tormented him.

Codependence Recovery is ninth step work, making amends to ourselves and others by changing the attitudes and behaviors that have caused us to hurt ourselves and others. And we cannot make those amends without owning the feelings. We are powerless to substantially change the behavior patterns in our most intimate relationships without doing the grief work.

next: Codependence - Defined

sexual fantasies

Some people have concern and confusion over having an intensely sexual and repetitive fantasy (like maybe ejaculating on a woman's body). If you're one of those, don't worry, you have some company-- a lot. Sexual fantasies are without a doubt the most common kind of sexual experience and are a part of the vast majority of men's and women's psychological landscape. They are completely private and safe and can actually be enhancing. Fantasies are a way of giving your sexual feelings a holiday--you can try different partners, positions, and situations without having to be accountable--or worry about disease.

Fantasy can allow one to role play upcoming encounters, temporarily escape from real life, relieve pent up pressures, or most commonly (in over 70% of men and women), to intensify sexual arousal during masturbation or love making. Fantasies can just pop into a person's mind unsolicited or can be carefully and elaborately orchestrated.

Many men and women report "unusual" sexual fantasies that they would never do because they seem dangerous, illegal or outside their value system. Some worry that having these unsettling daydreams means they might act on them or be mentally ill. Then their fantasy becomes a source of guilt, anxiety or fear. When a fantasy intrudes on real life to the point that it interferes with personal relationships, sexual functioning ( a person cannot respond to a real life partner), or work or a person becomes so obsessed with it that he feels compelled to act it out it is then a bona fide problem exists.

So check in with your fantasy. You may feel less "squirmy" if your fantasy fits the non-intrusive, non-compulsive category. If it does, you may want to seek professional help to uncover its sources.

Here's some interesting information on the sexual fantasies of child molesters.

next: The Gardener of Desire