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HOW BDD AFFECTS LIVES: VIOLENCE AND ILLEGAL ACTIVITIES

admin — Sat, 26 Mar 2011 08:35:32 +0000

BDD can also cause anger. Anger has many sources: frustration over looking abnormal, not being able to improve one’s appearance or stop it from further deteriorating, lack of control over the perceived defect, or a belief that others are being rejecting or mocking the defect. “I get angry because it isn’t fair that I’m the one with the small penis,” a college student told me. “And I get very angry at the people who laughed at me in the locker room in high school about my penis size.” Some people with BDD smash mirrors when feeling extremely angry about their reflection. Others have violent outbursts.
Research shows that, on average, people with BDD have higher levels of hostility than healthy control subjects or people with another psychiatric disorder. After treatment with an SRI, however, hostility levels drop dramatically. And while most people with BDD aren’t violent, 28% say they’ve been violent at some point in their life because of BDD. (Violence is defined as behavior that damages property or harms a person.)
Some people get so frustrated, despairing, and angry over their symptoms that they throw heavy objects like a brick or put their fist through a wall or door. Others are so certain people are mocking them that they physically harm the person. Violence can also be triggered by the belief that surgery or dermatologic treatment didn’t fix the problem, or even made it worse. A young man I saw, who believed face cream created dark spots on his face, went on a rampage around his parents’ house, attacking their furniture and splintering it with a hammer.
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ALCOHOLICS ANONYMOUS: THE TWELVE STEPS

admin — Sun, 19 Dec 2010 08:29:59 +0000

The Twelve Steps function as the therapeutic framework of AA. They were not devised by a group of social scientists; nor are they derived from a theoretical view of alcoholism. The Twelve Steps of AA grew out of the practical experience of the earliest members, based on what they had done to gain sobriety. They do, indeed, represent a doing: AA is not a passive process.
The initial undrugged view of the devastation can, and often does, drive the dry alcoholic back to the bottle. However, the Twelve Steps of AA, as experienced by the sober members, offer the possibility of another solution: hope for another road out of the maze.
Step 1, “We admitted we were powerless over alcohol—that our lives had become unmanageable,” acknowledges the true culprit, alcohol, and the scope of the problem, the whole life. Step 2, “Came to believe that a Power greater than ourselves could restore us to sanity,” recognizes the craziness of the drinking behavior, and allows for the gradual reliance on some agent outside (God, the AA group, the therapist, or a combination) to aid an about-face. Step 3, “Made a decision to turn our will and our lives over to the care of God as we understood Him,” enables the alcoholic to let go of the previous life preserver, the bottle, and accept an outside influence to provide direction. It has now become clear that as a life preserver, the bottle was a dud, but free floating cannot go on forever either. The search outside the self for direction has now begun.
Step 4, “Made a searching and fearless moral inventory of ourselves,” allows a close look at the basic errors of thinking and acting that were part of the drinking debacle. It also gives space for the positive attributes that can be enhanced in the sober state. An inventory is, after all, a balance sheet. Step 5, “Admitted to God, to ourselves, and to another human being the exact nature of our wrongs,” provides a method of cleaning the slate, admitting just how awful it all was, and getting the guilt-provoking behavior out in the open instead of destructively “bottled up.”
Steps 6 and 7, “Were entirely ready to have God remove all these defects of character,” and “Humbly asked Him to remove our shortcomings,” continue the mopping-up process. Step 6 makes the alcoholic aware of the tendency to cling to old behaviors, even unhealthy ones. Step 7 takes care of the fear of repeated errors, again instilling hope that personality change is possible. (Remember, at this stage in the process, the alcoholic is likely to be very short on self-esteem.)
Steps 8 and 9 are a clear guide to sorting out actual injury done to others and deciding how best to deal with such situations. Step 8 is “Made a list of all persons we had harmed and became willing to make amends to them all.” Step 9 is “Made direct amends to such people wherever possible, except when to do so would injure them or others.” They serve other purposes, too. First, they get the alcoholic out of the “bag” of blaming others for life’s difficulties. They also provide a mechanism for dealing with presently strained relationships and for alleviating some of the overwhelming guilt the now-sober alcoholic feels.
Steps 10 to 12 are considered the continuing-maintenance steps. Step 10, “Continued to take personal inventory and when we were wrong promptly admitted it,” ensures that the alcoholic need not slip back from the hard-won gains. Diligence in focusing on one’s own behavior and not excusing it keeps the record straight. Step 11, “Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out,” fosters continued spiritual development. Finally, Step 12, “Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs,” points the way to sharing the process with others. This is one of the vital keys Bill W. discovered to maintain sobriety. It also implies that a continued practice of the new principles is vital to the sober life.
A word can be said here about “Two Steppers.” This phrase is used to describe a few individuals in AA who come in, admit they are alcoholics, dry out, and set out to rescue other alcoholics. However, it is often said in AA that “you can’t give what you don’t have.” This refers to a quality of sobriety that comes after some long and serious effort applying the entire Twelve Steps. It is interesting to note that “carrying the message” is not mentioned until Step 12.
No AA member serious about the program and sober for some time would ever imply that the steps are a one-shot deal. They are an ongoing process that evolves over time (a great deal of it) into ever-widening applications. When approached with serious intent, the steps enable a great change in the individual. That they are effective is testified to not only by great numbers of recovering alcoholics, but also by their adoption as a basis for such organizations as Overeaters Anonymous, Gamblers Anonymous, and Emotions Anonymous. These other organizations simply substitute their own addiction for the word alcohol in Step 1.
A therapist/counselor/friend should be alert to the balance required in this process. The newly dry alcoholic who wants to tackle all Twelve Steps the first week should be counseled “Easy does it.” The longer dry member hopelessly anguished by Step 4, for instance, could be advised that perfection is not the goal and a stab at it the first time through is quite sufficient. The agnostic having difficulty with “the God bit” can be told about using the group or anything else suitable for the time being. After all, the spiritual awakening doesn’t turn up until Step 12 either.
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DID WE SLEEP?

admin — Fri, 08 May 2009 09:32:54 +0000

But everyone seems to know that they have slept, even though there is a blank in the memory during NREM sleep. How do we know that we have slept? We depend on two cues:

* Dreams, which are an inside cue

* The clock, which is an outside cue

When we wake from our dreams, we can recall the contents of the dream and we know that the dream is part of our normal sleep. Hence we are convinced that we have in fact slept There are people who need to recall that they have dreamt before they are convinced that they have slept Without dreams as a marker in the blank space in the NREM sleep, we are unable to give an account of what follows after the thought of ‘the wonderful lunch’.

The other cue is the clock. We look at the clock before we go to bed; it is 10.30 p.m. at night. We may wake up and go to the toilet, it is 2 a.m. When we wake up again and look at the clock it is 7 a.m. in the morning. Hence we are convinced that we must have slept about eight hours. Have you ever had the experience of the clock, for some mechanical reason, stopping at 6 a.m. in the morning, letting you believe that there was still an hour to sleep before your normal wake-up time. You go back to sleep, and later discover that the clock never went to 7 a.m.; the clock was not working! Too late, it was already 9 a.m. At night we are depending on the clock as an external cue, for during the NREM sleep our mind is blank.

A number of people constantly complain of chronic insomnia and always seek treatment. When they are placed in the sleep laboratory, however, the EEG and other recordings all confirm that they have been sleeping soundly. Yet, when they wake up, they insist that they have not slept at all. These people cannot remember any dreams, and hence they do not have the inside cue to convince themselves that they have in fact been sleeping.

Most of us believe that we do in fact sleep. But this belief is not easily held in the absence of the dream experience or a visible clock. Those people who believe they do not sleep at night do so because they cannot experience sleep itself. All they can experience is the distress they feel while awake. The blank period of NREM sleep is very important in understanding insomnia and in overcoming it. People who suffer from insomnia nearly always underestimate the amount of sleep they really have. This is because the individual’s own view of how much sleep he has is always inaccurate, as no one can recall how much NREM sleep he actually has.

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THE SELF-MANAGEMENT OF ANXIETY: THINGS TO REMEMBER-RELAXING MENTAL EXERCISES ARE NOT DIFFICULT

admin — Wed, 29 Apr 2009 10:23:12 +0000

I am going to spend some time in describing the relaxing mental exercises. Do not be put off by this. The exercises are not difficult. In fact they are very simple, and it is their simplicity that necessitates this rather detailed description because it is easy to go wrong from sheer inattention.

Those who are unimaginative might find an initial difficulty in accepting the idea of doing mental exercises. It may seem rather strange to them. But we all accept the connection between physical exercises and physical health, so let us try to accept the idea of mental exercises for mental health. Actually the idea of mental exercises is not as foreign to us as we may at first think. At school each of us have done arithmetic and algebra. Doings sums is itself a mental exercise the purpose of which is to help develop the intellectual powers of our mind. Some people practise meditative and religious mental exercises to develop the spiritual aspects of the mind. Our relaxing mental exercises aim to develop yet another aspect of the mind—the emotional.

Those who are rather lacking in ordinary determination have sometimes complained of difficulty in actually doing the exercises. They are usually people who want a thing done for them rather than to do it themselves.

A very successful businessman well past middle age came to see me because he had developed a distressing compulsion about checking over people’s names. He was normally a robust, good-natured, jovial man, but had recently become tense, anxious, and depressed.

He had worked hard, and had been successful. Over the last few years he had grown to overindulge himself. He ate too much and drank too much. He liked the theatre and television and the company of his friends. In short he was living for pleasure, and had lost the

self-discipline which had characterized Ms earlier life. This man would do the exercises very well in my consulting room when I was there to supervise him. But there was always some trivial reason why he had not practised at home. He settled down very well finally, but only because I continually kept him up to the mark. As you read this, please remember that this type of supervision should not be necessary.

It is also true that the medical profession has rather foisted the “easy way out” on to people by its readiness to prescribe tranquillizing drugs, rather than help the patient to cope with his inner tensions and learn to be relaxed. The relaxing mental exercises are not difficult. They merely require the minimum amount of patience which any new skill demands. If when you first try them, you are tense, don’t give up; instead bear in mind that obviously tense individuals usually get the greatest benefit in the shortest time.

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