Treatment Related Quotes

That is the idea -- that we should all be wicked if we did not hold to the Christian religion. It seems to me that the people who have held to it have been for the most part extremely wicked. You find this curious fact, that the more intense has been the religion of any period and the more profound has been the dogmatic belief, the greater has been the cruelty and the worse has been the state of affairs. In the so-called ages of faith, when men really did believe the Christian religion in all its completeness, there was the Inquisition, with all its tortures; there were millions of unfortunate women burned as witches; and there was every kind of cruelty practiced upon all sorts of people in the name of religion. You find as you look around the world that every single bit of progress in humane feeling, every improvement in the criminal law, every step toward the diminution of war, every step toward better treatment of the colored races, or every mitigation of slavery, every moral progress that there has been in the world, has been consistently opposed by the organized churches of the world. I say quite deliberately that the Christian religion, as organized in its churches, has been and still is the principal enemy of moral progress in the world. You may think that I am going too far when I say that that is still so. I do not think that I am. Take one fact. You will bear with me if I mention it. It is not a pleasant fact, but the churches compel one to mention facts that are not pleasant. Supposing that in this world that we live in today an inexperienced girl is married to a syphilitic man; in that case the Catholic Church says, 'This is an indissoluble sacrament. You must endure celibacy or stay together. And if you stay together, you must not use birth control to prevent the birth of syphilitic children.' Nobody whose natural sympathies have not been warped by dogma, or whose moral nature was not absolutely dead to all sense of suffering, could maintain that it is right and proper that that state of things should continue. That is only an example. There are a great many ways in which, at the present moment, the church, by its insistence upon what it chooses to call morality, inflicts upon all sorts of people undeserved and unnecessary suffering. And of course, as we know, it is in its major part an opponent still of progress and improvement in all the ways that diminish suffering in the world, because it has chosen to label as morality a certain narrow set of rules of conduct which have nothing to do with human happiness; and when you say that this or that ought to be done because it would make for human happiness, they think that has nothing to do with the matter at all. 'What has human happiness to do with morals? The object of morals is not to make people happy.

Mental illness" is among the most stigmatized of categories.' People are ashamed of being mentally ill. They fear disclosing their condition to their friends and confidants-and certainly to their employers.

During the Age of Glass, everyone believed some part of him or her to be extremely fragile. For some it was a hand, for others a femur, yet others believed it was their noses that were made of glass. The Age of Glass followed the Stone Age as an evolutionary corrective, introducing into human relations a new sense of fragility that fostered compassion. This period lasted a relatively short time in the history of love-about a century-until a doctor named Ignacio da Silva hit on the treatment of inviting people to recline on a couch and giving them a bracing smack on the body part in question, proving to them the truth. The anatomical illusion that had seemed so real slowly disappeared and-like so much we no longer need but can't give up-became vestigial. But from time to time, for reasons that can't always be understood, it surfaces again, suggesting that the Age of Glass, like the Age of Silence, never entirely ended.

It is exhausting explaining over and over again that yes, I am doing great and I feel fantastic, but I still cannot do the things I once did. My new normal with Cancer Related Fatigue.

Cathy slowly discovers the terrible childhood Dawn has had; rejected by her parents, left to fend for herself, then subjected to violent treatment by her relatives.

Every problem that we have in society has a suite of relative solutions that are also business opportunities. Agricultural waste is a problem. But solving that problem is a business opportunity. Energy inefficiency is a problem. But solving that problem is a business opportunity. The abusive treatment of animals is a problem. But solving that problem is a business opportunity. Reduced biodiversity is a problem. But solving that problem is a business opportunity. Plastic waste in the ocean is a problem. But solving that problem is a business opportunity. And the list goes on indefinitely. We just have to think creatively and fluidly and we can solve all of these problems that plague Earth and we can grow businesses and earn money and provide for our families in the process.

Depression, somehow, is much more in line with society's notions of what women are all about: passive, sensitive, hopeless, helpless, stricken, dependent, confused, rather tiresome, and with limited aspirations. Manic states, on the other hand, seem to be more the provenance of men: restless, fiery, aggressive, volatile, energetic, risk taking, grandiose and visionary, and impatient with the status quo. Anger or irritability in men, under such circumstances, is more tolerated and understandable; leaders or takers of voyages are permitted a wider latitude for being temperamental. Journalists and other writers, quite understandably, have tended to focus on women and depression, rather than women and mania. This is not surprising: depression is twice as common in women as men. But manic-depressive illness occurs equally often in women and men, and, being a relatively common condition, mania ends up affecting a large number of women. They, in turn, often are misdiagnosed, receive poor, if any, psychiatric treatment, and are at high risk for suicide, alcoholism, drug abuse, and violence. But they, like men who have manic-depressive illness, also often contribute a great deal of energy, fire, enthusiasm, and imagination to the people and world around them.

Urging an organization to be inclusive is not an attack. It's progress.

And people should be able to make choices related to their employment without worrying whether they will still be able to receive, say, treatment for cancer.

Health is normal. The human body is a self-repairing, self-defending, self-healing marvel. Disease is relatively difficult to induce, considering the body's powerful immune system. However, this complicated and delicate machinery can be damaged if fed the wrong fuel during the formative years. ... Healthy living with nutritional excellence throughout life can slow the decline of aging. It can prevent the years and years of suffering in ill health that is so common today as people get older and become dependent on medical treatments, drugs, and surgery. Nutritional excellence is the only real fountain of youth.

Their suffering essentially relates to a terrifying and painful past that haunts them.

There is scarcely any great author in European literature, old or new, who has not distinguished himself in his treatment of the supernatural. In English literature, I believe there is no exception from the time of the Anglo-Saxon poets to Shakespeare, and from Shakespeare to our own day. And this introduces us to the consideration of a general and remarkable fact, a fact that I do not remember to have seen in any books, but which is of very great philosophical importance: there is something ghostly in all great art, whether of literature, music, sculpture, or architecture. It touches something within us that relates to infinity

Once a patient goes brain dead and relatives sign his organ donation consent form, he will get the best medical treatment of his life. A hospital code blue may be a call for doctors to rush to the bedside of a beating heart cadaver who needs his or her heart defibrillated.

Victim-stancing - whereby the offender claims and believes that s/he is the real victim (one of the most prevalent sophistries in the false memory controversies)

No sense in proving your relative equality only to demand special treatment.

Structural factors are those such as ownership and control, dependence on other major funding sources (notably, advertisers), and mutual interests and relationships between the media and those who make the news and have the power to define it and explain what it means. The propaganda model also incorporates other closely related factors such as the ability to complain about the media’s treatment of news (that is, produce “flak”), to provide “experts” to confirm the official slant on the news, and to fix the basic principles and ideologies that are taken for granted by media personnel and the elite, but are often resisted by the general population.1 In our view, the same underlying power sources that own the media and fund them as advertisers, that serve as primary definers of the news, and that produce flak and proper-thinking experts, also play a key role in fixing basic principles and the dominant ideologies. We believe that what journalists do, what they see as newsworthy, and what they take for granted as premises of their work are frequently well explained by the incentives, pressures, and constraints incorporated into such a structural analysis. These structural factors that dominate media operations are not allcontrolling and do not always produce simple and homogeneous results.

For, as I have suggested, disruption of the unity of the self is not limited to the cases that come to physicians and institutions for treatment. They accompany every disturbance of normal relations of husband and wife, parent and child, group and group, class and class, nation and nation. Emotional responses are so total as compared with the partial nature of intellectual responses, of ideas and abstract conceptions, that their consequences are more pervasive and enduring. I can, accordingly, think of nothing of greater practical importance than the psychic effects of human relationships, normal and abnormal, should be the object of continues study, including among the consequences the indirect somatic effects.” – The unity of the human being

Their experiences led them to create assumptions about others and related beliefs about themselves such as "this is my lot in life" and "this is what I deserve". Some also learned that personal safety and happiness are of lower priority than survival and that it may be safer to give in than to actively fight off additional abuse and victimization. When abuse is perpetrated by intimates, it is additionally confounding in terms of attachment, betrayal, and trust. Victims may be unable to leave or to fight back due to strong, albeit insecure and disorganized, attachment and misplaced loyalty to abusers. They may have also experienced trauma bonding over the course of their victimization, that is, a bond of specialness with or dependence on the abuser.

When a worker is injured at an IBP plant in Texas, he or she is immediately presented with a waiver. Signing the waiver means forever surrendering the right to sue IBP on any grounds. Workers who sign the waiver may receive medical care under IBP's Workplace Injury Settlement Program. Or they may not. Once workers sign, IBP and its company-approved doctors have control over the job-related medical treatment - for life. Under the program's terms, seeking treatment from an independent physician can be grounds for losing all medical benefits. Workers who refuse to sign the IBP waiver not only risk getting no medical care from the company, but also risk being fired on the spot...Injured workers almost always sign the waiver. The pressure to do so is immense. An IBP medical case manager will literally bring the waiver to a hospital emergency room in order to obtain an injured worker's signature. When Lonita Leal's right hand was mangled by a hamburger grinder at the IBP plant in Amarillo, a case manager talked her into signing the waiver with her left hand as she waited in the hospital for surgery. When Duane Mullin had both hands crushed in a hammer mill at the same plant, an IBP representative persuaded him to sign the waiver with a pen held in his mouth.

Early traumatization is a major risk factor for more severe symptoms that persist over time. Thus childhood traumatization plays a central role in the development of trauma-related disorders in children and adults.

Although most psychotherapeutic approaches "agree that therapeutic work in the 'here and how' has the greatest power in bringing about change" (Stern, 2004, p. 3), talk therapy has limited direct impact on maladaptive procedural action tendencies as they occur in the present moment. Although telling "the story" provides crucial information about the client's past and current life experience, treatment must address the here-and-now experience of the traumatic past, rather than its content or narrative, in order to challenge and transform procedural learning. Because the physical and mental tendencies of procedural learning manifest in present-moment time, in-the-moment trauma-related emotional reactions, thoughts, images, body sensations, and movements that emerge spontaneously in the therapy hour become the focal points of exploration and change.

One day in my pharmacology class, we were discussing the possibility of legalizing marijuana. The class was pretty evenly divided between those that advocated legalizing marijuana and those that did not. The professor said he wanted to hear from a few people on both sides of the argument. A couple students had the opportunity to stand in front of the class and present their arguments. One student got up and spoke about how any kind of marijuana use was morally wrong and how nobody in the class could give him any example of someone who needed marijuana. A small girl in the back of the classroom raised her hand and said that she didn’t want to get up, but just wanted to comment that there are SOME situations in which people might need marijuana. The same boy from before spoke up and said that she needed to back up her statements and that he still stood by the fact that there wasn’t anyone who truly needed marijuana. The same girl in the back of the classroom slowly stood up. As she raised her head to look at the boy, I could physically see her calling on every drop of confidence in her body. She told us that her husband had cancer. She started to tear up, as she related how he couldn’t take any of the painkillers to deal with the radiation and chemotherapy treatments. His body was allergic and would have violent reactions to them. She told us how he had finally given in and tried marijuana. Not only did it help him to feel better, but it allowed him to have enough of an appetite to get the nutrients he so desperately needed. She started to sob as she told us that for the past month she had to meet with drug dealers to buy her husband the only medicine that would take the pain away. She struggled every day because according to society, she was a criminal, but she was willing to do anything she could to help her sick husband. Sobbing uncontrollably now, she ran out of the classroom. The whole classroom sat there in silence for a few minutes. Eventually, my professor asked, “Is there anyone that thinks this girl is doing something wrong?” Not one person raised their hand.

I guess I was always looking for something. What it was, I didn’t know. I wanted help from the VA, but didn’t want to go back, didn’t want to be subjected to that second-rate treatment any longer. I wanted to find peace within myself, but didn’t know how or where to locate it. I wanted to be a sergeant again, a writer, less angry, a better husband, and to ward off the constant bombardment of war-related thoughts. Most of all, I didn’t want any more Americans coming home from Iraq in boxes or with jingle-jangled minds.

after the war, historian Marilyn Young warned: The U.S. can destroy Iraq’s highways, but not build its own; create the conditions for epidemic in Iraq, but not offer health care to millions of Americans. It can excoriate Iraqi treatment of the Kurdish minority, but not deal with domestic race relations; create homelessness abroad but not solve it here; keep a half million troops drug free as part of a war, but refuse to fund the treatment of millions of drug addicts at home. . . . We shall lose the war after we have won it.

However we select from nature a complex (of phenomena) using the criterion of simplicity, in no case will its theoretical treatment turn out to be forever appropriate...But I do not doubt that the day will come when that description (the general theory of relativity), too, will have to yield to another one, for reasons which at present we do not yet surmise. I believe that that this process of deepening the theory has no limits.

trick, though. Treatment has always been more effective and cheaper than prison for true drug addicts. What’s changed, Norman said, is that no longer are most of the accused African American inner-city crack users and dealers. Most of the new Tennessee junkies come from the white middle and upper-middle classes, and from the state’s white rural heartland—people who vote for, donate to, live near, do business with, or are related to the majority of Tennessee legislators.

The study reported a 24 percent relative increase in the risk of breast cancer among a subset of women taking HRT, and headlines all over the world condemned HRT as a dangerous, cancer-causing therapy. All of a sudden, on the basis of this one study, hormone replacement treatment became virtually taboo. This reported 24 percent risk increase sounded scary indeed. But nobody seemed to care that the absolute risk increase of breast cancer for women in the study remained minuscule. Roughly five out of every one thousand women in the HRT group developed breast cancer, versus four out of every one thousand in the control group, who received no hormones.

...his condition in Roanoke is a strong testament that lassitude, indifference and the peculiarities of his thought were primarily the consequences of his illness and not of the early attempts to treat it. The popular view that anti-psychotics were chemical straight jackets that suppressed clear thinking and voluntary activity seems not to be borne out in Nash's case. If anything, the only periods when he was relatively free of hallucinations, delusions and the erosion of will were the periods following either insulin treatment or the use of anti psychotics. In other words, rather than reducing Nash to a zombie, medication seemed to reduce zombie like behavior.

The cost savings weren’t what did the trick, though. Treatment has always been more effective and cheaper than prison for true drug addicts. What’s changed, Norman said, is that no longer are most of the accused African American inner-city crack users and dealers. Most of the new Tennessee junkies come from the white middle and upper-middle classes, and from the state’s white rural heartland—people who vote for, donate to, live near, do business with, or are related to the majority of Tennessee legislators.

It is acknowledged that father-daughter incest occurs on a large scale in the United States. Sexual abuse has now been included in child abuse legislation. A conservative estimate is that more than 1 million women have been sexually victimized by their fathers or other male relatives, but the true figure probably is much higher. Many victims still fear reporting incest, and families continued to collude to keep the situation secret. Issues of family privacy and autonomy remain troublesome even when incest is reported and must be resolved for treatment to be effective. " Mary de Chesnay J. Psychosoc. Nurs. Med. Health Sep. 22:9-16 Sept 1984 reprinted in Talbott's 1986 edition

The treatment accorded the Negro during the Second World War marks, for me, a turning point in the Negro’s relation to America. To put it briefly, and somewhat too simply, a certain hope died, a certain respect for white Americans faded. One began to pity them, or to hate them. You must put yourself in the skin of a man who is wearing the uniform of his country, is a candidate for death in its defense, and who is called a “nigger” by his comrades-in-arms and his officers; who is almost always given the hardest, ugliest, most menial work to do; who knows that the white G.I. has informed the Europeans that he is subhuman (so much for the American male’s sexual security); who does not dance at the U.S.O. the night white soldiers dance there, and does not drink in the same bars white soldiers drink in; and who watches German prisoners of war being treated by Americans with more human dignity than he has ever received at their hands. And who, at the same time, as a human being, is far freer in a strange land than he has ever been at home.

The way we react to the Indian will always remain this nation’s unique moral headache. It may seem a smaller problem than our Negro one, and less important, but many other sections of the world have had to grapple with slavery and its consequences. There’s no parallel for our treatment of the Indian. In Tasmania the English settlers solved the matter neatly by killing off every single Tasmanian, bagging the last one as late as 1910. Australia had tried to keep its aborigines permanently debased—much crueler than anything we did with our Indians. Brazil, about the same. Only in America did we show total confusion. One day we treated Indians as sovereign nations. Did you know that my relative Lost Eagle and Lincoln were photographed together as two heads of state? The next year we treated him as an uncivilized brute to be exterminated. And this dreadful dichotomy continues.

We have passed some of the dirtiest chapters of mankind. Perhaps we are heading towards further inhuman treatments in many places such as Syria and Palestine.

Blood gets you related. Loyalty, bond and treatment makes you family.

Many survivors of relational and other forms of early life trauma are deeply troubled and often struggle with feelings of anger, grief, alienation, distrust, confusion, low self-esteem, loneliness, shame, and self-loathing. They seem to be prisoners of their emotions, alternating between being flooded by intense emotional and physiological distress related to the trauma or its consequences and being detached and unable to express or feel any emotion at all - alternations that are the signature posttraumatic pattern. These occur alongside or in conjunction with other common reactions and symptoms (e.g., depression, anxiety, and low self-esteem) and their secondary manifestations. Those with complex trauma histories often have diffuse identity issues and feel like outsiders, different from other people, whom they somehow can't seem to get along with, fit in with, or get close to, even when they try. Moreover, they often feel a sense of personal contamination and that no one understands or can help them. Quite frequently and unfortunately, both they and other people (including the professionals they turn to for help) do misunderstand them, devalue their strengths, or view their survival adaptations through a lens of pathology (e.g., seeing them as "demanding", "overdependent and needy", "aggressive", or as having borderline personality). Yet, despite all, many individuals with these histories display a remarkable capacity for resilience, a sense of morality and empathy for others, spirituality, and perseverance that are highly admirable under the circumstances and that create a strong capacity for survival. Three broad categories of survivorship, with much overlap between them, can be discerned: 1. Those who have successfully overcome their past and whose lives are healthy and satisfying. Often, individuals in this group have had reparative experiences within relationships that helped them to cope successfully. 2. Those whose lives are interrupted by recurring posttraumatic reactions (often in response to life events and experiences) that periodically hijack them and their functioning for various periods of time. 3. Those whose lives are impaired on an ongoing basis and who live in a condition of posttraumatic decline, even to the point of death, due to compromised medical and mental health status or as victims of suicide of community violence, including homicide.

Attachment is central to the context in which all other action systems mature. If attachment is disrupted early in life, it may lead to maladaptive functioning in various areas of life because the most basic action systems do not function well. Attachment relationships assist individuals in regulating their emotions and physiology, providing basic internal and relational stability.

Far more potently than any miracle medicine, relatively uncelebrated shifts in civic arrangements--better nutrition, housing, and sanitation, improved sewage systems and ventilation--had driven TB mortality down in Europe and America. Polio and smallpox had also dwindles as a result of vaccinations. Cains wrote, "The death rates from malaria, cholera, typhus, tuberculosis, scurvy, pellagra, and other scourges of the past have dwindled in the US because humankind has learned how to prevent these diseases.... To put most of the effort into treatment is to deny all precedent.

Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current healthcare system. There are few insurance reimbursement codes for most of the largely preventive interventions that I believe are necessary to extend lifespan and healthspan. Health insurance companies won’t pay a doctor very much to tell a patient to change the way he eats, or to monitor his blood glucose levels in order to help prevent him from developing type 2 diabetes. Yet insurance will pay for this same patient’s (very expensive) insulin after he has been diagnosed. Similarly, there’s no billing code for putting a patient on a comprehensive exercise program designed to maintain her muscle mass and sense of balance while building her resistance to injury. But if she falls and breaks her hip, then her surgery and physical therapy will be covered. Nearly all the money flows to treatment rather than prevention—and when I say “prevention,” I mean prevention of human suffering.

But the idea of a peace dividend could not be stifled so long as Americans were in need. Shortly after the war, historian Marilyn Young warned: The U.S. can destroy Iraq's highways, but not build its own; create the conditions for epidemic in Iraq, but not offer health care to millions of Americans. It can excoriate Iraqi treatment of the Kurdish minority, but not deal with domestic race relations; create homelessness abroad but not solve it here; keep a half million troops drug free as part of a war, but refuse to fund the treatment of millions of drug addicts at home. . . . . We shall lose the war after we have won it.

In perhaps the most revealing of all the health-related studies, a group of subjects who had contracted malignant melanoma received traditional treatment and then were divided into two groups. One group met weekly for only six weeks; the other did not. Facilitators taught the first group of recovering patients specific communication skills. (When it's your life that's at stake, could anything be more crucial?) After meeting only six times and then dispersing for five years, the subjects who learned how to express themselves effectively had a higher survival rate--only 9 percent succumbed as opposed to almost 30 percent in the untrained group.

... the silent client may be experienced as withholding, oppositional, and sulking or as holding the therapist "hostage" in ways that elicit resentment and other negative responses. Because it is not unusual that relational and other forms of traumatization began when the client was preverbal, he or she may not have words. The lack of access to emotions or to words to describe them is known as alexithymia and is a common response to trauma. What the client is likely to have instead is somatosensory, behavioral, dissociative, and relational manifestations that therapists must seek to understand and translate into words, a process that involves hard work and intense focus.

Instead of showing visibly distinct alternate identities, the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stressdisorder (PTSD) symptoms that are embedded in a matrix of ostensibly non-trauma-related symptoms (e.g., depression, panic attacks, substance abuse,somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions. - Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p5

Maternal/child attachment is mostly eroded in increments. The separation begins in hospitals, where mothers are not only made to feel inferior to medical professionals in relation to their infants, but regularly separated from their infants.

That concentration camps were ultimately provided for the same groups in all countries, even though there were considerable differences in the treatment of their inmates, was all the more characteristic as the selection of the groups was left exclusively to the initiative of the totalitarian regimes: if the Nazis put a person in a concentration camp and if he made a successful escape, say, to Holland, the Dutch would put him in an internment camp. Thus, long before the outbreak of the war the police in a number of Western countries, under the pretext of "national security," had on their own initiative established close connections with the Gestapo and the GPU [Russian State security agency], so that one might say there existed an independent foreign policy of the police. This police-directed foreign policy functioned quite independently of the official governments; the relations between the Gestapo and the French police were never more cordial than at the time of Leon Blum's popular-front government, which was guided by a decidedly anti-German policy. Contrary to the governments, the various police organizations were never overburdened with "prejudices" against any totalitarian regime; the information and denunciations received from GPU agents were just as welcome to them as those from Fascist or Gestapo agents. They knew about the eminent role of the police apparatus in all totalitarian regimes, they knew about its elevated social status and political importance, and they never bothered to conceal their sympathies. That the Nazis eventually met with so disgracefully little resistance from the police in the countries they occupied, and that they were able to organize terror as much as they did with the assistance of these local police forces, was due at least in part to the powerful position which the police had achieved over the years in their unrestricted and arbitrary domination of stateless and refugees.

McKusick's belief in this paradigm-the focus on disability rather than abnormalcy-was actualized in the treatment of patients in his clinic. Patients with dwarfism, for instance, were treated by an interdisciplinary team of genetic counselors, neurologists, orthopedic surgeons, nurses, and psychiatrists trained to focus on specific disabilities of persons with short stature. Surgical interventions were reserved to correct specific deformities as they arose. The goal was not to restore "normalcy"-but vitality, joy, and function. McKusic had rediscovered the founding principles of modern genetics in the realm of human pathology. In humans as in wild flies, genetic variations abounded. Here too genetic variants, environments, and gene-environment interactions ultimately collaborated to cause phenotypes-except in this case, the "phenotype" in question was disease. Here too some genes had partial penetrance and widely variable expressivity. One gene could cause many diseases, and one disease could be caused by many genes. And here too "fitness" could not be judged in absolutes. Rather the lack of fitness-illness [italicized, sic] in colloquial terms- was defined by the relative mismatch between an organism and environment.

It’s normally agreed that the question “How are you?” doesn’t put you on your oath to give a full or honest answer. So when asked these days, I tend to say something cryptic like, “A bit early to say.” (If it’s the wonderful staff at my oncology clinic who inquire, I sometimes go so far as to respond, “I seem to have cancer today.”) Nobody wants to be told about the countless minor horrors and humiliations that become facts of “life” when your body turns from being a friend to being a foe: the boring switch from chronic constipation to its sudden dramatic opposite; the equally nasty double cross of feeling acute hunger while fearing even the scent of food; the absolute misery of gut–wringing nausea on an utterly empty stomach; or the pathetic discovery that hair loss extends to the disappearance of the follicles in your nostrils, and thus to the childish and irritating phenomenon of a permanently runny nose. Sorry, but you did ask... It’s no fun to appreciate to the full the truth of the materialist proposition that I don’t have a body, I am a body. But it’s not really possible to adopt a stance of “Don’t ask, don’t tell,” either. Like its original, this is a prescription for hypocrisy and double standards. Friends and relatives, obviously, don’t really have the option of not making kind inquiries. One way of trying to put them at their ease is to be as candid as possible and not to adopt any sort of euphemism or denial. The swiftest way of doing this is to note that the thing about Stage Four is that there is no such thing as Stage Five. Quite rightly, some take me up on it. I recently had to accept that I wasn’t going to be able to attend my niece’s wedding, in my old hometown and former university in Oxford. This depressed me for more than one reason, and an especially close friend inquired, “Is it that you’re afraid you’ll never see England again?” As it happens he was exactly right to ask, and it had been precisely that which had been bothering me, but I was unreasonably shocked by his bluntness. I’ll do the facing of hard facts, thanks. Don’t you be doing it too. And yet I had absolutely invited the question. Telling someone else, with deliberate realism, that once I’d had a few more scans and treatments I might be told by the doctors that things from now on could be mainly a matter of “management,” I again had the wind knocked out of me when she said, “Yes, I suppose a time comes when you have to consider letting go.” How true, and how crisp a summary of what I had just said myself. But again there was the unreasonable urge to have a kind of monopoly on, or a sort of veto over, what was actually sayable. Cancer victimhood contains a permanent temptation to be self–centered and even solipsistic.

But since I could find nothing equivocal or neurotic in the facts about the son's relation to his father, I had no warrant for disturbing the young man's feelings with such a destructive pronouncement. To do so would have prejudiced the outcome of the treatment.

When I introduce myself as a card-carrying Libertarian, more often than not I get the same old response: 'Oh, you're the people who want to legalize drugs.' Well, not exactly. We're the people who understand that American taxpayers are paying absurd amounts of money to accomplish goals that could be met at a fraction of the cost. We're the people who think it's ridiculous that the majority of the growth in our prison populations in this country is due to slamming people in jail just because they were caught using drugs. We're the ones who understand that so much of the crime on the streets of our country is drug-related--crime that would largely disappear if the massive profits brought on by drug criminalization were eliminated. We're the party that understands that you can reduce drug usage more efficiently, and at a lower cost, through treatment than through law enforcement.

Novels aren’t about heroes. They’re about us. The novel is a literary form that arose at the same time as the middle class in Europe, those people of small business and property who are neither peasant nor aristocrat, and it has always treated of the middle class. Both lyric and epic poetry grew out of a time that was elitist, a time that believed in the innate rate of royalty to rule and the rest of us to amount to not very much. Hardly surprising, then, that both forms lean toward the aristocratic in subject matter and treatment. The novel, on the other hand, isn’t about them; it’s about us.

This extreme treatment was among the proliferating regimens developed in response to the stunning increase in nervous disorders diagnosed around the turn of the century. Commentators and clinicians cited a number of factors related to the stresses of modern civilization: the increased speed of communication facilitated by the telegraph and railroad; the “unmelodious” clamor of city life replacing the “rhythmical” sounds of nature; and the rise of the tabloid press that exploded “local horrors” into national news. These nervous diseases became an epidemic among “the ultracompetitive businessman and the socially active woman.

Trust of others is in short supply for many adult survivors, as complex trauma generally involves major relational betrayal. It is, therefore, expectable (although paradoxical) that clients with these histories are predisposed to be mistrustful at the outset of therapy, precisely because of (and in proportion to) the actual trustworthiness of the therapist. When past experiences have thought hard lessons, namely, that one can least afford to trust the people who should be most trustworthy, it stands to reason that confusion about trust results. The therapist must understand and not take offense either personally or professionally and not react judgmentally or defensively. Practically speaking, this involves the therapist being prepared to patiently and empathically respond to active or passive tests or challenges to trustworthiness as legitimate and meaningful communication that deserves a respectful reply in action as well as in words.

In these pages, we keep returning to one foundational principle: providing the possibility of emotional/relational safety for our people, be they patients, children, partners, friends or strangers. We are able to make this offer when they are experiencing their own neuroception of safety, not continuously, but as the baseline to which we return after our system has adaptively moved into sympathetic arousal or dorsal withdrawal in response to inner and outer conditions. When we neuroceive safety, we humans automatically begin to open into vulnerability, and the movement of our "inherent treatment plan" (Sills, 2010) has a greater probability of coming forward. When we have a neuroception of threat, we adaptively tighten down at many levels, from physical tension to activation of the protective skills we have learned over a lifetime (Levine, 2010). In that state, our innate healing path will often wisely stay hidden until more favorable conditions arrive.

In subject files labeled as correspondence related to Rosemary Kennedy, withdrawal sheets indicate the removal of hundreds of documents dating between 1923 and the 1970s. This leaves significant gaps in the historical record. A large amount of the withdrawn material is associated with Rosemary’s treatment and care after her lobotomy.

My belief that addiction was an issue of social injustice stemmed from my most basic understanding of things like the lack of treatment options for those suffering from addiction, or the way we are dehumanized. Listening to a mother talk about her “junkie daughter,” or my own relative talk about her friend’s “addict grandson”—in that way we are conditioned to talk about the sickest, most vulnerable people in our orbit as problems to be fixed or liabilities to be handled or criminals to be locked up—ripped something in me. I started out with a complete and heartbreaking rage over how we treat (and don’t treat) people suffering with addiction, and only because I was one of them.

This effect occurs relatively quickly, unlike the requirement to build up levels in the bloodstream that accompanies some prescription drugs for depression. It is, therefore, an effective, natural, and quick-acting treatment for mild depression. Human trials have also shown benefits for strengthening the liver and for relief from osteoarthritis.

In fact, the same intervention or response may even have the opposite effect on two different clients with contrasting developmental histories and cultural contexts. For example, if a client’s parent was distant or aloof, the therapist’s judicious self-disclosure may be helpful for the client. In contrast, the same type of self-disclosure is likely to be anxiety-arousing for a client who grew up serving as the confidant or emotional caregiver of a depressed parent. Greater sharing with the therapist may help the first client learn that, contrary to her deeply held beliefs, she does matter and can be of interest to other people. In contrast, for the second client, the same type of self-disclosure may inadvertently impose the unwanted needs of others and set this client back in treatment as, in her mind, she experiences herself back in her old caretaking role again—this time with the therapist. This unwanted reenactment occurs because the therapeutic relationship is now paralleling the same problematic relational theme that this client struggled with while growing up.

Portugal, for example, responded to persistent problems of drug addiction and abuse by decriminalizing the possession of all drugs and redirecting the money that would have been spent putting drug users in cages into drug treatment and prevention. Ten years later, Portugal reported that rates of drug abuse and addiction had plummeted, and drug-related crime was on the decline as well.

You find as you look around the world that every single bit of progress in humane feeling, every improvement in the criminal law, every step towards the diminution of war, every step towards better treatment of the coloured races, or every mitigation of slavery, every moral progress that there has been in the world, has been consistently opposed by the organised Churches of the world.

Themes of descent often turn on the struggle between the titanic and the demonic within the same person or group. In Moby Dick, Ahab’s quest for the whale may be mad and “monomaniacal,” as it is frequently called, or even evil so far as he sacrifices his crew and ship to it, but evil or revenge are not the point of the quest. The whale itself may be only a “dumb brute,” as the mate says, and even if it were malignantly determined to kill Ahab, such an attitude, in a whale hunted to the death, would certainly be understandable if it were there. What obsesses Ahab is in a dimension of reality much further down than any whale, in an amoral and alienating world that nothing normal in the human psyche can directly confront. The professed quest is to kill Moby Dick, but as the portents of disaster pile up it becomes clear that a will to identify with (not adjust to) what Conrad calls the destructive element is what is really driving Ahab. Ahab has, Melville says, become a “Prometheus” with a vulture feeding on him. The axis image appears in the maelstrom or descending spiral (“vortex”) of the last few pages, and perhaps in a remark by one of Ahab’s crew: “The skewer seems loosening out of the middle of the world.” But the descent is not purely demonic, or simply destructive: like other creative descents, it is partly a quest for wisdom, however fatal the attaining of such wisdom may be. A relation reminiscent of Lear and the fool develops at the end between Ahab and the little black cabin boy Pip, who has been left so long to swim in the sea that he has gone insane. Of him it is said that he has been “carried down alive to wondrous depths, where strange shapes of the unwarped primal world glided to and fro . . . and the miser-merman, Wisdom, revealed his hoarded heaps.” Moby Dick is as profound a treatment as modern literature affords of the leviathan symbolism of the Bible, the titanic-demonic force that raises Egypt and Babylon to greatness and then hurls them into nothingness; that is both an enemy of God outside the creation, and, as notably in Job, a creature within it of whom God is rather proud. The leviathan is revealed to Job as the ultimate mystery of God’s ways, the “king over all the children of pride” (41:34), of whom Satan himself is merely an instrument. What this power looks like depends on how it is approached. Approached by Conrad’s Kurtz through his Antichrist psychosis, it is an unimaginable horror: but it may also be a source of energy that man can put to his own use. There are naturally considerable risks in trying to do so: risks that Rimbaud spoke of in his celebrated lettre du voyant as a “dérèglement de tous les sens.” The phrase indicates the close connection between the titanic and the demonic that Verlaine expressed in his phrase poète maudit, the attitude of poets who feel, like Ahab, that the right worship of the powers they invoke is defiance.

It is due, however, to my mistress to say of her, that she did not adopt this course of treatment immediately. She at first lacked the depravity indispensable to shutting me up in mental darkness. It was at least necessary for her to have some training in the exercise of irresponsible power, to make her equal to the task of treating me as though I were a brute. My mistress was, as I have said, a kind and tender-hearted woman; and in the simplicity of her soul she commenced, when I first went to live with her, to treat me as she supposed one human being ought to treat another. In entering upon the duties of a slaveholder, she did not seem to perceive that I sustained to her the relation of a mere chattel, and that for her to treat me as a human being was not only wrong, but dangerously so. Slavery proved as injurious to her as it did to me. When I went there, she was a pious, warm, and tender-hearted woman. There was no sorrow or suffering for which she had not a tear. She had bread for the hungry, clothes for the naked, and comfort for every mourner that came within her reach. Slavery soon proved its ability to divest her of these heavenly qualities. Under its influence, the tender heart became stone, and the lamblike disposition gave way to one of tiger-like fierceness.

The rape and exploitation of enslaved black women was not just rampant, it was endemic. The writings of former slaves such Harriet Jacobs, as well those of sympathetic white women like abolitionist Sarah Grimké, paint a picture of black girls in their early teens getting routinely bribed with presents and “favors,” such as promises of better treatment, for agreeing to sex with white plantation workers or relatives of the owner.

We hit slavery through a great civil war. Did we destroy it? No, we only changed it into hatred between sections of the country: in the South, into political corruption and chicanery, the degradation of the blacks through peonage, unjust laws, unfair and cruel treatment; and the degradation of the whites by their resorting to these practices, the paralyzation of the public conscience, and the ever over-hanging dread of what the future may bring.

I have used the theologians and their treatment of apocalypse as a model of what we might expect to find not only in more literary treatments of the same radical fiction, but in the literary treatment of radical fictions in general. The assumptions I have made in doing so I shall try to examine next time. Meanwhile it may be useful to have some kind of summary account of what I've been saying. The main object: is the critical business of making sense of some of the radical ways of making sense of the world. Apocalypse and the related themes are strikingly long-lived; and that is the first thing to say tbout them, although the second is that they change. The Johannine acquires the characteristics of the Sibylline Apocalypse, and develops other subsidiary fictions which, in the course of time, change the laws we prescribe to nature, and specifically to time. Men of all kinds act, as well as reflect, as if this apparently random collocation of opinion and predictions were true. When it appears that it cannot be so, they act as if it were true in a different sense. Had it been otherwise, Virgil could not have been altissimo poeta in a Christian tradition; the Knight Faithful and True could not have appeared in the opening stanzas of "The Faerie Queene". And what is far more puzzling, the City of Apocalypse could not have appeared as a modern Babylon, together with the 'shipmen and merchants who were made rich by her' and by the 'inexplicable splendour' of her 'fine linen, and purple and scarlet,' in The Waste Land, where we see all these things, as in Revelation, 'come to nought.' Nor is this a matter of literary allusion merely. The Emperor of the Last Days turns up as a Flemish or an Italian peasant, as Queen Elizabeth or as Hitler; the Joachite transition as a Brazilian revolution, or as the Tudor settlement, or as the Third Reich. The apocalyptic types--empire, decadence and renovation, progress and catastrophe--are fed by history and underlie our ways of making sense of the world from where we stand, in the middest.

This extreme treatment was among the proliferating regimens developed in response to the stunning increase in nervous disorders diagnosed around the turn of the century. Commentators and clinicians cited a number of factors related to the stresses of modern civilization: the increased speed of communication facilitated by the telegraph and railroad; the “unmelodious” clamor of city life replacing the “rhythmical” sounds of nature; and the rise of the tabloid press that exploded “local horrors” into national news.

slavery never took the form of the large-scale plantations found in the American South, the Caribbean or South America. Plantations, though their establishment was desired by some colonists, were found to be incompatible with Canada’s climate and short growing season (Mackey 2010). As a result, the number of enslaved people in Canada was always lower, and the economy less reliant on slave labour than other parts of the Americas and the Caribbean. These distinctions have underpinned the assumption in some existing scholarship that enslavement in Canada was relatively benign. Yet, the absence of slave plantation economies does not negate the brutality of the centuries-long, state-supported practice of slavery. White individuals and white settler society profited from owning unfree Black (and Indigenous) people and their labour for hundreds of years while exposing them to physical and psychological brutality, and the inferiority ascribed to Blackness in this era would affect the treatment of Black persons living in Canada for centuries to come.

Anxiety (loneliness or “abandonment anxiety” being its most painful form) overcomes the person to the extent that he loses orientation in the objective world. To lose the world is to lose one's self, and vice versa; self and world are correlates. The function of anxiety is to destroy the self-world relationship, i.e., to disorient the victim in space and time and, so long as this disorientation lasts, the person remains in the state of anxiety. Anxiety overwhelms the person precisely because of the preservation of this disorientation. Now if the person can reorient himself—as happens, one hopes, in psychotherapy—and again relate himself to the world directly, experientially, with his senses alive, he overcomes the anxiety. My slightly anthropomorphic terminology comes out of my work as a therapist and is not out of place here. Though the patient and I are entirely aware of the symbolic nature of this (anxiety doesn’t do anything, just as libido or sex drives don’t), it is often helpful for the patient to see himself as struggling against an “adversary.” For then, instead of waiting forever for the therapy to analyze away the anxiety, he can help in his own treatment by taking practical steps when he experiences anxiety such as stopping and asking just what it was that occurred in reality or in his fantasies that preceded the disorientation which cued off the anxiety. He is not only opening the doors of his closet where the ghosts hide, but he often can also then take steps to reorient himself in his practical life by making new human relationships and finding new work which interests him.

The overarching principle of a therapeutic relationship is that therapists should be ever mindful of a variant of the Hippocratic oath and, to the degree possible, strive to "do no more harm" (Courtois, 2010). Complex trauma clients have already experienced considerable harm, much of it at the hands of other human beings. As a result of the ubiquitous processes of transference, attachment styles, and IWM [Internal working models], these clients often view the therapist's behavior and their relationship through the lens of their trauma-related negative interpersonal expectancies and unhealed emotional wounds and injuries. Therapists should not be surprised to be "guilty until proven innocent", not because clients with complex trauma histories are "unfair" or "unreasonable" but precisely the opposite - because the most realistic self-protective stance for them (given the fact that betrayal and harm have been more the rule than the exception) is to "distrust first and verify" (or to be hypervigilant) rather than to start with an expectation of safety and trustworthiness.

The most notorious story is the Trovan antibiotic study conducted by Pfizer in Kano, Nigeria, during a meningitis epidemic. An experimental new antibiotic was compared, in a randomised trial, with a low dose of a competing antibiotic that was known to be effective. Eleven children died, roughly the same number from each group. Crucially, the participants were apparently not informed about the experimental nature of the treatments, and moreover, they were not informed that a treatment known to be effective was available, immediately, from Médecins sans Frontières next door at the very same facility. Pfizer argued in court – successfully – that there was no international norm requiring it to get informed consent for a trial involving experimental drugs in Africa, so the cases relating to the trial should be heard in Nigeria only. That’s a chilling thing to hear a company claim about experimental drug trials, and it was knocked back in 2006 when the Nigerian Ministry of Health released its report on the trial. This stated that Pfizer had violated Nigerian law, the UN Convention on the Rights of the Child and the Declaration of Helsinki.

As a bonus, Rand agreed to design a personal calling card for Jobs. He came up with a colorful type treatment, which Jobs liked, but they ended up having a lengthy and heated disagreement about the placement of the period after the “P” in Steven P. Jobs. Rand had placed the period to the right of the “P.”, as it would appear if set in lead type. Steve preferred the period to be nudged to the left, under the curve of the “P.”, as is possible with digital typography. “It was a fairly large argument about something relatively small,” Susan Kare recalled. On this one Jobs prevailed. In

... as Herman (1992b) cogently noted two decades ago, these personality disorders can be iatrogenic, causing harm to individuals as an inadvertent result of the social stigma they carry and the widespread (but not entirely accurate) belief among professionals and insurers that those with Cluster B personality disorders (especially borderline personality disorder[BPD]) cannot be treated successfully, cannot recover, and are a headache to practitioners. For example, the BPD diagnosis continues to be applied predominantly to women often, but not always, in a negative way, usually signifying that they are irrational and beyond help. Describing posttraumatic symptoms as a personality disorder not only can be demoralizing for the client due to its connotation that something is defective with his or her core self (i.e., personality) but also may misdirect the therapist by implying that the patient's core personality should be the focus of treatment rather than trauma-related adaptations that affect but are distinct from the core self. In this way, both therapists and their clients may overlook personality strengths and capacities that are healthy and sources of resilience that can be a basis for building on and enhancing (rather than "fixing" or remaking) the patient's core self and personality.

S-adenosyl-methionine (SAMe) is a natural derivative of an amino acid normally produced by the body, and it plays a role in methylation (see Chapter 5). Levels of SAMe in the body often become depleted by middle age. Multiple clinical trials have shown that SAMe provides substantial benefit for patients with depression. This effect occurs relatively quickly, unlike the requirement to build up levels in the bloodstream that accompanies some prescription drugs for depression. It is, therefore, an effective, natural, and quick-acting treatment for mild depression. Human trials have also shown benefits for strengthening the liver and for relief from osteoarthritis.

Over the past twenty years, terrified of appearing culturally insensitive or even racist, Western nations have bent over backward to accommodate the demands of their Muslim citizens for special treatment. We appeased the Muslim heads of government who lobbied us to censor our press, our universities, our history books, our school curricula. We appeased leaders of Muslim organizations in our societies, who asked universities to disinvite speakers deemed ‘offensive’ to Muslims. Instead of embracing Muslim dissidents, Western governments treated them as troublemakers and instead partnered with the wrong people – groups such as the Council on American-Islamic Relations.

The media squabble over Shchepotin’s final day at the Cancer Institute, and the doubts it raised over the motivation of all concerned, were appropriate, because the most corrosive aspect of corruption is the way that it undermines trust. When corruption is widespread, it becomes impossible to know whom to believe, since the money infects every aspect of state and society. Every newspaper article can be criticized as paid for, every politician can be called corrupt, every court decision can be called into question. Charities are set up by oligarchs to lobby for their interests, and those then provoke doubts about every other non-governmental organization. If even doctors are on the take, can you trust their diagnoses? Are they claiming a patient needs treatment only because that would be to their profit? If policemen are crooked, and courts are paid for, are criminals really criminals? Or are they honest people who interfered in criminals’ business? Not knowing whom to believe, you retreat into trusting only those closest to you—your oldest friends, and your relatives—and that reinforces the divisions in society that corruption thrives on. It is impossible to build a thriving economy, or a healthy democracy, without a society whose members fundamentally trust each other. If you take that away, you are left with something far darker and more mercenary.

Collectively this work suggests that the prefrontal cortex and the amygdala are reciprocally related. That is, in order for the amygdala to respond to fear reactions, the prefrontal region has to be shut down. By the same logic, when the prefrontal region is active, the amygdala would be inhibited, making it harder to express fear. Pathological fear, then, may occur when the amygdala is unchecked by the prefrontal cortex, and treatment of pathological fear may require that the patient learn to increase activity in the prefrontal region so that the amygdala is less free to express fear. Clearly, decision-making ability in emotional situations is impaired in humans with damage to the medial and ventral prefrontal cortex, and abnormalities there also may predispose people to develop fear and anxiety disorders. These abnormalities could be due to genetic or epigenetic organization of prefrontal synapses or to experiences that subtly alter prefrontal synaptic connections. Indeed, the behavior of animals with abmormalities of the medial prefrontal cortex is reminiscent of humans with anxiety disorders: they develop fear reactions that are difficult to regulate. Although objective information about the world may indicate that a situation is not dangerous, because they cannot properly regulate fear circuits, they experience fear and anxiety in these safe situations.

Though diagnosis is unquestionably critical in treatment considerations for many severe conditions with a biological substrate (for example, schizophrenia, bipolar disorders, major affective disorders, temporal lobe epilepsy, drug toxicity, organic or brain disease from toxins, degenerative causes, or infectious agents), diagnosis is often counterproductive in the everyday psychotherapy of less severely impaired patients. Why? For one thing, psychotherapy consists of a gradual unfolding process wherein the therapist attempts to know the patient as fully as possible. A diagnosis limits vision; it diminishes ability to relate to the other as a person. Once we make a diagnosis, we tend to selectively inattend to aspects of the patient that do not fit into that particular diagnosis, and correspondingly overattend to subtle features that appear to confirm an initial diagnosis. What’s more, a diagnosis may act as a self-fulfilling prophecy. Relating to a patient as a “borderline” or a “hysteric” may serve to stimulate and perpetuate those very traits. Indeed, there is a long history of iatrogenic influence on the shape of clinical entities, including the current controversy about multiple-personality disorder and repressed memories of sexual abuse. And keep in mind, too, the low reliability of the DSM personality disorder category (the very patients often engaging in longer-term psychotherapy).

For us, the possibility of kindly use is weighted with problems. In the first place, this is not ultimately an organization or institutional solution. Institutional solutions tend to narrow and simplify as they approach action. A large number of people can act together only by defining the point or the line on which their various interests converge. Organizations tend to move toward single objectives -- a ruling, a vote, a law -- and they find it relatively simple to cohere under acronyms and slogans. But kindly use is a concept that of necessity broadens, becoming more complex and diverse, as it approaches action. The land is too various in its kinds, climates, conditions, declivities, aspects, and histories to conform to any generalized understanding or to prosper under generalized treatment. The use of land cannot be both general and kindly -- just as the forms of good manners, generally applied (applied, that is, without consideration of differences), are experienced as indifference, bad manners. To treat every field, or every part of every field, with the same consideration is not farming but industry. Kindly use depends upon intimate knowledge, the most sensitive responsiveness and responsibility. As knowledge (hence, use) is generalized, essential values are destroyed. As the householder evolves into a consumer, the farm evolves into a factory -- with results that are potentially calamitous for both.

We might ask what role relational neuroscience plays in these kinds of experiences. For me, it begins with the body. Cultivating an understanding -- and most importantly a felt sense -- of these neural pathways helps us attune body to body with our people as they enter these deeper, more challenging realms. Through resonance, our capacity to attend to our bodies while remaining in a ventral state gradually becomes theirs. An indispensable support comes from our left hemisphere's deepening understanding of the particulars of the healing process. The stability this provides helps our right stay as engaged as possible in the relationship with all its emerging uncertainty. When Joshua became so suddenly depressed, Jaak Panksepp came to mind, so I could remain curious rather than scared. When Caroline entered increasingly intense states with her mother, Stephen Porges helped me remain mindful of our joined windows of tolerance and the necessity of staying in connection for co-regulation and disconfirmation to occur. The whole process of leading, following and responding rests on his statement, "Safety IS the treatment". In the broadest way, Dan Siegel's voice fosters deep acquaintance with the principles of interpersonal neurobiology, which supports hope for healing, confidence in our inherent health, and appreciation for our co-organizing brains. Each of these strands of knowledge increases our trust in the process. You may sense yourself adding to the list those that have been most helpful for you.

But it is the nature of narcissistic entitlement to see the situation from only one very subjective point of view that says “My feelings and needs are all that matter, and whatever I want, I should get.” Mutuality and reciprocity are entirely alien concepts, because others exist only to agree, obey, flatter, and comfort – in short, to anticipate and meet my every need. If you cannot make yourself useful in meeting my need, you are of no value and will most likely be treated accordingly, and if you defy my will, prepare to feel my wrath. Hell hath no fury like the Narcissist denied. Narcissists hold these unreasonable expectations of particularly favorable treatment and automatic compliance because they consider themselves uniquely special. In social situations, you will talk about them or what they are interested in because they are more important, more knowledgeable, or more captivating than anyone else. Any other subject is boring and won’t hold interest, and, in their eyes, they most certainly have a right to be entertained. In personal relationships, their sense of entitlement means that you must attend to their needs but they are under no obligation to listen to or understand you. If you insist that they do, you are “being difficult” or challenging their rights. How dare you put yourself before me? they seem to (or may actually) ask. And if they have real power over you, they feel entitled to use you as they see fit and you must not question their authority. Any failure to comply will be considered an attack on their superiority. Defiance of their will is a narcissistic injury that can trigger rage and self-righteous aggression. The conviction of entitlement is a holdover from the egocentric stage of early childhood, around the age of one to two, when children experience a natural sense of grandiosity that is an essential part of their development. This is a transitional phase, and soon it becomes necessary for them to integrate their feelings of self-importance and invincibility with an awareness of their real place in the overall scheme of things that includes a respect for others. In some cases, however, the bubble of specialness is never popped, and in others the rupture is too harsh or sudden, as when a parent or caretaker shames excessively or fails to offer soothing in the wake of a shaming experience. Whether overwhelmed with shame or artificially protected from it, children whose infantile fantasies are not gradually transformed into a more balanced view of themselves in relation to others never get over the belief that they are the center of the universe. Such children may become self-absorbed “Entitlement monsters,” socially inept and incapable of the small sacrifices of Self that allow for reciprocity in personal relationships. The undeflated child turns into an arrogant adult who expects others to serve as constant mirrors of his or her wonderfulness. In positions of power, they can be egotistical tyrants who will have their way without regard for anyone else. Like shame, the rage that follows frustrated entitlement is a primitive emotion that we first learn to manage with the help of attuned parents. The child’s normal narcissistic rages, which intensify during the power struggles of age eighteen to thirty months – those “terrible twos” – require “optimal frustration” that is neither overly humiliating nor threatening to the child’s emerging sense of Self. When children encounter instead a rageful, contemptuous or teasing parent during these moments of intense arousal, the image of the parent’s face is stored in the developing brain and called up at times of future stress to whip them into an aggressive frenzy. Furthermore, the failure of parental attunement during this crucial phase can interfere with the development of brain functions that inhibit aggressive behavior, leaving children with lifelong difficulties controlling aggressive impulses.

Providence then - and this is what is most important to grasp - is not the same thing as a universal teleology. To believe in divine and unfailing providence is not to burden one's conscience with the need to see every event in this world not only as an occasion for God's grace, but as a positive determination of God's will whereby he brings to pass a comprehensive design that, in the absence of any single one of these events, would not have been possible. It may seem that this is to draw only the finest of logical distinction, one so fine indeed as to amount to little more than a sophistry. Some theologians - Calvin, for instance - have denied that the distinction between what God wills and what he permits has any meaning at all. And certainly there is no unanimity in the history of Christian exegesis on this matter. Certain classic Western interpretations of Paul's treatment of the hardening of Pharaoh's heart and of the hardened heart of Israel in Romans 9 have taken it as a clear statement of God's immediate determination of his creatures' wills. But in the Eastern Christian tradition, and in the thought of many of the greatest Western theologians, the same argument has often been understood to assert no more than that God in either case allowed a prior corruption of the will to run its course, or even - like a mire in the light of the sun - to harden the outpouring of God's fiery mercy, and always for the sake of a greater good that will perhaps redound even to the benefit of the sinner. One might read Christ's answer to his disciples' question regarding why a man had been born blind - 'that the works of God should be made manifest in him' (John 9:3) - either as a refutation or as a confirmation of the distinction between divine will and permission. When all is said and done, however, not only is the distinction neither illogical nor slight; it is an absolute necessity if - setting aside, as we should, all other judgments as superstitious, stochastic, and secondary - we are to be guided by the full character of what is revealed of God in Christ. For, after all, if it is from Christ that we are to learn how God relates himself to sin, suffering, evil, and death, it would seem that he provides us little evidence of anything other than a regal, relentless, and miraculous enmity: sin he forgives, suffering he heals, evil he casts out, and death he conquers. And absolutely nowhere does Christ act as if any of these things are part of the eternal work or purposes of God.

When it comes to the heart and soul of the Jewish faith - the law of Moses - Jesus was adamant that his mission was not to abolish the law but to fulfill it (Matthew 5:17). That law made a clear distinction between relations among Jews and relations between Jews and foreigners. The oft-repeated commandment "love your neighbor as yourself" was originally given strictly in the context of internal relations within Israel. The verse in question reads: "You shall not take vengeance or bear a grudge against any of your people , but shall love your neighbor as yourself" (Leviticus 19:18). To the Israelites, as well to Jesus's community in first-century Palestine,"neighbor" meant one's fellow Jews. With regard to the treatment of foreigners and outsiders, oppressors and occupiers, however, the Torah could not be clearer: "You shall drive them out before you. You shall make no covenant with them and their gods. They shall not live in your land" (Exodus 23:31-33)

Around that time, Musk was asked by a user on Twitter if he was bipolar. “Yeah,” he answered. But he added that he had not been medically diagnosed. “Bad feelings correlate to bad events, so maybe the real problem is getting carried away for what I sign up for.” One day, when they were sitting in the Tesla conference room after one of Musk’s spells, McNeill asked him directly whether he was bipolar. When Musk said probably yes, McNeill pushed his chair back from the table and turned to talk to Musk eye to eye. “Look, I have a relative who is bipolar,” McNeill said. “I’ve had close experience with this. If you get good treatment and your meds dialed right, you can get back to who you are. The world needs you.” It was a healthy conversation, McNeill says, and Musk seemed to have a clear desire to get out of his messed-up headspace. But it didn’t happen. His way of dealing with his mental problems, he says when I ask, “is just take the pain and make sure you really care about what you’re doing.

With the rise of molecular genetics, it has become possible to search for possible changes (mutations, polymorphisms) in target genes. Much effort has gone into investigating variations in genes that contribute to serotonin transmission, because serotonin-related drugs have antidepressant and anxiolytic properties. This assumes, however, that the treatment mechanism is the same mechanism that gives rise to the disorder.53 Although this is consistent with the old chemical imbalance hypothesis, it is not a conclusion that should simply be accepted without careful assessment. Nevertheless, studies of the genetic control of serotonin have found interesting results. For example, people with a certain variant (polymorphism) of a gene controlling a protein involved in serotonin transmission are more reactive to threatening stimuli, and this hyperreactivity is associated with increased amygdala activity during the threat.54 Further, it has been reported that this variant of the gene can account for 7 percent to 9 percent of the inheritance of anxiety.55

In fact, there did not seem to be any limit to what Grof's LSD subjects could tap into. They seemed capable of knowing what it was like to be every animal, and even plant, on the tree of evolution. They could experience what it was like to be a blood cell, an atom, a thermonuclear process inside the sun, the consciousness of the entire planet, and even the consciousness of the entire cosmos. More than that, they displayed the ability to transcend space and time, and occasionally they related uncannily accurate precognitive information. In an even stranger vein they sometimes encountered nonhuman intelligences during their cerebral travels, discarnate beings, spirit guides from "higher planes of consciousness, " and other suprahuman entities. On occasion subjects also traveled to what appeared to be other universes and other levels of reality. In one particularly unnerving session a young man suffering from depression found himself in what seemed to be another dimension. It had an eerie luminescence, and although he could not see anyone he sensed that it was crowded with discarnate beings. Suddenly he sensed a presence very close to him, and to his surprise it began to communicate with him telepathically. It asked him to please contact a couple who lived in the Moravian city of Kromeriz and let them know that their son Ladislav was well taken care of and doing all right. It then gave him the couple's name, street address, and telephone number. The information meant nothing to either Grof or the young man and seemed totally unrelated to the young man's problems and treatment. Still, Grof could not put it out of his mind. "After some hesitation and with mixed feelings, I finally decided to do what certainly would have made me the target of my colleagues' jokes, had they found out, " says Grof. "I went to the telephone, dialed the number in Kromeriz, and asked if I could speak with Ladislav. To my astonishment, the woman on the other side of the line started to cry. When she calmed down, she told me with a broken voice: 'Our son is not with us any more; he passed away, we lost him three weeks ago.

Out on the northwest side of Nashville, Tennessee, Judge Seth Norman has come to expect phone calls to start pouring in around late January every year. “The legislature comes back in session in January,” Norman said. The calls come from state legislators, each with the same problem: an addicted son, a daughter, a brother-in-law. “‘Um, uh, my nephew down in Camden, you think maybe you might be able to help?’ I get those kinds of calls,” he told me while we sat in the office adjacent to his courtroom. Most of the country’s twenty-eight hundred drug courts are set up to divert drug abusers away from jail and prison and into treatment somewhere. Seth Norman runs the only drug court in America that is physically attached to a long-term residential treatment center. He takes addicts accused of drug-related nonviolent felonies—theft, burglary, possession of stolen property, drug possession—and puts them in treatment for as long as two years as an alternative to prison. Down the hall from his court are dorms with beds for a hundred people—sixty men and forty women. I

I have practiced psychotherapy, family therapy, and hypnotherapy for over 25 years without a single board complaint or law suit by a client. For over three years, however, a group of proponents of the false memory syndrome (FMS) hypothesis, including members, officials, and supporters of the False Memory Syndrome Foundation, Inc., have waged a multi-modal campaign of harassment and defamation directed against me, my clinical clients, my staff, my family, and others connected to me. I have neither treated these harassers or their families, nor had any professional or personal dealings with any of them; I am not related in any way to the disclosures of memories of sexual abuse in these families. Nonetheless, this group disrupts my professional and personal life and threatens to drive me out of business. In this article, I describe practicing psychotherapy under a state of siege and places the campaign against me in the context of a much broader effort in the FMS movement to denigrate, defame, and harass clinicians, lecturers, writers, and researchers identified with the abuse and trauma treatment communities….

One is often told that it is a very wrong thing to attack religion, because religion makes men virtuous. So I am told; I have not noticed it. . . . You find as you look around the world that every single bit of progress in humane feeling, every improvement in the criminal law, every step toward the diminution of war, every step toward better treatment of the colored races, or every mitigation of slavery, every moral progress that there has been in the world, has been consistently opposed by the organized churches of the world. . . . My own view on religion is that of Lucretius. I regard it as a disease born of fear and as a source of untold misery to the human race. I cannot, however, deny that it has made some contributions to civilization. It helped in early days to fix the calendar, and it caused Egyptian priests to chronicle eclipses with such care that in time they became able to predict them. These two services I am prepared to acknowledge, but I do not know of any others. BERTRAND RUSSELL, WHY I AM NOT A CHRISTIAN, AND OTHER ESSAYS ON RELIGION AND RELATED SUBJECTS SEVENTEEN EXODUS They went in bitterness and in hope.

Bigotry disturbs me, too," I said, "but prejudice and segregation alone do not constitute the root of all evil. There are many nonracial elements common to humanity as a whole that create problems from the cradle to the grave regardless of race, creed, color, or previous condition of servitude." "But when you add a black face to all that," said Simple, "you have problem's mammy. White folks may be unemployed in this American country, but they get the first chance at the first jobs that open up. Besides, they get seniority. Maybe some white folks cannot read or write, but if they want to go to Ole Miss to learn to read or write, they can go without the President calling up the United States Army to protect them. Sure, white folks gets sick, but they don't have to creep in the back door of the hospital down South for treatment like we does. And when they get old, white folks have got more well-off sons and daughters to take care of them than colored folks have. Most old white folks when they get sick can suffer in comfort, and when they die they can get buried without going in debt. Colored folks, most in generally, do not have it so easy. I know because I am one.

Addicts should not be coerced into treatment, since in the long term coercion creates more problems than it solves. On the other hand, for those addicts who opt for treatment, there must be a system of publicly funded recovery facilities with clean rooms, nutritious food, and access to outdoors and nature. Well-trained professional staff need to provide medical care, counseling, skills training, and emotional support. Our current nonsystem is utterly inadequate, with its patchwork of recovery homes run on private contracts and, here and there, a few upscale addiction treatment spas for the wealthy. No matter how committed their staff and how helpful their services may be, they are a drop in comparison to the ocean of vast need. In the absence of a coordinated rehabilitation system, the efforts of individual recovery homes are limited and occur in a vacuum, with no follow-up. It may be thought that the cost of such a drug rehabilitation and treatment system would be exorbitant. No doubt the financial expenses would be great — but surely less than the funds now freely squandered on the War on Drugs, to say nothing of the savings from the cessation of drug-related criminal activity and the diminished burden on the health care system.

Outlawing drugs in order to solve drug problems is much like outlawing sex in order to win the war against AIDS. We recognize that people will continue to have sex for nonreproductive reasons despite the laws and mores. Therefore, we try to make sexual practices as safe as possible in order to minimize the spread of the AIDS viruses. In a similar way, we continually try to make our drinking water, foods, and even our pharmaceutical medicines safer. The ubiquity of chemical intoxicants in our lives is undeniable evidence of the continuing universal need for safer medicines with such applications. While use may not always be for an approved medical purpose, or prudent, or even legal, it is fulfilling the relentless drive we all have to change the way we feel, to alter our behavior and consciousness, and, yes, to intoxicate ourselves. We must recognize that intoxicants are medicines, treatments for the human condition. Then we must make them as safe and risk free and as healthy as possible. Dream with me for a moment. What would be wrong if we had perfectly safe intoxicants? I mean drugs that delivered the same effects as our most popular ones but never caused dependency, disease, dysfunction, or death. Imagine an alcohol-type substance that never caused addiction, liver disease, hangovers, impaired driving, or workplace problems. Would you care to inhale a perfumed mist that is as enjoyable as marijuana or tobacco but as harmless as clean air? How would you like a pain-killer as effective as morphine but safer than aspirin, a mood enhancer that dissolves on your tongue and is more appealing than cocaine and less harmful than caffeine, a tranquilizer less addicting than Valium and more relaxing than a martini, or a safe sleeping pill that allows you to choose to dream or not? Perhaps you would like to munch on a user friendly hallucinogen that is as brief and benign as a good movie? This is not science fiction. As described in the following pages, there are such intoxicants available right now that are far safer than the ones we currently use. If smokers can switch from tobacco cigarettes to nicotine gum, why can’t crack users chew a cocaine gum that has already been tested on animals and found to be relatively safe? Even safer substances may be just around the corner. But we must begin by recognizing that there is a legitimate place in our society for intoxication. Then we must join together in building new, perfectly safe intoxicants for a world that will be ready to discard the old ones like the junk they really are. This book is your guide to that future. It is a field guide to that silent spring of intoxicants and all the animals and peoples who have sipped its waters. We can no more stop the flow than we can prevent ourselves from drinking. But, by cleaning up the waters we can leave the morass that has been the endless war on drugs and step onto the shores of a healthy tomorrow. Use this book to find the way.

With regard to complex trauma survivors, self-determination and autonomy require that the therapist treat each client as the "authority" in determining the meaning and interpretation of his or her personal life history, including (but not limited to) traumatic experiences (Harvey, 1996). Therapists can inadvertently misappropriate the client's authority over the meaning and significance of her or his memories (and associated symptoms, such as intrusive reexperiencing or dissociative flashbacks) by suggesting specific "expert" interpretations of the memories or symptoms. Clients who feel profoundly abandoned by key caregivers may appear deeply grateful for such interpretations and pronouncements by their therapists, because they can fulfill a deep longing for a substitute parent who makes sense of the world or takes care of them. However, this delegation of authority to the therapist can backfire if the client cannot, or does not, take ownership of her or his own memories or life story by determining their personal meaning.Moreover, the client can be trapped in a stance of avoidance because trauma memories are never experienced, processed, and put to rest. Helping a client to develop a core sense of relational security and the capacity to regulate (and recover from) extreme hyper- or hypoarousal is essential if the client is to achieve a self-determined and autonomous approach to defining the meaning and impact of trauma memories, a crucial goal of posttraumatic therapy.

The development of a working alliance is crucial because it addresses a psychic phobia associated with relationships that is common in complex trauma clients. As we discussed, when primary relationships are sources of profound disillusionment, betrayal, and emotional pain, any subsequent relationship with an authority figure who offers an emotional bond or other assistance might be met with a range of emotions, such as fear, suspicion, anger, or hopelessness on the negative end of the continuum and idealization, hope, overdependence, and entitlement on the positive. Therapy offers a compensatory relationship, albeit within a professional framework, that has differences from and restrictions not found in other relationships. On the one hand, the therapist works within professional and ethical boundaries and limitations in a role of higher status and education and is therefore somewhat unattainable for the client. On the other, the therapist's ethical and professional mandate is the welfare of the client, creating a perception of an obligation to meet the client's needs and solve his or her problems. Furthermore, the therapist is expected to both respect the client's privacy and accept emotional and behavioral difficulties without judgment, while simultaneously being entitled to ask the client about his or her most personal and distressing feelings, thoughts and experiences. Developing a sense of trust in the therapist, therefore, is both expected and fraught with inherent difficulties that are amplified by each client's unique history of betrayal trauma, loss, and relational distress.

For Aristotle the literary plot was analogous to the plot of the world in that both were eductions from the potency of matter. Sartre denies this for the world, and specifically denies, in the passage just referred to, that without potentiality there is no change. He reverts to the Megaric view of the matter, which Aristotle took such trouble to correct. But this is not our affair. The fact is that even if you believe in a Megaric world there is no such thing as a Megaric novel; not even Paterson. Change without potentiality in a novel is impossible, quite simply; though it is the hopeless aim of the cut-out writers, and the card-shuffle writers. A novel which really implemented this policy would properly be a chaos. No novel can avoid being in some sense what Aristotle calls 'a completed action.' This being so, all novels imitate a world of potentiality, even if this implies a philosophy disclaimed by their authors. They have a fixation on the eidetic imagery of beginning, middle, and end, potency and cause. Novels, then, have beginnings, ends, and potentiality, even if the world has not. In the same way it can be said that whereas there may be, in the world, no such thing as character, since a man is what he does and chooses freely what he does--and in so far as he claims that his acts are determined by psychological or other predisposition he is a fraud, lâche, or salaud--in the novel there can be no just representation of this, for if the man were entirely free he might simply walk out of the story, and if he had no character we should not recognize him. This is true in spite of the claims of the doctrinaire nouveau roman school to have abolished character. And Sartre himself has a powerful commitment to it, though he could not accept the Aristotelian position that it is through character that plot is actualized. In short, novels have characters, even if the world has not. What about time? It is, effectively, a human creation, according to Sartre, and he likes novels because they concern themselves only with human time, a faring forward irreversibly into a virgin future from ecstasy to ecstasy, in his word, from kairos to kairos in mine. The future is a fluid medium in which I try to actualize my potency, though the end is unattainable; the present is simply the pour-soi., 'human consciousness in its flight out of the past into the future.' The past is bundled into the en-soi, and has no relevance. 'What I was is not the foundation of what I am, any more than what I am is the foundation of what I shall be.' Now this is not novel-time. The faring forward is all right, and fits the old desire to know what happens next; but the denial of all causal relation between disparate kairoi, which is after all basic to Sartre's treatment of time, makes form impossible, and it would never occur to us that a book written to such a recipe, a set of discontinuous epiphanies, should be called a novel. Perhaps we could not even read it thus: the making of a novel is partly the achievement of readers as well as writers, and readers would constantly attempt to supply the very connections that the writer's programme suppresses. In all these ways, then, the novel falsifies the philosophy.

The treatment accorded the Negro during the Second World War marks, for me, a turning point in the Negro’s relation to America. To put it briefly, and somewhat too simply, a certain hope died, a certain respect for white Americans faded. One began to pity them, or to hate them. You must put yourself in the skin of a man who is wearing the uniform of his country, is a candidate for death in its defense, and who is called a “nigger” by his comrades-in-arms and his officers; who is almost always given the hardest, ugliest, most menial work to do; who knows that the white G.I. has informed the Europeans that he is subhuman (so much for the American male’s sexual security); who does not dance at the U.S.O. the night white soldiers dance there, and does not drink in the same bars white soldiers drink in; and who watches German prisoners of war being treated by Americans with more human dignity than he has ever received at their hands. And who, at the same time, as a human being, is far freer in a strange land than he has ever been at home. Home! The very word begins to have a despairing and diabolical ring. You must consider what happens to this citizen, after all he has endured, when he returns—home: search, in his shoes, for a job, for a place to live; ride, in his skin, on segregated buses; see, with his eyes, the signs saying “White” and “Colored,” and especially the signs that say “White Ladies” and “Colored Women”; look into the eyes of his wife; look into the eyes of his son; listen, with his ears, to political speeches, North and South; imagine yourself being told to “wait.” And all this is happening in the richest and freest

Let me put the contrast in a single concrete example. The physician who finds time to give personal attention to his patients and listens to them. carefully probing inner conditions that may be more significant than any laboratory reports, has become a rarity. Where the power complex is dominant, a visit to a physician is paced, not to fit the patient's needs, but mainly to perform the succession of physical tests upon which the diagnosis will be based. Yet if there were a sufficient number of competent physicians on hand whose inner resources were as available as their laboratory aids, a more subtle diagnosis might be possible, and the patient's subjective response might in many cases effectively supplement the treatment. Thoreau expressed this to perfection when he observed in his 'Journal' that "the really efficient laborer will be found not to crowd his day with work, but will saunter to his task surrounded by a wide halo of ease and leisure." Without this slowing of the tempo of all activities the positive advantages of plenitude could not be sufficiently enjoyed; for the congestion of time is as threatening to the good life as the congestion of space or people, and produces stresses and tensions that equally undermine human relations. The inner stability that such a slowdown brings about is essential to the highest uses of the mind, through opening up that second life which one lives in reflection and contemplation and self-scrutiny. The means to escape from the "noisy crowing up of things and whatsoever wars on the divine" was one of the vital offerings of the classic religions: hence their emphasis was not on technological productivity but on personal poise. The old slogan of New York subway guards in handling a crush of passengers applies with even greater force to the tempo of megatechnic society: "What's your hurry...Watch your step!

That such a surprisingly powerful philosophical method was taken seriously can be only partially explained by the backwardness of German natural science in those days. For the truth is, I think, that it was not at first taken really seriously by serious men (such as Schopenhauer, or J. F. Fries), not at any rate by those scientists who, like Democritus2, ‘would rather find a single causal law than be the king of Persia’. Hegel’s fame was made by those who prefer a quick initiation into the deeper secrets of this world to the laborious technicalities of a science which, after all, may only disappoint them by its lack of power to unveil all mysteries. For they soon found out that nothing could be applied with such ease to any problem whatsoever, and at the same time with such impressive (though only apparent) difficulty, and with such quick and sure but imposing success, nothing could be used as cheaply and with so little scientific training and knowledge, and nothing would give such a spectacular scientific air, as did Hegelian dialectics, the mystery method that replaced ‘barren formal logic’. Hegel’s success was the beginning of the ‘age of dishonesty’ (as Schopenhauer3 described the period of German Idealism) and of the ‘age of irresponsibility’ (as K. Heiden characterizes the age of modern totalitarianism); first of intellectual, and later, as one of its consequences, of moral irresponsibility; of a new age controlled by the magic of high-sounding words, and by the power of jargon. In order to discourage the reader beforehand from taking Hegel’s bombastic and mystifying cant too seriously, I shall quote some of the amazing details which he discovered about sound, and especially about the relations between sound and heat. I have tried hard to translate this gibberish from Hegel’s Philosophy of Nature4 as faithfully as possible; he writes: ‘§302. Sound is the change in the specific condition of segregation of the material parts, and in the negation of this condition;—merely an abstract or an ideal ideality, as it were, of that specification. But this change, accordingly, is itself immediately the negation of the material specific subsistence; which is, therefore, real ideality of specific gravity and cohesion, i.e.—heat. The heating up of sounding bodies, just as of beaten or rubbed ones, is the appearance of heat, originating conceptually together with sound.’ There are some who still believe in Hegel’s sincerity, or who still doubt whether his secret might not be profundity, fullness of thought, rather than emptiness. I should like them to read carefully the last sentence—the only intelligible one—of this quotation, because in this sentence, Hegel gives himself away. For clearly it means nothing but: ‘The heating up of sounding bodies … is heat … together with sound.’ The question arises whether Hegel deceived himself, hypnotized by his own inspiring jargon, or whether he boldly set out to deceive and bewitch others. I am satisfied that the latter was the case, especially in view of what Hegel wrote in one of his letters. In this letter, dated a few years before the publication of his Philosophy of Nature, Hegel referred to another Philosophy of Nature, written by his former friend Schelling: ‘I have had too much to do … with mathematics … differential calculus, chemistry’, Hegel boasts in this letter (but this is just bluff), ‘to let myself be taken in by the humbug of the Philosophy of Nature, by this philosophizing without knowledge of fact … and by the treatment of mere fancies, even imbecile fancies, as ideas.’ This is a very fair characterization of Schelling’s method, that is to say, of that audacious way of bluffing which Hegel himself copied, or rather aggravated, as soon as he realized that, if it reached its proper audience, it meant success.

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Page 141: Group Polarization Patterns Political anger and demands for privileges are, of course, not limited to the less privileged. Indeed, even when demands are made in the name of less privileged racial or ethnic groups, often it is the more privileged members of such groups who make the demands and who benefit from policies designed to meet such demands. These demands may erupt suddenly in the wake of the creation (or sharp enlargement) of a newly educated class which sees its path to coveted middle-class professions blocked by competition of other groups--as in India, French Canada, or Lithuania, for example. * * * A rapid expansion of education is thus a factor in producing inter-group conflict, especially where the education is of a kind which produces diplomas rather than skills that have significant economic value in the marketplace. Education of a sort useful only for being a clerk, bureaucrat, school teacher--jobs whose numbers are relatively fixed in the short run and politically determined in the long run--tend to increase politicized inter-group strife. Yet newly emerging groups, whether in their own countries or abroad, tend to specialize precisely in such undemanding fields. Malay students, for example, have tended to specialize in Malay studies and Islamic studies, which provide them with no skills with which compete with the Chinese in the marketplace, either as businessmen, independent professionals, or technicians. Blacks and Hispanics in the United States follow a very similar pattern of specializing disproportionately in easier fields which offer less in the way of marketable skills. Such groups then have little choice but to turn to the government, not just for jobs but also for group preferences to be imposed in the market place, and for symbolic recognition in various forms. *** While economic interests are sometimes significant in explaining political decisions, they are by no means universally valid explanations. Educated elites from less advanced groups may have ample economic incentives to promote polarization and preferential treatment policies, but the real question is why the uneducated masses from such groups give them the political support without which they would be impotent. Indeed, it is often the less educated masses who unleash the mob violence from which their elite compatriots ultimately benefit--as in Malaysia, Sri Lanka, or parts of India, Africa, or the United States, where such violence has led to group preference policies in employment, educational institutions, and elsewhere. The common denominator in these highly disparate societies seems to be not only resentment of other groups' success but also fear of an inability to compete with them, combined with a painful embarrassment at being so visibly "under-represented"--or missing entirely—in prestigious occupations and institutions. To remedy this within apolitically relevant time horizon requires not simply increased opportunities but earmarked benefits directly given on a racial or ethnic basis.

Thus polyvictimization or complex trauma are "developmentally adverse interpersonal traumas" (Ford, 2005) because they place the victim at risk not only for recurrent stress and psychophysiological arousal (e.g., PTSD, other anxiety disorders, depression) but also for interruptions and breakdowns in healthy psychobiological, psychological, and social development. Complex trauma not only involves shock, fear, terror, or powerlessness (either short or long term) but also, more fundamentally, constitutes a violation of the immature self and the challenge to the development of a positive and secure self, as major psychic energy is directed toward survival and defense rather than toward learning and personal development (Ford, 2009b, 2009c). Moreover, it may influence the brain's very development, structure, and functioning in both the short and long term (Lanius et al., 2010; Schore, 2009). Complex trauma often forces the child victim to substitute automatic survival tactics for adaptive self-regulation, starting at the most basic level of physical reactions (e.g., intense states of hyperarousal/agitation or hypoarousal/immobility) and behavioral (e.g., aggressive or passive/avoidant responses) that can become so automatic and habitual that the child's emotional and cognitive development are derailed or distorted. What is more, self-integrity is profoundly shaken, as the child victim incorporates the "lessons of abuse" into a view of him or herself as bad, inadequate, disgusting, contaminated and deserving of mistreatment and neglect. Such misattributions and related schema about self and others are some of the most common and robust cognitive and assumptive consequences of chronic childhood abuse (as well as other forms of interpersonal trauma) and are especially debilitating to healthy development and relationships (Cole & Putnam, 1992; McCann & Pearlman, 1992). Because the violation occurs in an interpersonal context that carries profound significance for personal development, relationships become suspect and a source of threat and fear rather than of safety and nurturance. In vulnerable children, complex trauma causes compromised attachment security, self-integrity and ultimately self-regulation. Thus it constitutes a threat not only to physical but also to psychological survival - to the development of the self and the capacity to regulate emotions (Arnold & Fisch, 2011). For example, emotional abuse by an adult caregiver that involves systematic disparagement, blame and shame of a child ("You worthless piece of s-t"; "You shouldn't have been born"; "You are the source of all of my problems"; "I should have aborted you"; "If you don't like what I tell you, you can go hang yourself") but does not involve sexual or physical violation or life threat is nevertheless psychologically damaging. Such bullying and antipathy on the part of a primary caregiver or other family members, in addition to maltreatment and role reversals that are found in many dysfunctional families, lead to severe psychobiological dysregulation and reactivity (Teicher, Samson, Polcari, & McGreenery, 2006).

Kaffman (2009) described childhood victimization as a "silent epidemic", and Finkelhor, Turner, Ormrod, and Hamby (2010) reported that children are the most traumatized class of humans around the globe. The findings of these researchers are at odds with the view that children have protected status in most families, societies, and cultures. Instead, Finkelhor reports that children are prime targets and highly vulnerable, due principally to their small size, their physical and emotional immaturity with its associated lack of control, power and resources; and their related dependency on caregivers. They are subjected to many forms of exploitation on an ongoing basis, imposed on them by individuals with greater power, strength, knowledge, and resources, many of whom are, paradoxically and tragically, responsible for their care and welfare. These traumas are interpersonal in nature and involve personal transgression, violation and exploitation of the child by those who rely on the child's lesser physical abilities, innocence, and immaturity to intimidate, bully, confuse, blackmail, exploit, or otherwise coerce. In the worst-case scenario, a parent or other significant caregiver directly and repeatedly abuses a child or does not respond to or protect a child or other vulnerable individual who is being abused and mistreated and isolates the child from others through threats or with direct violence. Consequently, such an abusive, nonprotective, or malevolently exploitative circumstance (Chefetz has coined the term "attack-ment" to describe these dynamics) has a profound impact on victim's ability to trust others. It also affects the victim's identity and self-concept, usually in negative ways that include self-hatred, low self-worth, and lack of self-confidence. As a result, both relationships, and the individual's sense of self and internal states (feelings, thoughts, and perceptions) can become sources of fear, despair, rage, or other extreme dysphoria or numbed and dissociated reactions. This state of alienation from self and others is further exacerbated when the occurrence of abuse or other victimization involves betrayal and is repeated and becomes chronic, in the process leading the victim to remain in a state of either hyperarousal/anticipation/hypervigilance or hypoarousal/numbing (or to alternate between these two states) and to develop strong protective mechanisms, such as dissociation, in order to endure recurrences. When these additional victimizations recur, they unfortunately tend to escalate in severity and intrusiveness over time, causing additional traumatization (Duckworth & Follette, 2011). In many cases of child maltreatment, emotional or psychological coercion and the use of the adult's authority and dominant power rather than physical force or violence is the fulcrum and weapon used against the child; however, force and violence are common in some settings and in some forms of abuse (sometimes in conjunction with extreme isolation and drugging of the child), as they are used to further control or terrorize the victim into submission. The use of force and violence is more commonplace and prevalent in some families, communities, religions, cultural/ethnic groups, and societies based on the views and values about adult prerogatives with children that are espoused. They may also be based on the sociopathy of the perpetrators.

The Western medical model — and I don't mean the science of it, I mean the practice of it, because the science is completely at odds with the practice — makes two devastating separations. First of all we separate the mind from the body, we separate the emotions from the physiology. So we don't see how the physiology of people reflects their lifelong emotional experience. So we separate the mind from the body, which is not something that traditional medicine has done, I mean, Ayuverdic or Chinese medicine or shamanic tribal cultures and medicinal practices throughout the world have always recognized that mind and body are inseparable. They intuitively knew it. Many Western practitioners have known this and even taught it, but in practice we ignore it. And then we separate the individual from the environment. The studies are clear, for example, that when people are emotionally isolated they tend to get sick more quickly and they succumb more rapidly to their disease. Why? Because people's physiology is completely related to their psychological, social environment and when people are isolated and alone their stress levels are much higher because there's nothing there to help them moderate their stress. And physiologically it is straightforward, you know, it takes a five-year-old kid to understand it. However because in practice we separate them... when somebody shows up with an inflamed joint, all we do is we give them an anti-inflammatory or because the immune system is hyperactive and is attacking them we give them a medication to suppress their immune system or we give them a stress hormone like cortisol or one of its analogues, to suppress the inflammation. But we never ask: "What does this manifest about your life?", "What does this say about your relationships?", "How stressful is your job?", "To what extent do you lack control in your life?", "Where are you not authentic?", "How are you trying to work so hard to meet your attachment needs by suppressing yourself?" (because that is what you learn to do as a kid). Then we do all this research that has to do with cell biology, so we keep looking for the cause of cancer in the cell. Now there's a wonderful quote in the New York Times a couple of years ago they did a series on cancer and somebody said: "Looking for the cause of cancer inside the individual cell is like trying to understand a traffic jam by studying the internal combustion engine." We will never understand it, but we spend hundreds of billions of dollars a year looking for the cause of cancer inside the cell, not recognizing that the cell exists in interaction with the environment and that the genes are modulated by the environment, they are turned on and off by the environment. So the impact of not understanding the unity of emotions and physiology on one hand and in the other hand the relationship between the individual and the environment.. in other words.. having a strictly biological model as opposed to what has been called a bio-psycho-social, that recognizes that the biology is important, but it also reflects our psychological and social relationships. And therefore trying to understand the biology in isolation from the psychological and social environment is futile. The result is that we are treating people purely through pharmaceuticals or physical interventions, greatly to the profit of companies that manufacture pharmaceuticals and which fund the research, but it leaves us very much in the dark about a) the causes and b) the treatment, the holistic treatment of most conditions. So that for all our amazing interventions and technological marvels, we are still far short of doing what we could do, were we more mindful of that unity. So the consequences are devastating economically, they are devastating emotionally, they are devastating medically.