Some people unwittingly choose destructive relationships over and over again. The consequences of their choices are painful and emotionally damaging, yet those that engage in this repetitive behavior never seem to learn from their experience. Instead they go from one bad partner to the next, much to the chagrin of those closest to them (including therapists) who pull their hair out trying to stop them. Why does this happen?

Traditional psychoanalytic theory offered an intriguing, yet seemingly unlikely explanation for such self-destructive relationship choices. People who choose such partners must derive pleasure from being mistreated. Simply stated, the choosers are masochistic. If the "pleasure principle" drives people, as analysts argued, certainly this behavior follows the same rules. The therapist's task was to make the unconscious pleasure known to the patient--and then they would be free to choose a more appropriate partner.

Yet, in my years of doing therapy, I never found any client who received any pleasure at all, conscious or unconscious, from the abuse and neglect heaped on them by narcissistic or otherwise destructive partners. Rather, my clients were simply hurt over and over again. Still, the "repetition compulsion" was true enough: no sooner had a client ended with one particularly hurtful person then they found another wolf in sheep's clothing. There had to be a good reason. Here's what my clients have taught me over the years.

People who have not been given "voice" in childhood have the lifelong task of repairing the "self." This is an endless construction project with major cost overruns (much like the "Big Dig" in Boston). Much of this repair work involves getting people to "hear" and experience them, for only then do they have value, "place," and a sense of importance. However, not just any audience will do. The observer and critic must be important and powerful, or else they will hold no sway in the world. Who are the most important and powerful people to a child? Parents. Who must a person pick as audience to help rebuild the self? People as powerful as parents. Who, typically, is more than willing to play the role of power broker in a relationship, doling out "voice" only insofar as it suits him/her? A narcissist, "voice hog," or otherwise oblivious and neglectful person.

And so it goes. The person goes in the relationship with the hope or dream of establishing their place with a narcissistic partner, only to find themselves emotionally battered once again. These are not "oedipal" choices--people are not choosing their father or mother. They are picking people they perceive powerful enough to validate their existence.

But why doesn't a person leave when they realize they are in yet another self-destructive relationship? Unfortunately, on occasion things go well with a narcissistic partner--particularly after a blowout fight. A narcissist is often expert in yielding just enough "voice" to keep his or her victim from leaving. They grant a place in their world, if only for a day or two. The wish that this change is permanent sustains the voiceless person until the relationship regresses back to its usual pattern.

Giving up a destructive relationship is difficult. The brief moments of validation are cherished, and the person who finally leaves must relinquish the hope of "earning" more. When the person finally breaks free they are faced with an immediate and lasting feeling of emptiness and self-blame that makes them question their decision. "If only I had been different or better--then I would have been valued," is the usual refrain. Once the old relationship is sufficiently grieved, the person immediately resumes their search for another partner/lover with the qualifications and authority to again secure him or her a "place" in the world.

Ironically, this "repetition compulsion" is hardly masochistic. Instead, it represents an ongoing attempt to heal the self, albeit one with disastrous results. The cycle repeats itself because the person knows no other way of preventing themselves from feeling tiny or immaterial.

This is exactly where therapy comes into play. The analysts were correct in at least one important matter. This repetitive behavior has its roots in childhood, the time in which "voice" and self are established. People are often aware that they are struggling to be heard, to have a sense of agency, and to be valued in a relationship, but they are unaware that this is usually the very same struggle they had with one or both parents. A good therapist reveals this by closely examining their personal history.

And so the presenting problem is redefined and broadened to a life issue--and the work begins. A therapist bears down with all the resources available to him or her. Insight is certainly one--for, as suggested above, there is much the client does not know about the depth and breadth of the problem. Just as important is the relationship between therapist and client. Simply put, the relationship must be real, meaningful, and deep. The client must learn to establish voice, and it must be appreciated by the therapist in a genuine way. For the therapy to be effective, the relationship will likely be different from every other one the client has had. Advice and encouragement, often seen as hallmarks of good therapy, are by themselves insufficient. To make headway, the therapist must partially fill the same void that the client was unconsciously hoping their lover would. The client must feel: "My therapist is someone who hears me, values me, gives me a 'place' where I feel real and significant."

Once the client feels certain of this, they can begin looking for partners using more realistic, adult criteria. And they can finally free themselves from people who chronically hurt them. In this way, the self-destructive, repetitive cycle is broken.

About the author: Dr. Grossman is a clinical psychologist and author of the Voicelessness and Emotional Survival web site.

next: Relationships: The Role of the Hidden Message

Self-Therapy For People Who ENJOY Learning About Themselves

We are all lonely sometimes. One of the best things we can do for ourselves is to arrange our lives to be sure it doesn't happen regularly.

Everyone needs regular doses of attention every day.

DAILY LONELINESS

Daily loneliness comes from ignoring our natural impulses to make contact with other human beings. When we ignore these impulses we say something like this to ourselves:
"She'd probably be too busy."
"He might be in a bad mood."
"I'd better not go out. I don't look my best today."

Whenever you catch yourself saying such things you need to know that your impulse to talk to someone is far more trustable than this self-talk inside your head. Even if you decide not to talk to a certain person for some reason, remember that your impulse to make contact is still there.
So talk to someone else, spend time with your kids, or take a deeper interest in someone you've known casually... but do something with somebody. Or be lonely.

WEEKLY LONELINESS

Weekly loneliness refers to all the temporary, short term ways we create loneliness in our lives.
These usually have to do with screwed up priorities.
We say:
"I'd like to go to see him BUT..."
"... I need to clean out that closet"
"... this project at work is all I can think about now"
or "... It's too early (or too late, or too sunny or too cold, or.........)."

Weekly loneliness is about screwed up priorities. We think something is more important than the human contact we crave, and we are almost always wrong.

LONELINESS AS A LIFE PATTERN

Some people have always been lonely and expect that they always will be. They think "that's just the way I am" and that they can't change.

When Weeks Turn Into Years: Many people make loneliness into a way of life by continually thinking the way the "weekly" people do. They say, and somehow keep believing, that "the rush will soon be over." They are always shocked to look back a few years and find that they've been thinking this way regularly, habitually, continually.

I'm Just Not Good Enough: People who were neglected and demeaned in childhood believe they were destined to be alone. Some were so neglected by the adults in their house that they believe they aren't worth our time. Others were shamed and ridiculed so much that they assume we will look down on them. From their point of view, they are doing us a favor
by not making us "bother" with them. From our point of view, they are robbing us
of their presence in our lives.

People Are Just Too Scary: People who were abused in childhood believe they were destined to be hurt by everyone they meet. From their point of view, they are just protecting themselves
by staying away from us. From our point of view, they are grossly insulting us
by thinking we are so cruel.

Everyone who has a lonely life pattern thinks that something is more important than their need for human contact. And they are wrong 99.9% of the time! (Only our physical needs - like food, air, and water - are more important.)

REGULATING THE RISK

When you examine all of the reasons we have for avoiding each other they all come down to what therapists call "fear of intimacy." Some day I'll write about this fear more directly, but for now here's what we can do when we feel this fear.

We can regulate the degree of contact we allow. When we are lonely, we don't need intense human contact. We just need some human contact. Period.

We can decide whether to look people in the eye, and how long to keep the eye contact. We can decide whether to talk to the mailman and the sales clerk, and how much to say. We can decide how big of a psychological risk we are willing to take with each person we meet today.

Once we know we can regulate the amount of contact we have, we can go get what we want and need: CONTACT with the rest of the human race.

[Read "How Are You Spending Your Time?" for more information about regulating this risk.]

Enjoy Your Changes!

Everything here is designed to help you do just that!

next: Love Relationships

Chapter 76 of the book Self-Help Stuff That Works

by Adam Khan:

HERE'S AN ODD SUGGESTION: When you're working, try to burn calories. Be useful, helpful, and as productive as you can. Even if your job is sitting at a keyboard all day, try to do it energetically and with enthusiasm. It may seem stupid, but give it a try before you decide. Blast out your effort like a thousand-watt bulb and here's what you'll get in return:

1. You'll be more energetic, not less. You'd think it would wear you out, but that's not the case, as you can find out for yourself by trying it. You may have a pleasant sense of relaxation at the end of the day, as you would from some good exercise, but it won't make you tired. Holding back makes you tired. Going through the motions makes you tired. Just trying to get through the day makes you tired.
2. You'll advance faster. Of course, when opportunities come around, the person putting their all into the work (you, for instance) is going to be chosen over the people who are getting by doing as little as possible. Obviously.
3. Your job will be more secure. Giving your all will make you feel more secure in a sometimes insecure world. And you'll not only feel more secure, your feeling will be an accurate perception of the reality.
4. You'll feel better about yourself. It feels good to do well. And you can look your boss in the eye and know s/he's getting a good deal. You can see that there are very few people you work with (or none at all) who give their all. The comparison between you and the rest of the pack will make it very clear in your mind you can stand tall and proud when your supervisor is around.
5. You'll improve your abilities faster. Whatever skills your job requires will be honed more quickly when you're giving it your all.

THE HUMAN BRAIN and body has a default setting: Conserve energy. You know this from personal experience. It's probably hardwired genetically and kicks in with the onset of adulthood. You and I have a natural tendency to try to be conservative with our energy output. That's there naturally, but you're not stuck with it. You can override that default setting with a simple decision: Put out as much effort as you can.

Put the decision into action and before long, you'll forget. You'll be back to your default setting. When you notice you've gone back to the conserve energy mode, decide again to try to burn calories. Remake your decision again and again. Blasting out the energy won't wear you out or make you tired. But it will make you feel proud, secure, and confident.

When you're working, try to burn calories.

Here's a way to make your work more enjoyable.
Play the Game

One way to be promoted at work and succeed on the job may seem entirely unrelated to your actual tasks or purpose at work.
Vocabulary Raises

This is a simple technique to allow you to get more done
without relying on time-management or willpower.
Forbidden Fruits

Here is a way to turn your daily life into a fulfilling, peace-inducing meditation.
Life is a Meditation

A good principle of human relations is don't brag,
but if you internalize this too thoroughly, it can make
you feel that your efforts are futile.
Taking Credit

next: An Island of Order in a Sea of Chaos

Patti's Panic Place

I always remember being anxious. Growing up, everyone would simply say, "you are just a nervous child." So life went on.

I was raised, as many, in a "dysfunctional" family. I had scary thoughts and bad dreams. My father's alcoholism created chaos and additional feelings of insecurities. As a teenager, I suffered from eating disorders, bleeding stomach ulcer, irritable bowel problems. I began avoiding situations where I could not come and go as I pleased; situations where I couldn't be in control. High school was extremely hard. I was absent a lot and I became very good at making excuses.

By age nineteen, I was out on my own, controlling my anxious feelings with alcohol. I learned to cope with everyday situations, working and socializing, by drinking.

I was working in a disco, when I was 21 and met my first husband, David. I got married, had my first daughter, Lindsey, and moved into my home.

The marriage was not a good one. My husband was very irresponsible and didn't like the "tied down" feelings of being married and being a father. I was very insecure. David lost it one night and punched me once and I ended up in the hospital with a fractured nose. I had to have plastic surgery to replace the bones in my nose. We divorced when I was 26.

As a single mother I felt more insecure than ever before. Not only did I have myself to deal with, but I had a child. I was scared and lost.

My World Becomes Smaller:

By this time in my life, I started to avoid more-and-more places. I would wake up in the morning and get Lindsey up and go to my parents. I only went places with my mom. I'd go to the store and begin to feel dizzy and would leave and go sit in the car. I stayed at my parent's house all day and, reluctantly, would come home at night.

I increasingly started feeling more out of control. I had my first full-blown panic attack while shopping for asparagus with my parents and my daughter. I was in the car and all of a sudden I felt this overwhelming urge to find my parents and leave. When I got home, I felt better.

At this point, I stopped going to my parent's house. I stayed home and for a period of time. I didn't even leave my bedroom. My mom would come to my house and pick-up Lindsey and take her to her house. I was so alone and frightened.

I saw programs about panic disorder. I listened intently. They were describing what happened to me. There was a name for what I had: "Agoraphobia".

However, I soon discovered that knowing about the disorder didn't make it go away. And since I didn't know where to turn for help, things didn't get any better. I found doctors that prescribed a variety of tranquilizers, but they made things worse. As a result, I decided to live with the anxiety rather than the zombie fog of the tranquilizers.

Then I met my second husband, Clay. He was a very needy person. Since I couldn't help myself, helping him was my new project. It kept my mind off my problem.

I got pregnant with my second child. Now being completely housebound, I searched for a way to have my baby without leaving the house. I found a midwife and she came to the house for pre-natal visits.

We planned for a home birth. It didn't happen that way. Problems arose with the pregnancy. I had to go the hospital to try and have the baby turned. It didn't work. On the way home, I went into labor and my water broke. The ambulance was called, the babies heart wasn't beating, I had a prolapsed cord. At the hospital, they did a emergency C-section and my daughter, Kaydee, was born. It was a miracle, she was in the intensive care unit for sometime. She was premature, but healthy. Thank-GOD. I wasn't in very good shape, physically or mentally. I wanted out of the hospital, NOW!.

I came home with my new baby. Clay was sinking into drugs and alcohol. He was a very controlling, physically abusive man. He actually found pleasure in the fact that I was agoraphobic. The situation worsened, the arguments, constant upheaval, beatings-- my life was at the lowest point.

My daughters were suffering. Lindsey was a teenager and resented Clay and his sickness. I was losing her. Kaydee was scared and didn't understand what was going on. Things had to change. But how?

I got a computer for Lindsey, and soon found a library at my fingertips. I read everything I could find on panic disorders. I found support groups, other people to talk to. I wasn't alone anymore.

A New Beginning

At this point I had been on-line and reading everything I could get my hands on, finding out new information about PAD (panic anxiety disorder) with agoraphobia. I felt there was help out there for me, I just had to find it.

I sat down with the phone book and started getting phone numbers to therapists that specialized in PAD. I was really anxious and afraid to make the phone calls. What would I say? Would they think I was totally crazy? All these thoughts kept running through my head. I had to do this. I wanted out of this self-made prison I had built for myself.

I made the first phone call. I left messages and some returned my calls. I would explain how I was housebound and really needed someone to come to my house for the first visit. This is the point in the conversation where the therapist would usually say something to the effect of: "I don't make house calls." I felt so stupid and started slipping back into my old thoughts, that there was no help for me and I was being absurd for asking for a therapist to come to my house.

I was getting worse-and-worse. I couldn't sleep. I was waking in the middle of the night in a full-blown panic attack. I started making phone calls again. I had one therapist call me back and after explaining my situation to him, he said, "In the first place, I don't make house calls and I have a waiting list of people who want to come to my office to see me. How could I possibly come to your house!" "OH MY GOD," I thought, how awful for a therapist to say this. I thought "good thing I wasn't suicidal". At first, I felt like crawling in a hole, but then I thought, NO-WAY! I was actually moredetermined to find someone who understood.

The very next day, I got a phone call from another therapist. Once again, I explained. He started asking me questions. This was different. My heart started racing. He stopped and told me that he would think about it and call me back. I waited anxiously for his call. The phone rang, it was him, Dr. Cohn. He told me he had never come to anyone's house before (my heart sunk). I could hear his next words in my head, but then, to my surprise he said he was willing to come to my house!! I couldn't believe what he said. He said he would come. He set up a day and time for the appointment.

When the big day arrived, I was nervous and excited. I saw his car pull up. He was a tall, gray-haired man. He came in and smiled at me and introduced himself. I liked him already. He asked me a lot of questions, writing as we talked. He diagnosed me with extreme panic disorder plus agoraphobia.

He also asked about my family background, any other family members who suffered with any forms of PAD. I told him about my grandmother, who had committed suicide because of her problems with PAD and of my other family members with alcohol problems. He explained about the hereditary aspects of this disorder and chemical imbalances.

He wanted to start me on some medications. He told me to please take the medications as he prescribed and then explained how his patients were afraid of taking any medications. "He must be reading my mind," I thought. He talked about how the fear of taking medications is actually a symptom of PAD, how someone like me, is so in-tune with every little change in our body's reactions to anything that we won't take medications.

I felt reassured about the medication. I promised I would take them. He set up another appointment, in his office. He told me if I didn't feel like I could come, he would make one more visit to my house.

I started taking the medications. It wasn't easy. I was so afraid of putting anything inside my body, fearful of how it would make me feel. He started me out very slowly on low doses, increasing the dose in 5 days. I was on my way. I felt few side-effects from the medications.

The day came for my appointment. My daughter drove me to his office and there I was. Dr. Cohn gave me a big hug and we started talking. I had made it to his office. I felt like I had just ran a marathon and won. This was my first step back into my life.

My Angel

I met Sue, on a day that was like every other day, filled with loneliness and despair. She's the mother of Kaydee's (my daughter) friend, Whitney. Whitney came over to our house to play with my daughter. Sue came to pick her up. We started talking and Sue started to share with me her experiences with panic disorder. As I listened, I couldn't believe I was hearing that she too had suffered with this disorder. I was, to say the least, shocked to actually be hearing someone else had these symptoms I was having. I couldn't get enough. I was like a sponge, soaking up everything that came out of her mouth. I wasn't alone anymore. She knew. She understood. She wanted to help.

Sue started doing "Behavioral Therapy" with me. She would come over to my house and we started out with very small steps. First, she walked down to the corner of my street with me and then back. My legs shook, but I made it. I felt a great sense of confidence that night, something so small, but yet so important. The next time we walked to a park by my house. Sue held my arm and kept reassuring me I was okay, then she let go of my arm and walked ahead of me and then said, walk up to me. I remember telling her I couldn't. She said "Sure you can." I did and we walked further. Then we came home.

These were the first small steps, and how wonderful I felt, and how safe I felt with Sue. I practiced on my own and I noticed the panic feelings weren't there. I was totally amazed. It was working!!

Sue had everything planned out. I wouldn't know where or what we were doing next. The next things we did involved taking rides in Sue's van. She took me for a short drive the first time and it was so strange, like I had been in a coma for a very long time. How things had changed, streets, stores. With each new journey, I conquered another fear and built confidence.

I remember the first day Sue took me to Kaydee's (my daughter) school. It made me so happy to see where Kaydee was going to school. The first time in the grocery store, Sue came in with me. The next time we went, she parked and gave me a list and sent me in by myself. GEESH, was I nervous. I did it, I did it... YEAH

At this point, Sue decided it was time for me to go out on my own. This was really hard. She was my support and I didn't know if I could do it without her. Little-by-little I did, but I still missed her a lot.

Sue's family and I met for dinner a few times. It was really nice to go and do things like that. At this point, my husband was drinking and doing a lot of drugs. Finally one night, Clay went into a rage. He found out that I was going to my therapist without him. He thought I had been telling my therapist things about him and he got really mad. I told him that we needed to go for a ride because I wanted to get him away from the kids.

He lost it, Totally, and beat my head against the dashboard until I was unconscious and then threw me out of his truck, in front of my house. He called from his cell phone and told me he would be back with a big gun. Well, I called the police and they issued a warrant for his arrest. I was taken to the hospital, had a broken jaw and fractured arm. He did show up in the middle of the night, with a rifle and the police arrested him and he spent one night in jail. This was the beginning of more tests of my strength, I believe. I had to have many surgeries on my jaw, braces and pins, lots of physical therapy. After about a year of court dates, he spent 3 months in jail and is now on 5 years ISP probation. Our divorce was final in April of 98.

Sue and I still talk and visit, she will always be my Angel. I will be eternally grateful for her support, guidance and friendship.

My Life Now

It has been almost 3 years now since I started therapy. Many things have changed. I continue to see my therapist, but now our visits consist of different discussions. After one of my sessions, Dr. Cohn asked me if I would be willing to talk to a few of his patients. I did and little did I know this would be yet another journey. Now I do Cognitive Behavioral Therapy with patients of Dr. Cohn's. This has been such a rewarding experience for me. Being a part of their recovery inspires me so much. To see their strength and determination to fight this battle makes everything I went through totally worth it. Dr. Cohn told me that since agreeing to a house call for me, that he now will continue to do so if anyone asks.

I am now remarried to a unbelievable man, who has shown me what love, security and trust are really all about. He supports me in everything I do. I have truly been blessed.

My road to recovery was long, but not nearly as long as the years I did nothing and lived in fear. I challenged my fears. I had weekly appointments with my therapist. I did Cognitive Behavioral Therapy, relaxation exercises, breathing exercises, meditation and kept a journal of all of it. Recovery is a re-learning and re-training process. We need to learn coping techniques so that we can handle stressful situations in a different way than we did. So, I am going to explain the methods I used and continue to use. I hope they will help you too

next: Anxiety and Depression in Women
~ all articles on patti's panic place
~ anxiety-panic library articles
~ all anxiety disorders articles

Short essays exploring healing and recovery as well a number of issues that confront us from time-to-time.

Table of Contents - Select an Item

• Love tree
• Titanic and Mark McGwire
• Wounded angel
• Failure
• Having it all
• Healing a life
• Fear
• Letting go
• Change
• When you feel you can't go on
• Losing perspective
• Co-dependency
• Home Words
• Honoring Both Traditions and New Beginnings
• Nurturing Your Soul During the Holidays
• The Soul of a Scientist
• Reflections from the Rear View Mirror
• Pass It On
• Our Mother's Stories
• An Open letter to the Handless Maiden
• The Last Thanksgiving
• Unanswered Questions: Millennium Madness and Musings
• Letters on Parenting

  • A Mothers Darkness

  • Struggles and Snuggles

  • Another Close Call

  • Mommy Do You Love Me?

  • What Do They Need?

  • What Will You Remember?

  • Appreciating the Gift

  • On Rituals

  • Please Give Me Patience

  • You Can Do It but Can I?

The above are essays on issues related to recovery, personal growth, parenting and more. You may also want to pay a visit to some of the external links related to self-help listed below.

"There are two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle." Albert Einstein

next:Love tree

Some studies show that ginseng can improve mental functioning, but the science behind the claims is weak.

There are at least eleven different herbs labeled "ginseng". The most commonly used in herbal medicine are Panax ginseng (Asian or Korean ginseng) and Panax quinquefolius (American ginseng). Ginseng powder and extract are prepared from the roots of these perennial herbs. Standardized ginseng extract contains 4% ginsenosides, the primary active components of P. ginseng and P. quinquefolius.

Asian ginseng has been used for many years as a stimulant and a tonic for Qi deficiency, to treat gastrointestinal disorders (diarrhea, vomiting) and respiratory problems, to improve stamina, and to reduce the adverse effects of stress. Small doses are taken daily to ward off physical or mental impairment. Ginseng is widely used in the U.S. to increase energy and vitality, enhance physical performance, increase resistance to stress and improve immune function. Other uses include lowering blood sugar and treating male impotence.

Clinical Trials

A review of randomized, controlled trials evaluating ginseng for a number of uses (enhancement of physical and intellectual performance, stimulation of the immune system, treatment of type 2 diabetes and herpes infection) concluded that efficacy has not been established for any of these indications. Recently, a small study found that American ginseng taken 40 minutes before a meal decreases the post-meal rise in blood glucose in both nondiabetic patients and those with type 2 diabetes.

Adverse Effects

To date, serious adverse effects have not been reported with American ginseng. Side effects reported with Asian ginseng include insomnia, diarrhea and skin eruptions.

There is some evidence that both American and Asian ginseng may lower blood glucose levels. Until more data is available, ginseng products should be used with caution in patients with diabetes because the risk of hypoglycemia may be increased. Individuals with or without diabetes should probably take ginseng with meals. One case report suggests that ginseng may decrease the anticoagulant effect of warfarin (decrease the INR). One small study found no change in the INR, however, when patients stabilized on warfarin were given a two week course of ginseng. Two cases involving a possible interaction with phenelzine have been reported. One patient experienced headache and tremor and another developed mania. Further study is needed to establish the effectiveness of ginseng for any indication.

Quality & Labeling

Ginseng root varies in quality, with the highest quality being very expensive. Adulteration is common and significant variation can occur between the actual ginseng content in a product and the content stated on the label. In April and May 2000 an independent laboratory, ConsumerLab.com (see Resources inset page 5), evaluated the purity and potency of 22 brands of Asian and American ginseng products. Eight products contained excessive amounts of pesticides, two contained excessive lead, and seven had less than the minimum concentration of ginsenosides (2%). Only 10 products met or exceeded the claimed ginsenoside concentration on their labels.

Source: Rx Consultant newsletter article: Traditional Chinese Medicine The Western Use of Chinese Herbs by Paul C. Wong, PharmD, CGP and Ron Finley, RPh

next: Huperzine A for Treatment of Alzheimer's Disease

Article focuses on bipolar teens and school classroom issues, such as should you tell your school about your bipolar condition.

One of the many challenges a teen with bipolar disorder faces is attending school. The ways things are handled vary depending on the school you attend. In a public school, for example, teens are eligible for all sorts of assistance, from having an aide to assist with their ever-changing moods to having their schedules and classes tailored to their emotional needs. Private schools are only required to accommodate teens with bipolar disorder under the Americans with Disabilities Act, in which case the school has to accommodate any physical needs, like medications during school and side effects from such medications. The last kind of school is home schooling, where all accommodations and needs can be met. Teens with bipolar can succeed in any of these schooling environments. This article will focus on living day-to-day in the classroom with bipolar disorder, stable or unstable, what to do if you lose control of your emotions, how to set up a support network and the importance of doing so, along with other important topics.

First, should you tell the school about your bipolar condition? Yes, you should. Generally, this should be done before the school year starts. It is best to contact the guidance counselor, if available, or otherwise a principal, vice principal, or any other member of the administration.You should tell the school about your bipolar disorder and explain to them how it affects you in the classroom. At this discussion you should present any doctors' notes you have in regard to medication during school or accommodations needed due to medication side effects (such as needing access to water and bathrooms). Teachers should be notified before school starts about your bipolar disorder and how to handle things you were to lose control of your emotions (discussed below). Teens with bipolar need a support system or network, whether they are stable or not; these can be set up with the school rather easily. You should meet with your guidance counselor within the first few weeks of school. Talk with the counselor in general about how things are going and discuss any problems you may be having inside or outside of school. Ask if the school has a Student Assistance Program, as you should know who the teachers and staff on the team are. If the school doesn't have a Student Assistance Program, you should make yourself comfortable with teachers and staff. If there is a teacher you feel comfortable in confiding in, you should by all means discuss how you feel or any problems with that person. While with the guidance counselor, you should set up a plan in case emotions go awry in the classroom. An example of this would be if you put your head down on your desk in order to collect your thoughts. You shouldn't be given any trouble from the teacher for this. If you should feel you can longer stay in control of your emotions, you should be allowed to leave the classroom freely. No questions should be asked, as by this time your emotions are already stretched, and anything could set you off emotionally.

A safe spot should be established in the school, generally in the nurse's office. A safe spot is where a teen with bipolar disorder is allowed to go into a meltdown; also, efforts should be made to calm the teen down. The teen should be given the option of calling parents to talk and/or talk with a trusted adult in the building. Once the teen is calmed down, he or she should be given the option of returning to class. When returning to class, it should be at a time when the least amount attention be brought to the teen.

Having a meltdown or episode in class is one of the hardest and embarrassing things that can happen to a teen. Every measure should be taken so that you don't have an episode during class, but rather can leave the room in time without undue attention. However, if you do lose control of emotions during class time, you should quietly leave. If you are questioned by other students, you can just say that you didn't feel good and leave it at that. You should not feel obligated to tell your life story as to what happened, as most people simply won't understand.

These are just some suggestions and ideas for making life in high school easier for teens with bipolar. Some teens make it through high school without being affected much by their bipolar, while for other teens with bipolar disorder, high school may be four very long years. Arranging a good support network and making sure your teachers are aware of needed accommodations will help ease the way.

Important note: The above represents only the author's opinion. Each person must decide what is best for him or her.

next: Late-Life Bipolar Disorder Guidelines and Challenges
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It is always striking when a bright, attractive and otherwise accomplished person cannot maintain an intimate relationship. I have seen many people like this in my practice, and one of the first tasks is to figure out why. Most of the time the person appears in my office as the bewildered half of a distressed couple. Their spouse's/partner's complaints are legion: the offending partner doesn't listen, they're in their own world, they have little or no interest in sex, they prefer to be alone, they are unable to intuit or understand emotion. The spouse complains that the marriage consists of two people sharing the same living space, splitting chores.

The person's childhood usually provides clues to the problem. Sometimes, people tell terrible stories of abuse and neglect: in these cases one can easily understand why intimacy is avoided. But other times people depict a non-eventful childhood, devoid of conflict or even moments of common unhappiness. When pressed they remember few specific details positive or negative--and this is the rub. When their full story is revealed, it becomes clear the person dulled the abrasive experience of day to day family life by paying little attention. In doing so, they successfully pushed people away and retreated to the safety of their own inner world and preoccupations. This unconscious strategy reduced conflict and guaranteed their emotional survival.

Very often, such a person's parents never entered their world, except in a negative, critical, controlling, or otherwise unempathic way. Many parents were narcissistic: they were so intent upon maintaining their "voice", they completely overwhelmed their children's. As a result, the child retreated to a smaller, safer place where they could maintain agency and find some private satisfaction. Sheltered in this mini-world, the person experienced little shared pleasure and little disappointment.

As I have described in other essays on this site, often the child's unconscious adaptation to a dysfunctional family interferes with his or her adult relationships. This is certainly true for children who retreat. Because the real self is safely tucked away, the adult must "invent" a different one that will appear as normal as possible and be able to negotiate the day to day interactions of adult life. Invented selves, however, have no interest in true intimacy. Instead, they exist as a kind of interface between the true self and the outside world, carefully monitoring and controlling what is allowed in and out. As a result, passion and empathy have to be manufactured--while the person may take the time in the early/romantic phase of a relationship to "act" this out, many soon tire of the effort. Often partners notice the "wooden" nature of their response or their obliviousness. (A client once told me that her spouse [a software engineer] had sat in another couple's living room reading a book while the hosts were having a rip-roaring fight. She thought he was reading so as not to embarrass the couple. But when she asked him what he thought of the fight, he replied: "What fight?")

It is not unusual for these people to be particularly accomplished. They channel all of their energy toward a particular pursuit, and away from everything else that is happening around them. Computer related jobs are often ideal for these people, as are other tasks that require solitary focus and tremendous dedication to the exclusion of other life needs and demands. Workaholics often fit this category.

Can people like this be helped? Yes, but often long-term therapy is required. People who have built such walls jump at intellectual explanations of their problems, but this, by itself, does not help much. The relationship with the therapist is critical. Initially, the therapist is as much an outsider as anyone else and the client unconsciously tries to keep it that way. The therapist, using all his or her knowledge and skill, must chip away at the client's protective walls and gradually enter the client's hidden world in an empathic, benevolent way. This is hard work, for the walls are thick and whatever openings the therapist finds are quickly "patched." Ultimately, however, the therapist proves he or she is non-toxic and allowed inside. When this happens, the client discovers a shared world with potential for personal growth and intimacy.

About the author: Dr. Grossman is a clinical psychologist and author of the Voicelessness and Emotional Survival web site.

next: Why Do Some People Choose One Bad Relationship After Another?

A look at complementary treatments for Alzheimer's disease. Nutritional supplements, herbal medicine for Alzheimer's and the Alzheimer's diet.

Some people with Alzheimer's use alternative treatments-such as herbal remedies and natural dietary supplements-- though there is scant scientific evidence of their benefits. If you're considering any alternative treatments or want to advise a friend or loved one with Alzheimer's Disease on alternatives, it's a good idea to discuss your interest with a health care professional.

Here are some non-medication options for helping the patient with Alzheimer's Disease:

Treatment Strategy for Alzheimers

• Identify and address suspected underlying causes of Alzheimers.
• Use of dietary and nutritional strategies to improve cognitive function.
• Use of antioxidants to decrease oxidative damage.

Lifestyle for Alzheimers

• Use the mind: get adequate mental exercise.
• Institute a program of daily exercise which improves overall circulation and well-being.
• Stress management. Learn and utilize better coping skills.
• Avoidance of all known sources of aluminum including aluminum-containing antacids, aluminum-containing anti-perspirants, cooking in aluminum pots and pans, wrapping food with aluminum foil, and non-dairy creamers. Aluminum is also found in baking powder and table salt, as it is added to keep them from becoming lumpy.

Change the mood of the patient's home environment: he lighting in a house or apartment, colors in the decor and level of noise in the immediate living area can have a significant impact on how someone with AD behaves and feels. Researchers have found that certain types of lighting can make some people feel uneasy, while higher noise levels can induce frustration among others.

Create a routine and stay active: constructing a routine for everyday activities-including the basics such as dressing, bathing and cooking-can reduce depression and help keep a person with AD active longer. It may also reduce the chances of wandering because it is more likely the person will follow the daily routine of activities. Alzheimer's experts also recommend patients take up creative and pleasing activities that can bring more happiness into life, such as painting, reading or singing.

Alzheimers Diet

• Consume a diet rich in antioxidants with an emphasis on whole fruits, vegetables, grains, nuts, and seeds.
• Regularly consume of cold-water fish to increase essential fatty acid (EFA) levels. EFAs are fatty acids (also known as Omega 3 and Omega 6 fatty acids) which are essential to life, but which cannot be produced in the body and must be taken in through diet.
• A diet rich in magnesium is recommended. Aluminum absorption can be decreased by magnesium, because magnesium competes with aluminum for absorption, not only in the intestines but also at the blood-brain barrier. Focus on unprocessed foods, avoid milk and dairy products, and increase the consumption of vegetables, whole grains, nuts and seeds - all good sources of magnesium.

Nutritional Supplements for Alzheimers

Following is a comprehensive list of supplements that have been studied in the treatment of dementia or Alzheimer's disease. No person should take all of these supplements. It is essential to consult a physician trained in nutritional and botanical medicine to determine which supplements are most indicated and will be most effective for you, given your individual situation. They must also ascertain safe and effective doses for their use. Further, several of these supplements may interact with medications and should not be taken without medical supervision.

• High potency multiple vitamin and mineral supplement.
• Omega 3 fatty acids. Dietary intake of n-3 fatty acids and weekly consumption of fish may reduce the risk of Alzheimer disease.
• Vitamin E. In a prospective study, dietary vitamin E intake was associated with a reduced risk of Alzheimer's.
• Vitamin C. Vitamin C intake has been shown to decrease risk of AD.
• DHEA. DHEA administration may result in modest improvements in cognition and behavior.
• Taurine. In animal models supplementation increased acetylcholine levels in brain tissue.
• Acetyl-L-Carnitine (ALC). Effective in improving cognitive performance in patients suffering from Alzheimer's dementia.
• Phosphatidylserine (PS). Low levels of phosphatidylserine in the brain are associated with impaired mental function and depression in the elderly. Supplementation with PS consistently benefits memory, learning, concentration, word choice, and other measurable cognition parameters, as well as mood and the capacity to cope with stress. PS somehow encourages the regrowth of damaged nerve networks.
• Inositol. Supplementation with inositol may produce positive CNS effects in the treatment of AD.
• Thiamine has been shown to potentiate and mimic the effects of acetylcholine in the brain. High dose thiamine supplementation improves mental function in Alzheimer's disease and age-related impaired mental function (senility) without side-effects.
• Vitamin B12. Serum vitamin B12 levels are significantly low, and vitamin B12 deficiency is significantly common in Alzheimer's disease patients. Supplementation of B12 and/or folic acid may result in complete reversal in some patients (with documented low B12 levels), but generally there is little improvement in patients who have had Alzheimer's symptoms for greater than 6 months.
• Zinc. Zinc deficiency is one of the most common nutrient deficiencies in the elderly and has been suggested to be a major factor in the development of Alzheimer's disease. Zinc supplementation has good benefits in Alzheimer's disease.
• Coenzyme Q 10. Improves mitochondrial energy production.

Botanical (Herbal) Medicine for Alzheimers

• Ginkgo biloba extract (GBE). Improves circulation which can enhance memory and delay onset of Alzheimer's and other forms of dementia.
• Huperzine A. Derived from Hyperzia serrata (Club Moss). Acts as an acetylcholinesterase inhibitor, possibly more effectively than tacrine. Supplementation produced measurable improvements in memory, cognitive function, and behavioral factors in Alzheimer's patients with no significant side effects.
• Vinpocetine. Derived from Vinca minor (Periwinkle). Enhances brain circulation and oxygen utilization and other neuroprotective and anti-ischemic effects.
• Bacopa monnieri (Water hyssop, Brahmi). Enhances nerve impulse transmission and strengthens memory and cognition.

Supplement Quality Is Important

Nutritional and botanical supplements used in these treatments are intended to have a physiological effect and clinical benefit, i.e., they are effective and your health improves. The quality of nutritional supplements in the general marketplace is suspect. In order to get the maximum benefit to your health, be sure you purchase the highest quality nutritional supplements.

Source: Alzheimer's Association

next: Ginkgo Biloba For Treating Alzheimer's Disease

Chapter 79 of the book Self-Help Stuff That Works

by Adam Khan

HAVE YOU EVER WONDERED why your coworkers complain so much? Or why you find fault with people so easily? Or why you watch the news even though it's depressing? Why?

Our species evolved during the Ice Age (the Pleistocene epoch). In the last one or two million years, there have been four glaciations - four times when the ice advanced southward for a hundred thousand years or so, and then receded, changing the climate dramatically again and again. These ice invasions caused the extinction of many animals. But not humans. Our species lived through the harsh and radically-changing weather, famines, floods, fires, plagues, and the threat of deadly carnivorous animals walking around hungry. Lots of people died. Natural selection had a field day.

Let's speculate for a moment. During dangerous times, what kind of human do you suppose would evolve? Would a happy-go-lucky, everything-is-groovy attitude help one survive? I don't think so. Under those conditions, the best survivors would be those who compulsively noticed what was wrong and were constantly on the lookout for possible danger. In other words, conditions would have selected for a critical, negative, worry-wort. A relaxed, easygoing positive thinker probably wouldn't last one winter. Those people who survived are our ancestors, so those traits are built into our brains and hormonal systems. Even yours.

It is completely natural to notice what's wrong, what doesn't work, and what you don't like. It's somewhat unnatural to see what's good, what's going well, and what you like and appreciate. But it's also unnatural to be toilet-trained. It's unnatural to have good manners. It's unnatural to delay gratification. What comes naturally (like being negative) is not necessarily best. It might have been absolutely essential for survival a hundred thousand years ago, but times have changed.

Luckily, we are capable of doing things we don't naturally do - if we know it's in our best interest and if we firmly and definitely make up our minds to do so. One of the greatest talents of our species is that we're capable of doing what we don't naturally do.

You can learn to notice what's going well. It takes a deliberate, conscious effort. It'll probably never come naturally (that is, without thinking about it). No matter how many years you make that conscious effort, whenever you look around, chances are the first thing you'll see is what's wrong. And that's perfectly okay. It's useful to be able to see what needs fixing. But it also helps to notice the good stuff.

Today, deliberately notice something you like about the company you work for and tell somebody. Then take a good look at your coworkers and find something you honestly appreciate about someone and tell that person you appreciate it. Then talk about someone behind her back - talk about what you admire and respect about her. Make this effort a couple of times a day and your relationships will work better. You'll also be in a good mood more often.

Set a goal at the beginning of the day. How many sincere acknowledgments will you give today? Don't make your goal too big - you have work to do too. But create some way of keeping track. For example, you could put five pennies in your left pocket and every time you make a good acknowledgment, move one penny to your right pocket. Try to move all of them that day.

Make a regular practice of this and the atmosphere where you work will change. The people around you will feel more noticed and appreciated and liked. And they will treat you with more appreciation in return. All you need to do is commit some unnatural acts.

Does it bother you that some people where you work complain all the time? Do you wonder what you can do about it? Check this out:
Complaint Compunctions

Would you like to learn more about the fine art of positive thinking? Would you like to behold the power of positive thinking? How about the power of anti-negative thinking? Check this out:
Positive Thinking: The Next Generation

No matter what happens, you can determine your disposition by an act of will. Consider the fact that, no matter what the circumstances,
Maybe it's Good

Dale Carnegie, who wrote the famous book How to Win Friends and Influence People, left a chapter out of his book. Find out what he meant to say but didn't about people you cannot win over:
The Bad Apples

An extremely important thing to keep in mind is that judging people will harm you. Learn here how to prevent yourself from making this all-too-human mistake:
Here Comes the Judge

The art of controlling the meanings you're making is an important skill to master. It will literally determine the quality of your life.
Read more about it in:
Master the Art of Making Meaning

Here's a profound and life-changing way to gain the respect and the trust of others:
As Good As Gold

What if you already knew you ought to change and in what way? And what if that insight has made no difference so far? Here's how to make your insights make a difference:
From Hope to Change

next: The Shortest Distance