Showing posts with label character. Show all posts
Showing posts with label character. Show all posts

Tuesday, September 8, 2015

Pathological Jealousy

Jealousy is the anxiety that your friend or partner is closer to someone else than they are to you. It can come from having an inferiority complex oneself and not quite believing that anyone would want you over another.  Jealousy is usually related to time.  A person thinks that the other gives more time to someone else or even something.

"He puts more time into his sports shows, that he spends with me."

"She'd rather shop, that be with me."

"I think she likes my brother better than me."

The worst cases of pathological jealousy I have seen have been with alcoholism.  They're a subset of "paranoid disorder."  The paranoid disorder is the fear based trait of 'I and them" with them against me.  More commonly the highly attuned 'defensive' posture results in 'first strike thinking', what psychiatrists call "projection'.

" It's an eat or be eaten world.  Survival of the fittest.  (Psychopathic Lizard Like reasoning or  Sociopathic - wolf like thinking)....I'm afraid of anything different and unlike me.....  I don't know this. but I kill or destroy anything that is not me and not mine.   Everyone thinks like I do.  So they're thinking like me so I must destroy them before they destroy me. That's what I'd do."

"First Strike - 'defensive' thinking".

So with pathological jealousy the person who is jealous is really thinking I'd commit adultery so they must be thinking like I do so they're probably committing adultery.  Or they're going to leave me or they've going to steal from me.

I have seen a few cases of pathological jealousy with brain injury but that is uncommon where as pathological jealousy is common with alcoholism. I've seen it also with marijuana and cocaine.  So drug addiction and pathological jealousy run together.

I would hypothesize that addiction is associated with an "inferiority complex". A person with addiction is a slave to something outside themselves, the drug of choice, and therefore they see others as superior.  Self Pity is so common with addiction.  Therefore if the other person is superior then "if I was superior I'd take advantage of the other so they must be doing the same as me.'

Note that people who think others think like they do cannot imagine a higher level of cooperative relationship and hence live in the base 'eat or be eaten' 'paranoid' 'jungle ' reality.

Jealousy has always been an issue in human society, such that the  Biblical 10 commandments contain a clause, 'Thou shalt not covet thy neighbours (whatever) !".  Covetting is that fundamental.

Jealousy, "I want what you have' can be seen in the flip side as distorted admiration, "I want what you have' therefore I'll get a job and work and achieve what you have.  The thing about character traits is that they have a positive and negative pole.  Truthfullness without compassion can well be  cruel.

So jealousy is common and at low level experience not a concern. It's deemed pathological when the jealousy state is consuming and harmful to oneself or others.  Many a marriage has been destroyed by the delusional pathological jealousy of alcoholism and addiction.  Many a drug addicted alcoholic tyrant has lead his people to war because he covets what his neighbour has.  Jealous is destructive.

Pathological jealousy is combined with controlling behaviour.  Sociopathic or psychopathic "pimps' are commonly violently pathologicallly jealous and , tragically, the prostitutes, usually emotionally immature,  commonly interpret this as 'caring'.  Thirteen year olds are commonly learning to deal with jealousy in early adolescence. When it carries over to adulthood it's clearly evidence of a more deep seated developmental delay.

Obviously if the cause is alcoholism or addiction then the solution is stopping the alcohol or drug that is causing the brain damage which is showing as this particular form of paranoid state. In time when the chronic damage is stopped the healing can occur.  I have seen Pathological Jealousy caused by alcoholism disappear in months to a couple of years when abstinence is achieved.  I've not seen it resolve with any 'harm reduction' techniques.

Antipsychotic medications are the treatment of choice, often having major positive effect  in low dose.  Examples are seroquel (quetiapine) 25 mg three times a day, Abilify (aripiprazole) 2 to 5 mg a day, loxapine 10 to 50 mg a day, rispridone .25 mg three times a day.  The medication is titrated up against the persistence of the symptons.  Often too the antipsychotic is combined with an antidepresant such as prozac (fluoxetine) 20 mg or mirtazepine 30 mg,

Psychotherapy is aimed at first and foremost 'reality testing'.  Patients who are paranoid see psychotherapists as there, primarily to 'hear' their insaneity. Privately paid psychologists and counsellors make a fortune off paranoids as they support and agree with their delusions and listen to their insane schemes.  Unfortunately these therapists are sociopaths themselves and by doing this 'listening' and 'supportive' therapy entrench the paranoia.'

"Yes, Adolf Hitler, I feel how the Jews are so disturbing to you that you must gas them on mass. That must be so difficult. Tell me more about your feelings."

Freud's famous 'Ratman' psychoanalysis case of  shows just how difficult therapy is with paranoids. Freud, the great master, certainly had his work cut out with him there.

Alcoholics and addicts love to spend fortunes on psychiatrists, psychologists and counsellors with their own unresolved sociopathic and paranoid traits.  These poor examples of therapists collude with patholigically jealous ad infinitum.  They never "reality test' and they never set deadlines to change their drinking and drugging behaviour.  They're rich agreeable 'mommy loves you always' therapists who should be limitted to the adult equivalent of 'well baby care'.

Once you 'limit set' in therapy you separate the children therapists from the adults.  Positive transference is what all the untrained want to have.  Transference is the collective feelings of the patient to the therapists.  If you see a paranoid long enough or confront them by 'limit setting' then you will encounter 'negative transference'.   Usually they will be "fire you' and bad mouth you to everyone else,  They are the bread and butter of complaint organizations.  They complain to the authorities with delusional material all because you've told them to 'stop drinking' and that their 'marijuana' is the reason they think their wife is cheating on them.  You've sided with 'them' , their evil ex or their unloving partner. The paranoid patients want to use therapy to 'build a case'. Rich sociopathic children therapists want their money and see them till they turn then they 'fire' the patient.

"She put on lipstick and that proves that she has a boyfriend."

"Did she never where lipstick before."

"No she has always worn lipstick but the way she puts it on now is different."

Ugly is in the eye of the beholder.  The paranoid will take any detail and twist it to prove their insaniety.

"She cooked me my favourite dish because I know she thinks I'm onto her sleeping around."

Limit setting therapy can include things like

"Let's talk 5 minutes about your suspicions' and then I'd like to hear more about what you're doing about your alcoholism.  Or I'd like you to tell me why you think your mother loved your sister more....etc..etc. "

The point is that the therapy isn't 'controlled' by the insane person but rather that the therapist 'reality tests'.

"What you have shared with me could be concerning if I first believe that your husband was having an affair, but a court  would call all this 'circumstantial evidence.  Indeed as we know that 'pathological jealousy' is caused by alcoholism the best proof you could present that your husband is
having an affair is for you to stop drinking. I know when you tried to stop before that you couldn't stay stopped so what about going to AA or entering a treatment centre to deal with this. "

"This all must be very disturbing and anxiety provoking.  This medication rispiridone .25 mg might well be very helpful."

Building a therapeutic alliance with a paranoid may require one to avoid 'confronting' the delusion and listening at first but the question then is how long.  How many sessions of 'listening' and being 'aggreeable' is 'collusion' and 'money making' or actually therapeutic with a goal of recovery.

Some senior therapists believe that junior therapists should have a supervisor when they are doing therapy with the pathologically jealous or paranoids in general.  Freud found the Ratman very difficult.  These are not easy cases.


Wednesday, September 17, 2014

Seventh Step Prayer

I enjoyed reading in Richard Rohr's "Breathing Underwater" that it was unlikely that a person, who was being rewarded materially and fully engaged in a superficial life with all the positive experiences of early attachment to that which can become addicting, would look deeper.  This is why youth seem clever but appear to lack wisdom which comes more slowly with maturity.  The 'education' process gives a great deal of 'intellectual' material which is most helpful and not really 'questioned' until there is a 'reversal' or 'set back'. 
I've prayed and meditated all of my life.  I was raised Christian and the prayer traditional was a central part of my childhood and youth. Later as a student of Paramahansa Yogananda I studied meditation and meditated.  Later in analytic work and philosophy I questioned my own 'ideas', thoughts and 'counter transference'.  The whole issue of personality and character were part of my training in psychiatry. 

The Seventh Step Prayer found in the literature of Alcoholics Anonymous addresses the issue of 'character'.  Television has superficial personalities but 'character' is a deeper developmental process with much of the basis laid down by the end of youth.  Habitual ways of relating to the world and other individuals are found in the depth of character assessment.  In diseases of addiction there are certain ways of thinking and relating which serve to perpetrate the alcoholism.

In contrast to what every alcoholic tends to think, that is "if you had my problems, you'd drink too', the journey of self discovery through the Steps of Alcoholics Anonymous reframes this into the truer form which goes "If you create problems like I do, you must drink too", or "If you didn't create the problems I do, you wouldn't have an excuse to drink".

The Seventh Step Prayer goes as follows:

"My Creator, I am now willing that you should have all of me, good and bad. I pray that you now remove from me every single defect of character which stands in the way of my usefulness to you and my fellows.  Grant me strength, as I go out from here to do your bidding.Amen".

A fine prayer for me.  Under duress when life is not 'running' as smoothly as I feel it should I'm glad today to look under the hood and see if I can improve things by changing filters and tweaking matters a mite. (or more).  

Wednesday, March 14, 2012

Narcissism

Narcissism is a psychiatric term referring excessive self interest. It's been equated with terms such as egoism, vanity, self conceit, and selfishness. Developmentally it is considered a normal stage in early childhood. It is thought that a baby simply focuses on itself and it's self interest at the earliest developmental stages.  Narcissists as adults have also been called 'King Baby".  or "Queen Baby".  Developmentally the journey of a person is seen as moving from excessive self interest to health interest in others.  The golden rule is 'do unto others as you would have them do unto you'.   Also spiritually the second greatest command of the Bible after Love God was "Love your neighbour as yourself."  Abnormal love of self is narcissism named after the Greek boy who drowned from falling in love with his mirror image in the lake. Altruism the opposite of narcissism is considered a healthy coping strategy and evidence of psychological maturity.  In lay language, a narcissist is a 'taker' .
Narcissism is an excessive trait in sociopaths and psychopaths and anti social personality disorders.  It is common and transitory in mood disorders in general but more prominent in Bipolar Mood Disorders.  People who suffer from Mania act and appear very Narcissistic.
Drug addiction and alcoholism are commonly associated with narcissism.  Social skills are commonly lost in addiction and people only care about themselves and getting their drugs.
Empathy is a mature depth of relation which a person can have with another. Narcissists commonly lack the capacity for empathy. Empathy is different from sympathy which is more superficial and less connecting.
Narcissism in general is equated with emotional immaturity and spiritual immaturity.  However, narcissists can be very smart and clever though they would not be wise.

Sunday, July 10, 2011

I am a Christian

I am a Christian. I am not the enemy.  I am concerned that I am portrayed as such by people whose animosity, intolerance and arrogance frankly concern me.  I was raised Christian in a Christian community, in a Christian country.  I believe in a loving God. I believe God cares for all of us as the sun shines on all.  I believe that Jesus was the son of God.  I believe 'son' of God doesn't mean God, the father, Hugh Heffner'd Mary Angelina Oprah Jolie Kidnman.  I believe that the Bible is a Holy Book with many layers of understanding. I believe that Jesus as son of God describes the relationship of transcendent God and imminent God.  I believe that Jesus taught us to Love God and Love Our Neighbour as Ourself. I believe that much of the teaching of Jesus Christ has been interpreted by man but that the Holy Spirit, the unseen hand of God guides these interpretations.  I believe that the work of God is unfolding in history.
I believe that the world of religion is evolving. Child sacrifice was a part of Jewish religion at the time of Abraham. It is still a part of many religions and acceptable to much of the secular world though this is often not admitted, just as slavery is often a part of other religions and the secular world but it goes under another name.  Child sacrifice in the Bible story of Abraham was rejected  though self sacrifice and the choice of a spiritual end instead of an immediate material end is something believers don't themselves see as 'sacrifice' per se.  I believe that doing one's duty and fullfilling one's obligations and being the best person one can be are more important than bestial temporal pleasure.  I like bestial temporal pleasure but I know that a one night stand sexually is not the in the ball park compared to a loving sexual relationship with time to explore in safety and security the great potential of relationship personally and sexually between consenting adults.  I believe that there is a scale and that much of greatest value comes at greatest cost while so much of value is found in utter simplicity.  Poverty of a monk is a blessing whereas poverty of a refugee is a curse.
I believe that the Bible is the history of God's unfolding plan to Jews and Gentile.  I believe that God is first and I'm second.  I believe that I am a creature and that God is Creator.  I believe that much of the law of the old testament and more importantly the new testament are laws for mankind that serve best because they represent the learning and revelation of generations.  I believe that much of the teaching of the old testament is historic and that it can only be understood today as metaphoric. The terrible teachings of Deuteronomy were kind in their day. The teaching of an 'eye for an eye' was 'merciful' when I could in the day enact a slaughter of your family and community for you hurting my pig.  Early laws limitted the 'retaliation' often of the powerful. The new testament and teaching of Jesus was a lesson of love that went beyond the local and embraced the divine. Much of the teaching of Jesus can be found in disparate religions, obviously, the love lessons of the Moslem, but also in the teaching of the Buddhists and the Hindus..
I believe that Jesus's teaching was universal but that he was speaking locally and that his teachings were understood by fine men, but limitted men, like Peter and Paul who themselves disagreed on what Jesus and therefore God wanted. Jesus was God's mouthpiece and I believe God acts through humans. I believe also, in the celtic, and scientific wisdom that God's manifestation is not only through the Bible, through religious tradtion and the history of man but also through nature and the revelation of science. I believe that DNA tells us of God. I believe that String Theory speaks of God. I believe that holographs speak of God.  I believe Fractuals speak of God. I believe that the whole of creation sings God's existence.  I believe that pseudoscience is not science. Much that has been presented as 'science' by media is not 'science' but 'scientism'. I believe 'scientism' is a very silly religion.
I believe in 'do unto others as you would have them do unto you'. I believe this is the golden law and it's found in Christianity but also in almost all religions of of the world.
I believe that some religions and some people still believe that they can 'win' for themselves without consideration of others."  This was considered 'gnosticism', a secret religion only for the special initiates who gained power over others by their arcane knowlege. I believe that the teaching of Jesus was exactly opposite to this idea of gaining power over others.   I believe that Jesus taught that we are to serve and that the 'big baby' or the 'bullies' aren't closest to God because they don't grasp that they have their 'reward' in the external world and that rewards in the internal world are of a different kind than the 'consumer mind' can grasp.
I am saddened that some idiots are chosen by media for media's purposes to 'represent' Christianity.  Christianity is millions of people with as many individual ideas about what it is to be Christian. The Creeds are the way to understanding what Christians have agreed is Christianity. These ideas are developing over time just as 'papal declarations have changed through the ages." Our understanding is growing.  Individuals and individual churches are often not representative of the whole. This isn't a bad reflection on them but media commonly likes to 'quote' individuals and churches out of context for it's own religion of 'sensationalism'.  The mainstream is as liberal and inclusive as the requirements of most nations in the world. Nations today war and there is much that is required of 'citizens' of nations that is not appealing when separated out from the whole. There are many 'laws' on the books and judges make horrendous errors as have Kings and Queens and Presidents and Prime Ministers. The errors of the media can be seen easily in a quick glance at the men and women they have celebrated over the years.  Jesus never said that Hitler was a good man but much of the world's media and most of the secular authorities supported him as they have most tyrants.  Human's are prone to error.  It's work not to.  We are easily lead astray , easily duped, and are often unprepared for the facts of life.
Being a Christian is being a member of a community that seeks to know God and God's will for us.  As Christians we believe that individually and collectively we are moving forward with a direction from what we call 'old Jerusalem' to a 'new Jerusalem".  There are many ideas about this. To date there has never been agreement in the Christian community at large as to the exact meaning of Revelations.
I have said that Christianity is too important to leave to fools.  I have said that we all must participate in our institutions. The idea that 'voting only encourages them' is false.  We lose if we let fools and bullies rule our political world and our religious world.  The church as changed often over the years but the essence of Christianity has flourished for thousands of years.
As a Christian I pray.  I read my Bible. I attend a church and talk with other Christians about  ideas, beliefs and behaviour.  I like the song by Crosby, Stills, Nash and young, that goes 'those who are on the road, must have a code, that they can live by.' I believe Christianity is that code.  I believe that there are many codes and that together we much compare and correlate our different codes. I am highly suspicious of people who claim not to have a code and especially those who would question my 'code' while claiming they don't have one.  I believe we all have codes and that we need to understand what our own code is.   I am a Christian but while I know the laws I personally may only be as good at following the laws as the average judge or lawyer is at being a 'law abiding citizen'.
I am very concerned that there are those who claim to be 'liberal' and claim to 'represent free speech' and 'freedom of religion' but only pay lip service to these ideas.  It is within the Christian community that 'freedom of religion' and 'freedom of speech' came to fullest light.  I see them and many core values of community and caring for others, especially those not like ourselves, and those less fortunate being lost with the concerted attack on Christianity and God and the very idea of an inner world joined and collectively calling for better conduct in the external world of manifestation.
I am a Christian.

Saturday, July 2, 2011

The Apparent Prosperity of Evil

Psalm 73 speaks to the apparent prosperity of Evil.  If God is good and just, then there should be no favouritism. Yet we look about and it seems clearly that there are those who prosper yet do 'evil' things.  Rather than loving their 'neighbour', they are cruel.  They hoard while others go without.  They kill for profit and without consideration of spiritual laws.
Then there are those who are so righteous and loving and caring of others but are poor and unhealthy.  The "health and wealth' spiritual movement would have us believe that the outward manifestation of wealth and health speak to the inner well being. Health and wealth can coexist with spiritual advancement  but obviously tyrants and criminals can have apparent health and wealth without any spiritual advancement whatsoever.
If a person "believes" he too can have wealth and health, this pretty pleasant shallow promise claims without consideration of Jesus's death on the cross and the high cost paid by the early disciples for the depth of their belief.  Apparently no one gets to heaven without scars, because  come from believing in something and standing up for it. When one stands up for good, one makes themselves a target.
There are those with wealth and health who do not believe in God and do not hold God as central in their lives. Instead they're actually against God and have ungodly lives.  Some in organized crime as depicted in the media come to mind.  Some corrupt politicians and beaurocrats also come to mind.  Certainly CEO's and Boards of Directors of companies that have dumped dangerous drugs in third world countries or covered up the dangers of products for profits are at the top of the list.  Those whose sins are 'sins of commission' like Hitler are no different from those whose sins are 'sins of omission" like Eva Braun.  Cigarette producers and their families, and the lawyers and judges who work for them, come to mind.   Abortionists for hire and profit are also in the list.  They put 'money' and the God of Mammon before the God of Love.  They seem at times to have greater wealth.  Also the rich by any means can buy heart transplants, kidney transplants and medications that the poor cannot afford thereby having a standard of health that surpasses others.  Gordon Lightfoot's song Don Quixote does a good job of pointing the finger at those who that great Spanish knight would find unworthy of the company of his Dulcinea.
The psalmist is equally and more eloquently angered.  He cries, "For I envied the arrogant when I saw the prosperity of the wicked."
But then he says that he saw also that in time those who do evil get their own according to the law of 'karma' and retribution.  Almost all religions teach 'do unto others as you would have them do unto you.'  Clearly, murderers are missing the mark on this one and thieves profit only in the short run by their trade.  The idea of 'hell' and 'afterlife' has served to address this apparent 'disparity'.  But Marx said "religion was the opiate of the masses' because as a Jewish aetheist he rejected the God of Abraham and Jacob.  The communist product of his philosophy is apparent today with massive failures of those systems founded on the reactionary division of the world into beaugeosie and proletariat only to be followed by the revolutionary 'necessity' of 'dictatorship of the proletariat.'
Yet this is not the only argument that the psalmist puts forward.  Indeed, he goes on to say "How suddenly they are destroyed, completely swept away by terrors."  Faith and trust in God and seeking the Holy brings immediately benefit in this life, peace of mind.  My own experience with the powerful, rich, arrogant criminals is at variance with my experience of the powerful, rich, and humble servants of God.  One is snake like in their behaviour, eyes darting, rapacious while the other has 'peace of mind'.
The key is love and fear.  The more I love God the more I am at one with Love.  Jesus spoke of God the Father, as Abba, papa, daddy.  The more of a musician I am the more music I can appreciate. The better a marksmen the better I can appreciate shooting.  In all cultures there is an appreciation of the refinements of skills yet to what end is that skill used is the issue of morality.  Nuclear energy can be used to light the world or destroy it.  The same truth is heard in the statement,  'guns don't kill people, people kill people'.  The problem isn't in the 'tools', but rather how they are used.
Evil isn't intrinsic but a product of choices we make. I am a child of God, hence I have the capacity to make Godly choices, however if I choose wrongly and selfishly then I increase my distance from God and my eventual alienation.  There are spiritual laws of right and wrong.  Those laws go to the essence of Love God and Love your neighbour as yourself.  The 'relationships' one has with self and others and this world are either loving or fearful.  Fear is the basis of hate.  Alienation is the sense of being alone and persecuted. From that place comes the idea that "offence is the best defence".  It's the 'separation' from others, the tribalism of the soul. It is a really sad and lonely state of darkness.
Movement towards God is movement towards love and peace and laughter.  The psalmist writes "When my heart was grieved and my spirit embittered I was senseless, and ignorant. I was a brute beast before you".
The psalmist recognises that the state of Godliness is a distinctively different state than that of the devolved brute.  Darwin is entertaining in some aspects but the worship of Darwin leads to the appreciation of what the psalmist is saying, the monkey can be dressed in fine clothes, live in a fine house and eat fine food but he will just be a monkey. He will be a dressed up pig, a 'rude beast'.
The psychopath is likened to a 'lizard' having the capacity to acquire (consume),  protect (fear), reproduce (like a pac man).  The CEO's of tobacco companies are such simple programs as are those who profit from drug pushing, selling war, and slavery.
The quality of a psychopath and lizard is that they can 'chameleon'. They can 'act' like they 'appreciate art' . They can 'fit in' . They are Phillistines. They are able to be toilet trained and to actually present to their own children their husbands and wives as 'people'.  Yet in the delightful movie 'Little Big Man', these are not 'people' because they waste and are infantile in their seeking of their own desires at whatever cost to others.  They lack kindness.
The psalmist concludes "Whom have I in heaven but you, and earth has nothing I desire besides you."  The realization of God and the coming into the possibility of kindness and humanity, the reaching for the true humanity of 'loving my enemy', 'doing unto all others as I would have them do until me', having trust and faith in the rightness of God, all of this comes with greater appreciation and insight and understanding. It's likened sensually to gaining 'sight' when before I was blind.  "I was blind, but now I see," the famous hymn is sung.  All the senses of the angry, fearful, covetous, ard murderous are muted senses. Indeed the psalmist describes them as 'senseless'.  They don't have 'colours' in their black and white world and indeed like the drug addicted or alcoholic live in their own fantasies rather than reality.  They can't appreciate a sunset because they're looking over their backs at who of their friends will 'do unto them as they have done unto others'.  When you 'steal' you enter a world of thieves and what you have is no longer 'safe' even with your friends. Murderers fear murder daily.
Hell isn't then a place we go to but a place here and now we can be in.  This is the experience of psychiatrists who treat  psychopaths and sociopaths.  Psychopaths and sociopaths can lack empathy and compassion and all that is so much more.  Scott Peck has written of this "evil" in his remarkable book, People of the Lie.  Robert Hare has written about the same in his book, "Snakes in Suits".
In the end the psalmist writes, "as for me, it is good to be near God".

Thursday, December 9, 2010

Psychological Regression

It is extremely common to encounter psychological regression in therapy. It's so common that it is often readily apparent in observing friends and co workers over time.
What is meant by psychological regression is that a person reverts to an earlier developmental behaviour in face of new challenge or under stress.
Psychological regression is commonly noted where trauma has been significant.
Probably the most common today though not always so is the psychological regression seen in men and women who have been sexually abused.
Watching the behaviour and interaction of a 40 yo you might say, they are behaving more like people who are in their 20's. Alternatively a 25 yo might be said to be sounding and acting like an 13 year old.
Indeed diagnostically there's often a behavioral 'tell' which is a fixation that occurred around the time of trauma. I usually pick this up in 'tonal' shifts or use of language and in the inappropriate laughter which would be alright if the person were the stated age but really 'fits' better with a much 'younger' person. It's downright eerie at times and often comes across as 'fake' because of the inherent falseness.
Trauma is commonly associated with dissociation. While most people think of war and violent rape when they think of trauma, it's well recognized that to the growing immature individual a lot of experiences, clearly not in the league of front line war or physically violent rape by strangers, but nonetheless traumatizing to the undeveloped individual do occur. These are what constitute the inclusion criteria for Post Traumatic Stress Disorder, near death experiences, experiences of crippling or threatened crippling, significant sexual abuse, but also death of a parent, divorce of parents, multiple moves in childhood, serious childhood illness. Much of the psychological impact of the trauma is a product of the age of exposure. A 5 year old sexually penetrated will have far more likelihood of psychological regressive phenomena than a 17 year old sexually penetrated in an 'unwanted' sexual experience. Similar divorce is perceived by a 7 year old very differently from a 20 year old. Age and experience tend to protect so that the 19 year soldier shooting a child by mistake is more likely to develop ptsd than a battle hardened 40 year old sergeant who has been through many campaigns.
Multiple personality disorder is a direct consequence of trauma and most commonly associated with early childhood sexual abuse. This level of regression, often a childlike character in the midst of many other separate characters, is the most extreme.
Regression is seen in lesser degrees but is a part of the dissociative process.
Trauma leads to a person having a 'split' reaction to reality, feeling like they're struggling with two or more people inside. Having internal dialogues where they feel others wouldn't be so divided.
Alcohol and drugs are so commonly associated with trauma that regression is the norm the worse the disease. Indeed dissociation is considered psychologically to be the fundamental process in just addiction without trauma, the drug and alcohol abuse being it's own trauma as it subjects the brain to what biologically is a full blown chemical assault.
What I notice in therapy is a 'baby like' quality or 'innocent' quality in a person mature enough to be less naive. They also commonly are insensitive and indifferent to the really caring people about them. Their choice of friends is often poor and while this is associated with with the shame that is associated with alot of trauma, the fact remains that they commonly seek advice from those who have a limited experience. They commonly look for agreement and react sometimes violently in that adolescent and pre adolescent way to any wise or mature advice.
When men return from war the dissociation and regression is seen in their return to adolescent male activities, excessive drinking, drug abuse, playing games, lacking interest in commitment or work and generally childlike behaviour. This is a feature commonly understood when the inner workings of Post Traumatic Stress Disorder are recognized.
A very big problem is an individuals lack of commitment to the present and future, living in past failures and believing that the past will recur in the future. Rather than try they perpetuate the false belief by self destructive tendencies and trying to prove their negative world view while blaming everything on the outside world because they're experiencing themselves and others from a regressed childlike position.
The work of analytic psychiatry developed an understanding of the unconscious process that a person was being controlled by and explained much of the background noise that to those close to a traumatized person was just plain 'irritating'.
One can imagine reading Freud and Jung's histories of some of their early patients, especially one famously sexually traumatized woman, those around her, would just say "grow up". Yet as those famous analysts showed she was afraid of life itself and ran from the present and the future by regressing to the pre trauma levels so that she acted silly and like a baby at times. Indeed to the external observer the patient was ridiculous, phony and immature but seen through the analytic lens the doctors recognised that she was dealing with the unresolved effects of trauma.
In a true history of the war, well represented in the movie Patton, the general is haranguing a shell shock soldier who is literally regressed to infancy, almost sucking his thumb as a result of war exposure. The general harangues him and abuses him such that subsequent official complaints almost lost Patton his generalship. Wiser minds than his understood the effects of trauma. Indeed it was in WWII building on the horrendous experience of WWI that it was recognized that 'everyone' had a breaking point in war and all (including General Patton) would collapse and regress and dissociate if they were exposed to (I believe 40 days and nights was the rough number) of days and nights of actual assault and threat. Ancients knew this and it was the basis of many defeats that followed long sieges. Trauma with it's tendency to nightmares damaged sleep and interfered with other reparative psychologic and physical processes.
Judith Herman, director of the Harvard University Trauma center, is a leading authority and her book Trauma and Recovery remains a classic decades after it's writing.
Regression has been seen as a 'generational' response and indeed some questionable elders wrote off the 60's hippy era as a collective psychological regression of young adults who had come through a cold war and now were threatened with conscription in the Vietnam war as the western world feared the expansion of that war to WWIII.
First Nation elders in Canada saw that their young were commonly psychologically regressed and unable to maintain commitments and marriages with more often than not the grandparents caring for the children because of the effects of residential school system sexual abuse on the community. Increasingly these young adults however as the community heals and returning to the normative and health producing, community building roles of child raising, work and longer stable relationships.
This is especially true in the AA and NA communities where drugs and alcohol and trauma were associated with the immaturity recognized by psychological studies as far back as the 30's. In recovery the flip side of the irresponsibility is the joy people take in the privilege of parenting and work. As one fellow said, "I'm thankful I can pay taxes today."
Indeed the move from narcissism to altruism is often seen as the key evidence of recovery from trauma. The person traumatized is often in survival mode and regressed to a self centered child but when she or he makes that critical decision the change occurs and the person begins really considering how their actions affect others, putting children first, or caring for old people, asking what benefit an action will have in the short term and long term rather than just thinking of the one night stand or the party.
What is so sad is that the 'regression' is so obvious to the adults in the community around the person. However only when the person is ready to give up the temporary and destructive false self soothing that comes with the almost masturbatory quality of the regression is there any hope of growth and recovery. This movement towards health is commonly seen when the adult turns to those more experienced, recovered alcoholics or addicts for instance, soldiers who have been to war had ptsd but got on with it, sexually abused therapists who have left the subsequent gender wars to go on and have successful marriages and raising children so they can talk seriously about recovery firsthand as well as from books, and seeing the elders of the community, the old people, those old elephants as it were who look like shit but have indeed been there, done, that and got the tshirt and ball cap to prove it. Sometimes the latter individuals are physicians, psychiatrists, priests and ministers. Sometimes they are not.
The key though is when the regressed individuals ask and follow advise from those more experienced rather than childishly wallowing in their own shit, making more muck and being what kids today call these men and women, "drama queens".
Indeed modern psychaitrisy, especially the work that has come from the pure laboratory of war zones, indicates that the longer the person is 'stuck' the more long term potential for growth is lost. Being 'stuck' in the past, living in the safety of the masturbatory " I'm alright, you're not" world, since alone and with those who agree with me " I'm right, you're not," is a nice safe suckling sort of zone. It's like people with elevator phobia. As long as they avoid elevators they're fine. But the longer they avoid , the sicker they become and the more difficult it is for them to get back on the elevator.
This was seen in the political gender wars of the 60's and 70's with the girls lining up on one side of the room in angry feminist camps while the boys lined up on the other side in indifferent playboy camps. One was in the classic tempertantrum regressive mode while the other was in the equally classic regressive pout mode. In the 80's and 90's the Sex in the City 'role reversal' occurred with the playgirls and the angry househusbands. This mirrored the political world of left and right before the real movement to the so called 'third corner' positions.
Without getting into the historic developments in modern and post modern psychiatry, group and marriage therapies or the developments in political science which is beyond the scope of a regression discussion, it's just worth considering the equivalent terms from other areas such as 'devolution' and "reactionary" and 'luddism."
Sometimes the regression is so obvious, the behaviour so plain that I find myself as a therapist listening to a 30 year old and asking "were you traumatized" at 5 or 6 and seeing them do that "how did you know' thing. Similiarly I ask the 50 yo 'playboy', were you in the Vietnam war and he tells me he was. It's not rocket science. It's just obvious when a person isn't acting their age but it's also true that no one who has ever really been there can 'snap out of it'. It's just that the sooner they do the sooner they get help and heal.




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Wednesday, December 1, 2010

Suicide is an Autoimmune Disease

The title of this article is, "Suicide is an autoimmune disease". In truth I can't say for sure if 'Suicide' is a disease or the principal symptom of the underlying auto immune disease. What is imminently clear is that is an autoimmune phenomena.
It is seen in a wide variety of mental illness and mental illness associated with physical illness. Suicide has been reported with Thought Disorders like Schizophrenia, Addictive Disorders like Alcoholism, Mood Disorders, both unipolar and bipolar, personality disorders, especially borderline and sometimes in adjustment disorders.
What is clear is that it is not conceptualized as an autoimmune disease phenomena in general yet it is imminently clear that it is highly consistent with autoimmune phenomena seen in genetic and acquired immune disorder.
To this end I would propose that psychological, sociological and especially pharmacalogical therapies be developed along these lines. With respect to the latter there has been use of prednisone in the treatment of mental illness but not specifically looking at suicidal behaviour, thought and speech. Certainly the increasing variety of medications used in the treatment of autoimmune disease warrant a trial of therapy along the lines of Star D trials as adjunctive medications in relationship to suicidally as it arises in mental illness.


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Friday, September 10, 2010

Noblesse Oblige

Noblesse Oblige was the doctrine that the nobility owed an equal duty to their underlings as those owed to them. It was recently well portrayed in the film of Tolstoy. The theology of medieval days intrinsically interconnected leadership and followers in earth metaphors. One of the oldest of these was Sun and Moon with the eclipse representing a variety of interactions. Metaphors of family and reproduction dominated hunting gatherer societies and agricultural societies.

Today we're said to be in post modern times. The modern world was dominated by the machine with the metaphor of the 'clock' and it's various interconnected but obviously loveless parts. Today the question is what metaphor explains to us our relationship to others.

For many it would seem the entertainment industry has dominated their psyche. The idea is to be a 'star' probably because the 'worker paradise' of today has to such a large extent killed the mother. Without mothers the young seeks adulation of the stranger. Institutions dominate a child's life from 'cradle to grave'. The saddest children more often are those most deprived of family by repeated foster homes, jails and asylums. So often the constant of all children today is the television. The television dramas are superheros and villains mostly. PBS barely exists. Reality television has brought with it just a slight variation with it's orchestrated 'survival' shows based on Hollywood ideas of social organization that derive solely from the imagination of Hollywood.

There's a unreality intrinsic in this 'canned' and 'pampered' urban motif. Medicine and law provide other metaphors as does politics to some extent. Of these only medicine, to my mind, biased as it is, remains 'grounded' in nature. The rest seem to be the stuff of Berkeley whose very existence was but an idea. Philosophy and theologies abound disconnected from any inherent experience. Everything is a theory and one person says his theory is the best theory because more often than not it is merely the latest retelling of a more ancient truth lost in the layers upon layers of theory. The ideas of beaurocracies rival the fashion industry, all vying to convince the emperor or in this case, the people, that they really are 'new clothes.'

M-theory, 'model dependent theories' and pluralisms and amorality arise in the ethics free vacuums. What really is proven? Society compared to a clock was made to work as such. Winning wars of mass destructions the leadership imposed the metaphor of military on the society at large without apparently that glue of the 'noblesse oblige' of yesteryear.

Indeed, the metaphor of the individual as 'consumer' is a weak one as such and yet it's used to fuel all manner of seller dominated production of poison. Missiles, tobacco, crack and opiates all are equal to diapers, wheat, clothing and houses in the market analogy of modern valueless economics. Bean counters distinguished by their relative heartlessness are setting standards for society when their very methodologies are those of technicians not savants.

What is the relationship that governs the obligations of the rich to the poor, the powerful to the powerless. Post Christianity as some would celebrate, what is the relationship that will protect us all from the equal ideologies of big 'C' Communism under Stalin and big "F" fascism under Hitler.

The leadership are indeed more educated perhaps than ever before. They've had privilege and lives protected and indeed pampered. Seeing Prince Harry in the military like his father before him was certainly a blast from the past as far as 'noblesse oblige' was concerned. Here was the future King learning that a man must feed the men and lead the men not just send them out like one would 'mercenaries'. It hearkened to the likes of Henry Ford on the assembly line.

But what of the Rockerfellers and Roschilds. Would the 'banking' families have a concept of 'noblesse oblige' or ever actually 'mix' with the people. Would they not remain 'effete' in their protected worlds using the 'emperor's' of China 'gated community' analogies for their relationships. Is this necessarily intrinsic in the television metaphors of the Divas surrounded by sycophants and protected from their 'fans'. Princess Di was killed apparently by paparazzi.

Without 'noblesse oblige' what really protects us from another World War since we're just 'toys', perhaps in the schemes of men, women and monsters. Science would say we are interconnected but not in the way of God, not in the way of the nature of Newton. It's necessarily a frightening thought as one goes into old age and adage. To the banker, old money is just discarded. To the marketing ad man, the old images are discarded until time makes them all new again. To the Chinese Emperor or Stalin or Hitler, what were a thousand deaths compared to a million in the grand scheme of their designs for world domination.

I would rather a society see me in a way that protects me in old age and protects it's young. Television is too dominated with the healthy and the beautiful. Feeling ugly and old I trust the farmer's respect for the 'old grey mare' and the king who cared for his elders, especially those who served his father.




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Sunday, August 22, 2010

Anti-authoritarianism and Alcoholism

Alcoholism engenders 'anti authoritarianism'. This is a direct consequence of the effects of alcohol and drugs on the brain. The frontal lobes which are associated with good judgement, the stuff of wisdom and sanity, appears to be inhibited to some degree as a result of the disinhibition caused by alcohol and drugs on the Amygdala or feeling centers of the brain. Dopamine transmission is altered by drugs and alcohol. Not only that glucose utilization and even DNA expression have been altered by alcohol.

What character or personality or feelings preceded the continued abuse by alcohol and drugs may be a mot point. The drugs and alcohol are like brain damage in this regard. Mostly reversible brain damage but brain damage nonetheless.

So studies show that alcoholics at least are immature on formal testing. But the question remains whether they were before since clearly alcoholism causes regression. Part of the work of AA and the steps of AA is the resocialization and psychological training that mere 'abstinence' and 'harm reduction' programs simply don't address. The expression that captures this well in AA is that " if you only sober up a horse thief you'll get a better horse thief." Abstinence may address the characterological and cognitive and emotional disturbances in time but socialization and maturation aren't necessarily going to magically appear. The program of AA as opposed to the fellowship of AA aims to expedite the process of maturation.

It's here that anti authoritarianism becomes an issue. Drunks don't" take guff from anyone nohow." They are particularly 'proud' of their independence. Indeed some drunks and addicts living under the bridge celebrate their 'freedom' though they're slaves to alcohol and singing the 'hobo existence' is mostly making a 'virtue of necessity.'

Given the extent of post traumatic stress disorder associated with alcoholism it's extremely common to have drunks really have some person in authority really do them wrong. Women are raped, men are stolen from and battered and sometimes raped ,as women are stolen from and battered as well. Studies of alcoholism and drug abuse show that this population is weighted with betrayal disillusionment and abuse. That most of this occurs after the development of the disease of alcoholism and addiction doesn't account for that which seems to precede the addiction.

Given that underlying all addiction and alcoholism there is an anxiety disorder which responds to the anti anxiety effects of drugs and alcohol, the increased anxiety is a product of the increased environmental threats or hypersensitivity that precedes the development of alcoholism. With alcoholism there is at most a 50% contribution of genetics and this is not even shown in drug abuse. The consequence is that most of addiction and alcoholism is a response to environment. Toxic settings beget toxicity.

There is a well used expression in the program of AA called "pitiful incomprehensible demoralization." The psychic change or spiritual awakening that has been said to need to precede real change from alcoholism is the realization that the whole course of one's life has been going awry. The authority in the life of alcoholism and addiction has been the drugs and alcohol and all the supports that have been given to the life of alcoholism and addiction. The enablers and the philosophies and even the theologies and politics that appeared to support the drunken life now no longer hold the sway they once did.


For some alcoholics this starts first with the realization that the police are not the enemy. Sober and functioning as positive contributing citizens, able to obey laws because the erraticism of alcoholism is gone, there is no longer conflict with the law. No longer drinking and driving the alcoholic no longer has to 'fear' the police. Indeed the police are often the greatest fans and support of recovery. Partly this is because many of the members of the police have developed alcoholism themselves and are in recovery. Alcoholism and addiction respect no social class. Indeed the higher one rises in society and status with the money and freedom that comes the greater the risk and opportunity for the development of alcoholism and addiction. A day doesn't go by that a politician, judge, doctor, engineer, pilot, senior bureaucrat, isn't enterring a program of recovery to address their addiction. The original founders of AA were indeed upper and middle class men, surgeons and lawyers and businessmen.

The disease of alcoholism is said to be 'cunning, baffling, and powerful'. In recovery it becomes apparent how ubiquitous its influence was. Voting for the political party that wanted the bars to stay open later was just one of many things that became apparent. Alcoholics were like kids who ate foods full of sugar. If an event allowed the liberal flow of alcohol then it was a great event.

So much of civil libertarianism is attractive to the alcoholic or addict that the question recently asked was "would Shambala exist without the drugs and alcohol." Certainly Woodstock might have happened but the whole movement of the day was quickly hijacked by the drugs and alcoholism much as soccer games are increasingly being hijacked by the drunk and stoned elements in the audience.

The alcoholic in the Big Book of AA is described as the great 'critic'. So much of the thinking of alcoholism and addiction, the actual brain disease which is associated with suicide and depression, is negative. The regression of alcoholism is best seen in the pot smokers who never leave the couch follow the news and criticize ad infinitum all the actions expressed in the media. Alcoholics and addicts and 'big shots' and such "legends in their minds" and so full of false promises and 'superman beliefs' that they commonly believe they can do whatever the booze and drugs make them 'feel' they can do. A well honed AA slogan addresses this peculiarity. "If you talk the talk, walk the walk!"

In this regard alcoholics and addicts in recovery will often still be criticizing politicians and priests, leaders of business and professionals. Naturally the 'alcoholic' knows better. Their most common refrain is 'I could do that too if I wanted to". So naturally in AA people who are living in their heads are repeatedly told "Show me, don't tell me."

The anti authoritarianism of alcoholism seems even worse with addiction. Part of this is that today so many of the addicts have begun their careers of drug abuse prior to any socialization. Many alcoholics, especially those referred to in the early years of the Big Book of AA, were well established in their lives before their relative wealth and freedom and success allowed them to indulge their alcoholism. The difference with addiction is that so many of the addicts missed the socialization of stable homes, schools and work dropping out and living on the streets and developing anti social and criminal ways as the 'only' way of life because their addiction took them down in their teens. Drugs are said to 'bring people to their knees' earlier. Addiction is more commonly showing up now in the teens and twenties where as it used to be encountered most in 30s, 40s and 50 year olds.

Much of the anti authoritarianism in alcoholics and addicts is merely 'adolescent'. The disease of alcoholism and addiction has kept them aways from the normal avenues of socialization and character maturation. Alcoholism and addiction makes non joiners and isolators and loners of individuals as a direct part of the disease itself. Addicts and alcoholics especially those who relapse and especially those who keep relapsing must keep themselves free for the call of their master so they stop drinking and drugging but maintain a lot of 'free time' on their hands. They remain 'anti social' and insist that this is just the way they are. Often they are actually 'pouting' like adolescents while the rest of society is inviting them in. But the disease of addiction has taken over this aspect of their thinking and they remain 'aloof' mostly as a means of being ready to relapse, free to respond to the 'craving'. Indeed anti social behaviour, isolation, per se, is a form of 'craving equivalent'. Addiction and alcoholism are 'parallel play' activities and there is no need for 'commitment' to relationships or groups or societies or families or other individuals. The only commitment needs to be to the drug or alcohol. That is the God that is being worshipped and a crack house even more than a bar shows that same almost sacred participation in alienation. Even the love making of addiction is more 'mutual masturbation' than true love. This is the reason the sex addict despite the number of partners or players is caught in the prison of masturbation without the joining that comes with relationship. The sensational overrides the relational.

It's with these thoughts that anti authoritarianism must be considered. The Big Book of AA cautions the alcoholic against even 'righteous anger'. Addicts select from their environment all the negatives that government for instance does and repeats them. This may indeed be a 'craving equivalent' as well because it's tied to the self pity that justifies drug and alcohol abuse and relapse. Ultimately if everything is so wrong, if all those people in charge are fools, 'why not drink?"

That said, human rights and civil liberties and political action are all a very important part of community involvement. Eventually the alcoholic or addict in recovery moves into a world of decision making that involves criticizing positions of ones' government. At this point it seems important to remember that alcoholism and addiction present as diseases of 'immaturity'. It's been said that 'children break things and adults fix them." To this end alcoholics and addicts who are very good at breaking things and putting down and criticizing and belittling are asked "what would you do better." RAther than allowing addicts and alcoholics to wax poetic about the problem they are derailed early and asked 'what is the solution". What would you do differently from the President or Prime Minister? How would you solve the problem of terrorism? How would you get the votes to build a child centre? The specific feature dominant in the critic is that they dare not propose their own ideas because they lack the courage to face the kind of criticism they themselves so readily dish out. In AA people are told "if you can't stand the heat get out of the kitchen." "Too many cooks spoil the broth." The critics are mostly commonly the ones that are interfering with things being done unless they actually are apart of solutions.

Indeed it is in community involvement that addicts and alcoholics eventually move. The 'business meeting' of AA with it's disagreements and confusion is a place where people learn to controll their tempers and work with others to a common goal. The rallies and round ups of AA are major community projects where people learn to put on events and address all the grievances and expectations associated with these. The alcoholics in AA cheer the leaders and organizers of these and eventually see that the same 'feelings' are what normal people feel for the leaders of society and all their organizations. The tendency of addiction is to see the cup half empty whereas one political leader versus another in the Western world is more often not the paranoid position of the childish alcoholic and addict, black and white but rather shades of grey.

Clinton, Bush and Reagan, are all A students but clearly the Aplus is preferred to the A minus. Mulroney and Chretien, Harper and Ignatieff are A students as well. The political question is which one is A plus versus A minus. None of these individuals are satanic, evil, losers or any other description that the anti authority alcoholic might give them. The Pope is like wise not terribly machiavellian. Surely the whole system is at fault because it doesn't place the 'critics' as the billionaires and move the car washers into the big chairs smoking cigars. But that's childish thinking. It's destructive and doesn't have a solution beyond revolution that would get the critic off the couch and into the real work of society. The organizers of AA event, those too often thankless, are appreciated as leaders should be. It's said though that those most criticized in AA are those that do the most.

But all who stand up make themselves a target. Studies of monkey behaviour show that the bleachers are always full and that few are ready to do the work and take the risks but all want the rewards. This may be a part of the animal we are. Alcoholism and addiction may only bring this worst side of human character to the fore.

It's with thoughts like these that I personally like to temper my tendency to criticize my political leadership. Government and taxes aren't necessarily popular. Yet addicts and alcoholics have a tendency to project their own past negative experiences associated with drugs and alcohol onto whatever authority that presents today. This anti authoritarianism needs be balanced against the overall good that organizations do whereas the addiction flourishes in chaos so the call of the addiction will always be in the back ground.

Anti authoritarianism is part of the disease of addiction and alcoholism. To be an exemplary leader you must first be an exemplary follower. Recovery is about being of service in recovery. Service doesn't start at the top and service isn't usually being a critic. Anyone in organizations knows that the 'talkers' are a dime a dozen where the "doers" are few and far between.







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Tuesday, August 3, 2010

Aging

My father does not know his sons.
Often he has asked me who my brother is.
Now he asks who I am,
And who the man is sitting next to me,
My brother.

He is frightened. At times he's been paranoid.
I reassure him constantly that my brother is not stealing.
My mother managed his affairs before my brother did.
It has been so long since he could manage his affairs himself.
The year my mother became sick aged him most.

The winters he pushed her wheelchair around the hospital.
The years he returned to church.
He talks to me now of the priest.

A terrible time, the depression
My mother said. It changed him.
Made him as he is, she said.
Some stories we did not know.
My parents shared so little outside themselves.

As a teen ager what he saw and what he did
There was hunger in those years.
He told me the tough times, driving logging horses.
His eyes would look at painful distance.
That was after he left home in anger with my grandfather
My grandfather, the Reeve.

His mother died in childbirth with his brother
The one who became a military police
While dad was the RCAF bombardier.
"They said it was a submarine, but I think it was a whale,"
he said of a mission off the Pacific coast.

My step mother was a fine woman too
Farming in northern Manitoba was a hard life.
My father the oldest son,
Then his brother whose birth he thought had caused
His mother's death
And then step brothers, good men, but different.
Cowboys, loggers.

When my grandfather died,
the lawyer stole the money and the farm
Millions stolen by a lawyer protected by laws made for lawyers.

Years later I'd meet children of other Minetonas farmers
We'd talk of that lawyer, the millions stolen, their losses, and ours,
So many years before Hillary Gate
Less directly stole billions of farmers hard earned money.
They actually said he stole while she was never convicted.

Dad worked with a salesman alcoholic
His drinking destroyed their business
After many years of Dad's commitment and sacrifice
The business closed and Dad was very anxious then

But he and mom rallied. Their business together thrived.
Veteran's Affairs was good to it's own.
Life was good those many years.
Retirement, the motor home, Good Sam, his canoe and fishing,
Mom's mink coat and years of world travel.
In the end they loved the cruise ships.
And sailed the seven seas.

"I'll be 90 soon," he says. He's turning 92 in a couple of weeks.
"It was good until I was 80," he says. "Losing my eyes was the worst."
He tells me of his back.
I remember years ago he died and I resuscitated him.
I always wonder why I chose that time to visit the hospital,
Finding him comatose. Anaphylactic shock,
Another time he had a bad reaction to a medication
Leaving my mother in a fit of rage and driving night and day
To tell me all about it.
Calling his doctor. Calling so many doctors over the years.
The good ones were easy. The bad one wasn't so easy.
Threatening a colleague is frowned upon but I've done it.

Modern medicine has saved so many of our family
And I became a doctor remembering the doctor
Who came to the home and calmed my mother and father
When I could not breathe and antibiotics gave me back my breath.

"Where are we," he asks when we have travelled to Quebec,
I tell him and he says, "I thought we'd gone to Winnipeg."

I think it's St. Boniface, he remembers.

Mostly I tell him about my dog and we talk of Sonny, his dog.
He remembers my cat. "She sings," he says.

When Mom was dying there were those who tried to take their money.
Old people terrified would kill for a veteran's pension.
My brother and I saved him from going to the grave with her.
She'd sustained us all and loved us all, equally, but him first and foremost.
"He was always her man," her sister would say.

He had congestive heart failure then.
A friend had put in his first pace maker when his doctor
Insisted it was 'gas', the one I threatened.
Mom and I talked.

In the end my brother and I were parents.
Dad would rally. He flew out with Ron to visit me.
Ate the moose I'd shot and said it was best he'd had.
Had told me he'd wanted to taste moose one more time.

Wanted to live in British Columbia except they told him
They'd not have health insurance. It was a cold year in Ontario.
"I don't like the snow," he'd said.
But ideas came and went. He seemed safe and secure.
"I want to ride the train again," he said.
Reminding me of all the trips he'd taken us on as kids.
I loved the train. He and mom came out to see me on the train.
I drove him through the mountains and he told me of the war years.
He was stationed in BC.

He was hang gliding and motorcycling in his 70's.
He told us after my mother died.
"I was afraid you'd tell your mother," he'd said.
The wives thought they were off hiking or seeing.
His cousin played Johnny Cash on guitar and sang with me.
I'd guess he was the bad influence
But riding bronchs with Dad and his friends that week in Saskatchewan
I'd say my father might have been.
My Torontonian mother with her civilized Eastern and Baptist ways
Made him the man he was as much as her love.

My brother and I, the dog and he would go hunting and fishing.
Then it was Dad and me and my brother's dog that would hunt for years.
It's always been so good to be with my father in the old pick up truck.
He made us feel so safe as kids even in the Cold War
And the Cuban Missile Crisis. Men always turned to him for support.
A natural leader. I worked for him. My brother did too.
I loved to hear all the men I worked with speak so highly of my father.
"He's a fair man......best boss I ever had.......worked alongside the men.....didn't just talk and wear a suit....he always knew how to fix it, even when the blue prints were wrong.....never cared what a man's background was, what colour, whatever, just if they were honest and worked."

He liked to garden in his later years. Mom had been the gardener but when she was gone he grew tomatoes on his balcony.

I ate one today. This morning when I went to his room to accompany him to breakfast. The taste of that tomato burst in my mouth.

The men respect him. The women all like him. For years I've heard from women, "Your father is a very handsome man." I'd not seen it. But he'd always been a gentleman and liked in the church. He had a priest and a minister as a friend and helped so many charitably with his time and skills. He liked to tell stories about the clergy not knowing how to fix roofs and how you'd think they'd be closer to God if they did. And fixing a roof he'd become close to the priest, the years he drove around the province of Manitoba selling lightbulbs and roofing material to small stores.

My brother and I am who we are thanks to him and Mom. We can never repay the gift of life their love gave.
I am forever indebted to this man of men.
He was hard on me. I left home because we fought at 17. I was so angry then. And wrong. Years later he'd tell me he didn't know and no one told him.
There's so much a father doesn't know.
"Don't worry about having children," my mother told me. "You've saved so many children and helped so many lives, I just hope you'll make time for yourself."
Dad cried when she died. They'd been inseparable.
Her wishes were his and his wishes were hers.
For 50 years they'd struggled and compromised and worked together
Raising a family, pillars of community, working and making businesses.

I owe my work ethic to them. All the years I lived in hospitals and lived for medicine and lived for practice and squeezed the good times into the constant years of medicine and sick wives and their dying in laws.

I asked dad for lunch one day and asked him about why his marriage worked and mine didn't. "I don't know son," he said. "I don't understand your mother at all sometimes. I thought you chose good women but I didn't like their parents, the drinking and such. I've only really known machines in my life. Didn't trust horses as much as I trusted machines. Take your car. I remember you just bought it new. But listen to this door. You can hear it needs oil. You don't seem to hear that but machines need maintenance and maybe that's where you go wrong with women too. Your mother says it's because you're always worried about your patients. Your mother has been good to me. Not that we haven't had our fights. It's just that she's different somehow. I don't know why you're asking me about this."

He's settling down in that way one does. He used to argue with me just to see if I 'still had it in me." "See Lady Hay I can still get the kids worked up," he say and I'd later, much later, think of myself playing with my puppy and wonder why I took it all so seriously.

If only I could have those years back. All the library time, the wards, the darkness and the nights without sleep. Night after night at bedsides. And all those languages of pharmacology, biochemistry, epidemiology, neuroanatomy and on and on. I've forgotten so much more than I've learned and yet day in, day out, I answer the questions right. My colleagues and I agree and more often than not they ask me. Even though I dye my hair.

Dad comes and goes. We talk weekly on the phone. He sometimes knows the prime minister. It doesn't matter. He says my brother hasn't been to visit in weeks and doesn't remember his nephew and I talked together on his phone only days ago.

Mom knew us all when she died. She knew us better than we knew ourselves. Dad knows us in a different way. We known each other well over half a decade. Going on sixty years for me and then some for my brother. Yet the dreams of us began in WWII when mom and he met.

WWII. That and the depression changed him. Changed all of them. As the Cold War changed us.

Dad's brain may change but his mind and soul and heart are still the same. He's the biggest man I've ever known, the finest and wisest and most true.

He'd want to be known by his actions. His is a legacy of love.

I'm afraid for him as I know for all these years he's been afraid for me.











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Courage

Courage has been described as not the 'absence of fear', but doing the right thing in spite of fear. I think about this as I've had my share of fear and on occasion acted courageously.

I'm afraid a lot but I've mostly ignored my fears or resisted the temptation to give in to them and instead done what seemed the 'right' thing even though doing the right thing carries with it so much obvious risk and as often as not pain.

Today I remember things like rafting on ice flows on the Red River during break up, hopping on strangers cars and being towed along the icy roads at 50 mph, phoning my first girl for a date, winter camping, canoeing Lake Winnipeg in the winds, asking the first girl to dance, standing in front of the classes, stepping first time onto the big stage, playing guitar in front of the crowd, sharing poetry, facing up to the school bully and fighting back, defending myself from the first kid who tried to knife me, facing down the first gun pointed in my face, remaining calm, talking steady and standing my place, not running, feeling the brass knuckles hit my face even as I was throwing the guy over my shoulder, taking the chains across my shoulder, not crying out being strapped, not complaining being caned, having sex for the first time, diving for cover the first time I was shot at, making my way cool headed to safety, rescuing the drowning person, doing mouth to mouth rescue on strangers, putting out the fire, standing with the others holding back the forest fire, facing the gangs alone or outnumbered, fighting free, not leaving a friend when all I wanted to do was flee, facing the bear in the berry patch, punching the bear in the tent, applying for university, proposing, sitting down for the exam and completing the test, asking the questions in chemistry and anatomy when others laughed and I knew they couldn't know the answer, finding the questions the professors didn't know, cutting the first chest, putting first intraspinal needle, so many firsts alone in medicine and surgery and elsewhere alone when the teacher and mentor is no longer present, being alone in the woods miles from all others wilderness camping, climbing the mountain cliff, slipping, the night in the igloos, being stalked by the polar bear, facing the grizzly and backing away with only a bow in my hand bird hunting, setting that first shoulder dislocation at the rodeo, delivering the first baby outside of the university, delivering the first baby alone, delivering twins, using forceps to free the baby's head in a northern hospital with only a nurse, wrestling with the dangerously insane person trying to kill me, facing loaded threatening guns again and again, having that fellow put the rifle in my face and pull the trigger thinking there were bullets in his gun and I'd removed them, being in court, answering the judge, so many times alone at sea, hurricane force winds, the hospital, and sickness, facing the knife myself, the greatest terror in waiting, wanting to die but living, being knocked down alone over and over again in 40 foot seas, facing the wolverine without a weapon and staring it down, punching the pit bull, leaving her, going to the lab for the examination and waiting for the results, standing naked and alone waiting, imprisoned, being under the power of the incompetents and sociopath depending on and being fooled by psychopaths, so many nights and days without help, alone and without sleep, the plane crash, the car crashes, the motorcycle crashes, the bicycle crashes, the moments before you know it's all going sideways and you just hold on. Waiting for rescue. Lying very still. Rescuing so many people, over and over and over again. Touching the diseased, breathing their air, immersing yourself in their bodily fluids and thoughts,being alone in a room with the emotionally out of control, working in the prison and the asylum, holding the person trying to harm you and not harming them, over and over and over again, asking the right question when it would be so much easier to fudge and fib and fabricate. Not cutting corners when it would be easier and safer, yet wrong. Doing the drill. Getting on to the horse after the galloping throw. Taking the high speed turn on the motorcycle and refusing to give into the fear, doing the counterintuitive, breaking the rules because they're wrong and would kill, finding the motorcycle brakes gone on the icy downhill road, sommersaulting the car 180 degrees in the air when the other highway driver tried to pass on black ice and failed, being lost in the blizzard, going through ice and walking miles in frozen clothes to save the old man, making love.

It seems a long list some days and short others. There are so many more times more frightening and even more courageous. Somehow I've carried on. I don't know ever if I'll have courage the next time though. It's always surprised me that I've gone on. I've often been shocked looking back. I sometimes look back at how foolish it was. Volunteering for the dirty and dangerous. Going where no one else would go but where there was a need and commitment. Telling the truth over and over and over again when lying would be so rewarding and so much easier.

I am awed by my father and his friends. At 91 he faces each day not knowing whether he'll make it or what the day will bring. Illness is harder on him. It's easier to forget or get lost. He's shown more courage than I can imagine because I've always known him as the most courageous man and I never knew him when younger he made even more of a name for himself.

I trust my fear. It's at the very core of my being. It's the worry I know and yet over and over again I've done the right thing. I've faced the fear and done just the right thing to come through alive. Those who've been where I've been attest that they know what I did was right. The very proof is in my survival. The fact is I have thrived. Those who've never been have silly ideas that mostly come from fantasy. They watch too much television and read romantic stories. The silliest who know the least insist they could have prevented or avoided such and such events. Their lives are spent hiding in priviledged bunkers living lives loud with quiet desperation. They simply don't know.

There's a humility that comes with courage. Arrogance thrives in ignorance. I'm afraid, really afraid, and though I have been known for my courage, I seem only to trust the fear. I know the fear will be there when I'm doing the next right thing.

It's a strange fear that's somehow wrapped up in faith. As I grow older I can only hope I'll have half the courage of my elders.






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Saturday, March 6, 2010

Robert Redford

http://en.wikipedia.org/wiki/Robert_Redford
He's just about the best male actor of my life time. His movies have certainly had a profound impact on me. He's amazing as an actor, a director and producer. Something about him always spelt the word integrity.

Butch Cassidy and the Sundance Kid made me a life long fan. With Barbara Streisand in the Way We Were he stole my heart. His love stories simply brought such depth to theatre. Out of Africa still lingers.

All the President's Men and Brubacher raised my political awareness and touched my conscience. Movies like a Bridge Too Far and Havanna gave me insight into history. Always he was true. The psychology of Ordinary People and Indecent Proposal was unsurpassed while the Horse Whisperer simply touched the soul.

I've just watched Spy Games. I loved it when I first saw it at the theatre and yet I've enjoyed it even better the second time through. I'm not one to watch movies over and over again. I like them to age. Turner Classic Theatre is my cup of tea. But Robert Redford's movies I can watch again and again because there's so much nouance of expression and depth of character as well an ageless joie d' vivre.

I was amazed to learn he was a baseball star. How very typically American can one get. Then to learn he lost a scholarship through drinking only to rise above that past to his later fame and fortune. I like the true love story of his life that clearly has given him the depth of character that he forever portrays.

Just as I've loved his acting I've loved his directing, the latest being Lions for Lambs and so enjoyed his production, the Motorcycle Diaries.

I like what I've heard of Sundance, too. Those who I've met who have known and worked with Mr. Redford all speak of him as a gentleman. His genius is quiet and American in the best of the sense of that word. I'm just simply thankful for his work.

Sunday, February 28, 2010

Suburban Mayhem






This movie is genius. http://www.suburbanmayhem.com/main.html



The movie should be required viewing for all judges and juries. It's would make an ideal case study for any psychologists or psychiatrists with the question, "and what would you do differently".



It's an Australian production that could never have been made in America because quite frankly it could well be a metaphor for America. Winnipeg's Guess Who wrote the song banned throughout the US, America Woman. It was just this kind of woman the song was about. http://www.youtube.com/watch?v=gkqfpkTTy2w&NR=1

http://www.youtube.com/watch?v=DZVzH5yBFQA



Katrina is a clinically accurate portrait of the true female psychopath. Her sociopathic brother ends up in jail because the 'system' can deal with men but is wholly incapable of dealing with the new age female version of an ancient and most endearing mask of the devil. The movie shows just why the 'system' fails when it comes to women but it in no way enlightens us as to how things could be handled differently. With a docu drama twist, it is a truly violent action flick that turns into a witchy horror film. Like watching a snake dance I couldn't keep track of all the moves and didn't see the strikes coming when they did. That's the genius of writer and director. The acting is all superb.



The women and men in the movie are unable to deal with Katrina's sexual manipulations. A regular blue collar Cleopatra she demonstrates well how women can use sex and proxy violence for social terrorism. The movie captures the Eva Braun Syndrome to a tee. Absolutely a must see.

Writer: Alice Bell (only a woman could have the balls to write this!)

Director: Paul Goldman

Katrina: Actress Emily Barclay

Monday, February 15, 2010

Arrogance & Addiction

Arrogance is the opposite of humility. Humility is not however low self esteem. Humility represents the healthy positive attitude of a 'right sized' ego. Like most aspects of health, mental health and spiritual health included there is a concept of homeostasis. Like weight, and temperature, etc. ,too much or too little of a thing is equally unhealthy.

Arrogance is commonly a sign of drug or alcohol addiction, active or "dry" but certainly not 'sober'. Emotional sobriety refers to having humility as a cornerstone of one's life. Humility is that middle place between a superiority complex or an inferiority complex both of which vie as unique and carry with them 'narccisstic entitlement". Entitlement is a key feature of arrogance.

While souls may be equal before God, and individuals equal in democratic votes, they are not equal in skills or capacity. A pilot flies a plane while an arrogant person may claim they can fly a plane without experience, education and credentials. They overstate their situation, claiming either a monopoly on superiority or a monopoly on suffering. Both deviations represent arrogance.

In addiction work they are said to be a "legend in their own mind". Another term is 'egomaniac with an inferiority complex'. Whatever the underlying issues, they come accoss as arrogant, self centered and shallow.

The trouble with addiction is that it disconnects an individual from community and profoundly affects their capacity for relationships. The paranoia associated with addiction results in a sense of inferiority (I need my addiction) and I need to prove myself, so I can deny my addictive need. Lacking internal valedation, dependent on their addiction, they have need for more increasing external validation. This is the 'more' of addiction. How much do you want? More. How much do you need? More.

The addiction to substance moves to addiction to external validations such as fame or fortune. The greater this is driven by fear or comparison or envy the greater the arrogance. Some arrogant people thrive in hierarchy because they have those below them to sneer at and those above them to fawn.

Arrogant people rarely know they are arrogant. This is because their arrogant exterior stems from either a superiority complex or inferiority complex both of which stem from an 'emptiness' and a need to 'fill' that emptiness with anything but 'relationship': relationship with self, relationship with others or relationship with God. Arrogance is false pride. They prefer their own lies about themselves and are masterful at arranging their lives to avoid hearing truth, either by prickliness, threats of suicide or homicide or variations of such emotional extortion, or by surrounding themselves with yes men and yes women or isolation. They tend to keep moving. They "use" and "take" and do little to 'reciprocate' and 'replenish'.

They are often also called psychopaths or sociopaths because of their lack of empathy and over riding self centeredness and manipulativeness. Addiction is called the "great eraser' as it removes first the highest ideals of humanity, that which separates us from animals, the mammalian relational world of family and community and ultimately all but the "false self". For the arrogant and the addicted all is sacrificed for the 'false self". The true self is "apart of" and not "a part from". Happy individuals are 'happy in their own skin' and in their 'relationships". They are not 'paranoid'.

Arrogance is only possible with gross dishonesty. Honesty leads us directly to humility. Honesty is the cornerstone of recovery from addiction. With honesty one can see that they are indeed "not God" and that they can not be the 'best' in everything, being human they make mistakes, are finite and have limitations. They understand the 'golden rule' "love thy neighbor as thyself' or put another way 'do unto others what you would have them do unto you." The arrogant fundamentally can't accept this rule and believe themselves above the law. They believe that there will be no ultimate consequence to their action. They commonly make fun of the spiritual because an afterlife would be frightening to them when they're living on the idea that they can get away with murder. Their principal rule is 'don't get caught.' They are 'baby' souls and as such need to be understood.

But they also don't recognize that the more 'reductionist' they are, treating others as 'things' the more 'thing like' they become. Consequently eating a steak they really only experience cardboard. The difficulty for the young is that they compare their 'insides' with others 'outsides' and can't recognize the 'chameleon nature' of the arrogant. The arrogant put on a good show but in the end it's just a show because the more they alienate the more alone and afraid and alien they become.

The ancient Greeks saw arrogance as 'false pride' and that 'false pride' invariably lead to a major fall in which the individual's physical losses are matched with the potential for spiritual gains and insights into the truth about themselves, their relationship to others and ultimately their relationship to God.

This is what is called 'recovery'. When one stops the addiction they enter onto a journey of recovery where they regain their relationships with self, others and God. They become 'child like' again experiencing life at it's fullest rather than as the shallow false reality of addiction. No longer arrogant they learn humility and experience gratitude. The greatest gift of recovery for so many is being thankful to be alive. The arrogant are never satisfied with life. The humble celebrate life.

Friday, January 29, 2010

Personality Disorder

Personality is seen in psychiatry to be a collection of traits and behaviours that can be traced from adolescence forward. Everyone has "personality traits". DSMIV asks examiners to record what these traits are in Axis II of the diagnosis. Broadly is the person 'odd' or "peculiear' or are they introverted or extroverted.

The traits reflect the internal defences that an individual develops to cope with the desires of the individual child and the introjected demands of adult society. Defences were the 'interpreted" mechanisms of interaction between the super ego and id. Eissenberger describes the history of this development in his thoroughly brilliant classic, "The Discovery of the Unconscious". Later these 'defences' would be more commonly called 'coping strategies" referring to how the individual interacted with the society about them.

Personality and character were terms to described the facets of the individual who 'rough' is 'smoothed' in their relationships to the external demands of the group. A defect was sort of an "unpolished' bit or indeed a coping strategy which worked well enough at a younger age or in a different social milieu but was no longer adaptive.

Personality disorders have much in common with addictions because the disorders themselves can be understood as addiction to an earlier useful 'strategy'. With alcoholism there's 'fun', 'fun and trouble' and 'trouble'. Alcohol and drugs serve to cope with the anxiety the individual feels and serves to 'self soothe'. Similiarly personality disorders reflect persistence of 'self serving ' or even 'self soothing' strategies beyond their 'do not use date'.

Borderline personality disorders act in many ways similar to the adolescent in the first phase of adolescence. Adolescence is that time of leaving home and establishing an adult family. The first phase is usually a partial or complete rejection of the parents and a move to the safety of the same sex age group. Once separated with hopefully at least an uneasy détente with the past the adolescent comfortable in the new group moves on to establish a primary bond with another and moving on to form in the third phase the new nuclear unit.

It's a fact of modern and priviledged societies that childhood can be prolonged. In cultures more involved in survival the length of adolescence is not uncommonly brief, at most a year or two and the rituals of the group clearly delineated the end of childhood and the obligations and responsibilities of adulthood. In the west post modern contemporary society adolescence has extended into the 20's with the extension of education and adults living at home for lack of funds to establish a separate home.

With personality disorders there's a tendency to be somewhat surprised to see what is a normal acceptable behavior developmentally much earlier being pulled out and used in interactions in adulthood. The passive aggressive personality disorder famous for prolonged "pouts" and "chronic depressions" is reminiscient of the "terrible twos" with the child refusing to put poo poo in the potty and treating the whole issue as a kind of 'game' much to the horror of parents.

The dependent personality disorder is the 'clinger' , the child holding onto mommy's skirt and refusing to move further. They glom onto people taking hostages and calling that "love".

The antisocial personality disorder is the school yard bully who as an adult has a quick draw baton or gun if he's blue collar and quick draw lawyer if he's white collar. Wealth and status don't mean there are 'less' personality disorders but in fact wealth and status can increase the very tendency to develop and sustain personality disorders. However in the rich and powerful these are usually called "eccentricities". Only the truly rich and powerful can fully avoid growing up and live of life of childhood with it's narcissistic entitlement and utter disregard for the concerns of others.

Personality disorders are terms that are given to those who encounter the psychiatric system, the social support system, or the courts and the less resources the more likely one is to fall afowl of these societal agencies vested with powers of maintaining the peace.

Personality disorders tend to 'rub' one the wrong way. The borderline personality disorder threatens suicide a tad too easily or perhaps too often. The antisocial personality disorder would rather beat you up as to have a cup of tea. The paranoid personality disorder sees conspiracy in every action of the government, including garbage collection.

The fact is everyone is looking for love and personality disorders are usually people who didn't get it in their families. They may have got it but didn't recognize it but on the inside they look like those obese or anorexic or scarred kids whose hurt shows. Personality disorders are the hidden handicaps like learning disabilities and physical disabilities like deafness. I've told personality disorders that they'd probably have an easier life if they just wore a bandage around their head or wrapped their chest with white linen to indicate to the world that they're 'wounded'.

They're the survivors of the 'war of childhood' in which a child wants attention from their parents much as another child may long for food. Often the parents didn't get what the child seeks so can't give what they haven't got. More commonly the natural disasters and losses like deaths and calamities have disrupted the child raising process.

Paranoia is a life saving trait in a war torn zone and may well be what keeps you alive if your father or mother is an violent alcoholic. The histrionic personality disorders desire for intimacy is coupled with a fear of in depth engagement more commonly because of countless broken promises that result in that superficiality and external warmth coupled with the guarded interior.

The borderline wanting love says come hither, stay away, vacillating in between and so comfortable in being rejected that they more commonly set up a set of 'traps' and 'challenges' for any one who is considered to be let in but of course everyone or most everyone fails these "tests".

The 'coping mechanism' of the personality disorder are like 'guns' and to learn the more adaptive tools of the adult trade one has to put down the 'gun' and learn to wrestle or bargain or trade. It's terrifying to let go of a 'gun' and there's little promise of safety in a handshake or an embrace. At the merest threat one goes for the gun that might even have been tossed away.

So in times of crisis all the 'old' ways surface. And sadly drugs and alcohol make even the best of us look like "personality disorders' because chemical addictions cause a reversible brain damage with higher levels of functioning , the forebrains most human aspects of what theorists like Piaget called the realm of 'abstract thinking' and Maslow described as 'self actualization' slowly eroding giving alcohol and drugs the name, "the great eraser'. They take everything away even character.

No one is immune. It was the arrogance of the men of the age of rationalism who figured if they were captured in the female sex trade and fed heroin and cocaine then put out to work as slave prostitutes by their sociopath pimps that they the men wouldn't do this but women 'succumbed' because they had weak character.

Patton almost lost his generalship when he beat a 'shell shocked' soldier. Later research showed everyone would develop 'shell shock' if they were exposed to 220 days of a war zone necessitating the modern effective rotations. Much of the damage being done by noise and sleep deprivations. Sleep deprivation studies showed that everyone went psychotic eventually.

And the senior crack cocaine researcher in New York said that in his experience that if anyone did crack for 6 months steadily and kept doing it , they'd sell their grandmother for more crack at two years because crack changed the brain drastically.

Sometimes the treating community feels sad for the personality disorders or even those with the more offensive 'eccentricities' because the alcoholics and addicts who abstain from alcohol and drugs and join AA or NA or one of the other therapeutic communities, they have a higher success rate for recovery than those who haven't turned to drugs and alcohol to smooth the interface between themselves and society. Sober, personality disorders are treatable within the community and with therapy individually after the 'first stage' of recovery.

It's one of the amazing facts of work in addiction psychiatry but it's a place where the personality disorders are seen to disappear especially for those who enter into service, get jobs, develop altruism and humor and have gratitude for being able to pay taxes. It's a process of maturity and it begins in the addiction community with saying no to the first drink or drug.

It's harder for a mere personality disorder to 'volunteer' or 'pay taxes' or 'say no to angry outburst or running away, or to join a club. Personality disorders show most when people are in longer term relationships or in longer term jobs or when they have to change and their limitations in adaptation to change show.

The fact remains there is love and it can be found and when the 'guns' are dropped adult love is possible without the drama. Thankfully for all personality disorders are treatable conditions and not uncommonly simply 'burn out' as the individual gets 'tired' of burden of carrying all the 'baggage from the past' and having the same old same old problems always seem to be recurring.