Treatment Time Quotes

If something doesn't work exactly right, or maybe needs some special treatment, you don't just throw it away. Everything can't be fully operational all the time. Sometimes, we need to have the patience to give something the little nudge it needs.

Cognitive robotics can integrate information from pre-operation medical records with real-time operating metrics to guide and enhance the precision of physicians’ instruments. By processing data from genuine surgical experiences, they’re able to provide new and improved insights and techniques. These kinds of improvements can improve patient outcomes and boost trust in AI throughout the surgery. Robotics can lead to a 21% reduction in length of stay.

I believe in the brotherhood of man, all men, but I don't believe in brotherhood with anybody who doesn't want brotherhood with me. I believe in treating people right, but I'm not going to waste my time trying to treat somebody right who doesn't know how to return the treatment

As I got closer to the fence, I held my shirt over my nose to block the smell. One stallion waded through the muck and whinnied angrily at me. He bared his teeth, which were pointed like a bear's. I tried to talk to him in my mind. I can do that with most horses. Hi, I told him. I'm going to clean your stables. Won't that be great? Yes! The horse said. Come inside! Eat you! Tasty half-blood! But I'm Poseidon's son, I protested. He created horses. Usually this gets me VIP treatment in the equestrian world, not this time. Yes! The horse agreed enthusiastically. Poseidon can come in, too! We will eat you both! Seafood! Seafood! The other horses chimed in as they waded through the field.

Learn to be difficult when it counts. In school as in life, having a reputation for being assertive will help you receive preferential treatment without having to beg or fight for it every time.

It’s estimated that AI could free up to 25% of clinician time across different specialties. This increased amount of time could mean less hurried encounters and more humane interactions, including more empathy from happier doctors. This is important because empathy has been shown to improve outcomes by boosting patient adherence to the prescribed treatments, increasing motivation, and reducing anxiety and stress.

AI-powered passive monitoring is taking off and has huge advantages over the traditional way of monitoring patients. The advantage of passive monitoring, as opposed to data collected from wearables, is that it doesn’t require patients or seniors to actively wear a device at all times. Used in a hospital setting, the tech reduces healthcare workers’ risk of exposure to COVID-19 by limiting their contact with patients and automating data collection for vital signs. Also, camera-based monitoring is unpopular for the simple reason that a lot of people don’t like being watched by a camera.

It's taken me all this time, all this loss, to realize what really matters is now.

With psychiatric medications, you solve one problem for a period of time, but the next thing you know you end up with two problems. The treatment turns a period of crisis into a chronic mental illness. - Amy Upham

Isn't there something in living dangerously?' There's a great deal in it,' the Controller replied. 'Men and women must have their adrenals stimulated from time to time.' What?' questioned the Savage, uncomprehending. It's one of the conditions of perfect health. That's why we've made the V.P.S. treatments compulsory.' V.P.S.?' Violent Passion Surrogate. Regularly once a month. We flood the whole system with adrenin. It's the complete physiological equivalent of fear and rage. All the tonic effects of murdering Desdemona and being murdered by Othello, without any of the inconvenience.' But I like the inconveniences.' We don't,' said the Controller. 'We prefer to do things comfortably.' But I don't want comfort. I want God, I want poetry, I want real danger, I want freedom, I want goodness. I want sin.' In fact,' said Mustapha Mond, 'you're claiming the right to be unhappy. Not to mention the right to grow old and ugly and impotent; the right to have syphilis and cancer, the right to have too little to eat; the right to be lousy; the right to live in constant apprehension of what may happen tomorrow; the right to catch typhoid; the right to be tortured by unspeakable pains of every kind.' There was a long silence. I claim them all,' said the Savage at last. Mustapha Mond shrugged his shoulders. 'You're welcome,' he said.

What better place to kill time than a library? And for me, what better way to get to know someone than through her choice and treatment of books?

I was astonished, bewildered. This was America, a country where, whatever its faults, people could speak, write, assemble, demonstrate without fear. It was in the Constitution, the Bill of Rights. We were a democracy... But I knew it wasn't a dream; there was a painful lump on the side of my head... The state and its police were not neutral referees in a society of contending interests. They were on the side of the rich and powerful. Free speech? Try it and the police will be there with their horses, their clubs, their guns, to stop you. From that moment on, I was no longer a liberal, a believer in the self-correcting character of American democracy. I was a radical, believing that something fundamental was wrong in this country--not just the existence of poverty amidst great wealth, not just the horrible treatment of black people, but something rotten at the root. The situation required not just a new president or new laws, but an uprooting of the old order, the introduction of a new kind of society--cooperative, peaceful, egalitarian.

Now, for the first time, I wonder if this is how my mother felt. If cancer was her prison; the chemo treatments, torture. I understand it. I would rather die.

You are not an alcoholic or an addict. You are not incurably diseased. You have merely become dependent on substances or addictive behavior to cope with underlying conditions that you are now going to heal, at which time your dependency will cease completely and forever.

On those days when we're not ready to stop being offended, not ready to forgive, still determined to dish out the silent treatment, what we're actually saying is, "Thanks, but I don't want to become more like the Savior today. Maybe tomorrow, but not today." Perhaps those are the times when we need to pray the hardest, the times it becomes clear that a change in behavior is not enough--that we must have a change in nature.

We each have the innate ability to heal ourselves. To empower ourselves with natural solutions, instead of succumbing to life-altering chemicals. There's a time and place for pharmaceuticals, but it shouldn't be the first answer, nor the only form treatment.

I lost hope when I saw the horses’ teeth. As I got closer to the fence, I held my shirt over my nose to block the smell. One stallion waded through the muck and whinnied angrily at me. He bared his teeth, which were pointed like a bear’s. I tried to talk to him in my mind. I can do that with most horses. Hi, I told him. I’m going to clean your stables. Won’t that be great? Yes! The horse said. Come inside! Eat you! Tasty half-blood! But I’m Poseidon’s son, I protested. He created horses. Usually this gets me VIP treatment in the equestrian world, but not this time. Yes! The horse agreed enthusiastically. Poseidon can come in, too! We will eat you both! Seafood!

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.

In response to threat and injury, animals, including humans, execute biologically based, non-conscious action patterns that prepare them to meet the threat and defend themselves. The very structure of trauma, including activation, dissociation and freezing are based on the evolution of survival behaviors. When threatened or injured, all animals draw from a "library" of possible responses. We orient, dodge, duck, stiffen, brace, retract, fight, flee, freeze, collapse, etc. All of these coordinated responses are somatically based- they are things that the body does to protect and defend itself. It is when these orienting and defending responses are overwhelmed that we see trauma. The bodies of traumatized people portray "snapshots" of their unsuccessful attempts to defend themselves in the face of threat and injury. Trauma is a highly activated incomplete biological response to threat, frozen in time. For example, when we prepare to fight or to flee, muscles throughout our entire body are tensed in specific patterns of high energy readiness. When we are unable to complete the appropriate actions, we fail to discharge the tremendous energy generated by our survival preparations. This energy becomes fixed in specific patterns of neuromuscular readiness. The person then stays in a state of acute and then chronic arousal and dysfunction in the central nervous system. Traumatized people are not suffering from a disease in the normal sense of the word- they have become stuck in an aroused state. It is difficult if not impossible to function normally under these circumstances.

The atypically depressed are more likely to be the walking wounded, people like me who are quite functional, whose lives proceed almost as usual, except that their depressed all the time, almost constantly embroiled in thoughts of suicide even as they go through their paces. Atypical depression is not just a mild malaise...but one that is quite severe and yet still somehow allows an appearance of normalcy because it becomes, over time, a part of life. The trouble is that as the years pass, if untreated, atypical depression gets worse and worse, and its sufferers are likely to commit suicide out of sheer frustration with living a life that is simultaneously productive and clouded by constant despair. It is the cognitive dissonance that is deadly. Because atypical depression doesn’t have a peak- or, more accurately, a nadir, like normal depression, because it follows no logical curve but instead accumulates over time, it an drive its victim to dismal despair so suddenly that one might not have bothered to attend to treatment until the patient has already, and seemingly very abruptly, committed suicide.

It's taken me all this time, all this loss, to realize what really matters is now. Not our memories.

My daughter, Carly, has been in and out of drug treatment facilities since she was thirteen. Every time she goes away, I have a routine: I go through her room and search for drugs she may have left behind. We have a laugh these days because Carly says, “So you were lookingfor drugs I might have left behind? I’m a drug addict, Mother. We don’t leave drugs behind, especially if we’re going into treatment. We do all the drugs. We don’t save drugs back for later. If I have drugs, I do them. All of them. If I had my way, we would stop for more drugs on the way to rehab, and I would do them in the parking lot of the treatment center.

Does your manager know that you talk to your customers like this? (Blaine) If you’d like to talk to my mother, who owns this bar, my overindulgent brother, who manages it, or my father, who delights in kicking everyone’s ass around, about your treatment by me, just let me know and I’ll be more than happy to go get one of them for you. I know they’d just love to waste their time dealing with you. They’re real understanding that way. (Aimee)

Forget about the scant hours in her brief life when Sylvia Plath was able to produce the works in Ariel. Forget about that tiny bit of time and just remember the days that spanned into years when she could not move, couldn’t think straight, could only lie in wait in a hospital bed, hoping for the relief that electroconvulsive therapy would bring. Don’t think of the striking on-screen picture, the mental movie you create of the pretty young woman being wheeled on the gurney to get her shock treatments, and don’t think of the psychedelic, photonegative image of this sane woman at the moment she receives that bolt of electricity. Think, instead, of the girl herself, of the way she must have felt right then, of the way no amount of great poetry and fascination and fame could make the pain she felt at that moment worth suffering. Remember that when you’re at the point at which you’re doing something as desperate and violent as sticking your head in an oven, it is only because the life that preceded this act felt worse. Think about living in depression from moment to moment, and know it is not worth any of the great art that comes a its by-product.

It is time to embrace mental health and substance use/abuse as illnesses. Addiction is a disease.

We have treatments for disturbed persons, Nicholas. But, at least for the time being, we have no treatment for disturbing persons.

How odd that we spend so much time treating the darkness, and so little time seeking the light. The ego loves to glorify itself by self-analysis, yet we do not get rid of darkness by hitting it with a baseball bat. We only get rid of darkness by turning on the light.

The only time I can ever remember Steven crying over any of it was after my treatment, when I tried to use my foot on his bass drum pedal, and we realized I could never play a drum set.

principle of treatment can be summarized as: Facing Accepting Floating Letting time pass

As for time, it is forever shrinking. Oppressed by multitasking and managerial efficiency, we live under a perpetual time pressure. The disease of this millennium will be called chronophobia or speedomania, and its treatment will be embarrassingly old-fashioned. Contemporary nostalgia is not so much about the past as about vanishing the present.

Eighty two percent of the traumatized children seen in the National Child Traumatic Stress Network do not meet diagnostic criteria for PTSD.15 Because they often are shut down, suspicious, or aggressive they now receive pseudoscientific diagnoses such as “oppositional defiant disorder,” meaning “This kid hates my guts and won’t do anything I tell him to do,” or “disruptive mood dysregulation disorder,” meaning he has temper tantrums. Having as many problems as they do, these kids accumulate numerous diagnoses over time. Before they reach their twenties, many patients have been given four, five, six, or more of these impressive but meaningless labels. If they receive treatment at all, they get whatever is being promulgated as the method of management du jour: medications, behavioral modification, or exposure therapy. These rarely work and often cause more damage.

Time to start getting more sleep. This beautiful physique needs royal treatment.

A doctor should be a clown at heart, a scientist at brain and a mother at conscience.

At that time the only treatment of angelism, that is, excessive abstraction of the self from itself, was recovery of the self through ordeal.

In the beginning—and neither can this be overstated—a Negro just cannot believe that white people are treating him as they do; he does not know what he has done to merit it. And when he realizes that the treatment accorded him has nothing to do with anything he has done, that the attempt of white people to destroy him—for that is what it is—is utterly gratuitous, it is not hard for him to think of white people as devils.

While in general I avoid the use of torture - torture locates the opponent and mobilizes resistance - the threat of torture is useful to induce in the subject the appropriate feeling of helplessness and gratitude to the interrogator for withholding it. And torture can be employed to advantage as a penalty when the subject is far enough along with the treatment to accept punishment as deserved. To this end I devised several forms of disciplinary procedure. One was known as the Switchboard. Electric drills that can be turned on at any time are clamped against the subject's teeth; and he is instructed to operate an arbitrary switchboard, to put certain connections in certain sockets in response to bells and lights. Every time he makes a mistake the drills are turned on for twenty seconds. The signals are gradually speeded up beyond his reaction time. Half an hour on the Switchboard and the subject breaks down like an overloaded thinking machine.

Now, the error which many parents commit in the treatment of the individual at this time(adolescense) is, insisting on the same unreasoning obedience as when all he had to do in the way of duty was, to obey the simple laws of "Come when you're called," and "Do as you're bid!" But a wise parent humours the desire for independent action, so as to become the friend and adviser when his absolute rule shall cease.

Melody began to mumble incomprehensibly under her breath as she worked frantically on securing her most important papers into bankers boxes. Her father stomped into her room, eating a banana. Melody looked up at him with a sweaty and nauseated look on her face. “What are you tramping around so heavily about?” she asked him. Bernie finished the last of the banana, and then held the peel in his hand as though it were a washcloth he had just found on the floor of a gym locker room. Melody pointed to her trashcan with her eyes. “I make an insane amount of noise when I approach you, because you once yelled at me claiming that I was 'sneaking up on you',” Bernie replied, using finger quotes on the last phrase. “That kind of treatment stays with a guy.” Melody shook her head. Her father knew how much she hated finger quotes. Why he insisted on using them was beyond her. “I was five at the time”, she said. “Ah,” Bernie said, with a knowing grin on his face. “The angry period.

By the same token, I think it's time that we allow ourselves to experience real anger as women. And I don't mean that passive aggressive dance that we've employed for too many years. It's not real anger if it is implied or a few degrees removed, if it takes the form of whispering, or cold shoulders, or silent treatment. Real anger is what popular culture would have us be afraid of, based on the fact that it is not courteous, elegant, or feminine.

The night before brain surgery, I thought about death. I searched out my larger values, and I asked myself, if I was going to die, did I want to do it fighting and clawing or in peaceful surrender? What sort of character did I hope to show? Was I content with myself and what I had done with my life so far? I decided that I was essentially a good person, although I could have been better--but at the same time I understood that the cancer didn't care. I asked myself what I believed. I had never prayed a lot. I hoped hard, I wished hard, but I didn't pray. I had developed a certain distrust of organized religion growing up, but I felt I had the capacity to be a spiritual person, and to hold some fervent beliefs. Quite simply, I believed I had a responsibility to be a good person, and that meant fair, honest, hardworking, and honorable. If I did that, if I was good to my family, true to my friends, if I gave back to my community or to some cause, if I wasn't a liar, a cheat, or a thief, then I believed that should be enough. At the end of the day, if there was indeed some Body or presence standing there to judge me, I hoped I would be judged on whether I had lived a true life, not on whether I believed in a certain book, or whether I'd been baptized. If there was indeed a God at the end of my days, I hoped he didn't say, 'But you were never a Christian, so you're going the other way from heaven.' If so, I was going to reply, 'You know what? You're right. Fine.' I believed, too, in the doctors and the medicine and the surgeries--I believed in that. I believed in them. A person like Dr. Einhorn [his oncologist], that's someone to believe in, I thought, a person with the mind to develop an experimental treatment 20 years ago that now could save my life. I believed in the hard currency of his intelligence and his research. Beyond that, I had no idea where to draw the line between spiritual belief and science. But I knew this much: I believed in belief, for its own shining sake. To believe in the face of utter hopelessness, every article of evidence to the contrary, to ignore apparent catastrophe--what other choice was there? We do it every day, I realized. We are so much stronger than we imagine, and belief is one of the most valiant and long-lived human characteristics. To believe, when all along we humans know that nothing can cure the briefness of this life, that there is no remedy for our basic mortality, that is a form of bravery. To continue believing in yourself, believing in the doctors, believing in the treatment, believing in whatever I chose to believe in, that was the most important thing, I decided. It had to be. Without belief, we would be left with nothing but an overwhelming doom, every single day. And it will beat you. I didn't fully see, until the cancer, how we fight every day against the creeping negatives of the world, how we struggle daily against the slow lapping of cynicism. Dispiritedness and disappointment, these were the real perils of life, not some sudden illness or cataclysmic millennium doomsday. I knew now why people fear cancer: because it is a slow and inevitable death, it is the very definition of cynicism and loss of spirit. So, I believed.

If, in all that you wish to do, you begin by asking yourself: am I certain that I would wish to do this an infinite number of times? This should be for you the most solid centre of gravity . . . My doctrine says, the task is to live your life in such a way that you must wish to live it again - for you will anyway! If striving gives you the highest feeling, then strive! If rest gives you the highest feeling, then rest! If fitting in, following and obeying give you the highest feeling, then obey! Only make sure you come to know what gives you the highest feeling, and then spare no means. Eternity is at stake! This doctrine is mild in its treatment of those who do not believe in it. It has neither hell nor threats. But anyone who does not believe merely lives a fugitive life in the consciousness of it.

This wasn’t what she expected. Never, in her wildest dreams. This... this was the Blood Queen of Garbhán Isle? Scourge of the Madron lands? Destroyer of Villages? Demon Killer of Women and Children? She who had blood pacts with the darkest of gods? This was Annwyl the Bloody? Talaith watched, fascinated, as Annwyl held onto Morfyd the Witch’s wrists. Morfyd — the Black Witch of Despair, Killer of the Innocent, Annihilator of Souls, and all around Mad Witch of Garbhán Isle or so she was called on the Madron lands — had actually tried to sneak up on Annwyl to put ointment on the nasty wound the queen had across her face. But as soon as the warrior saw her, she squealed and grabbed hold of her. Now Annwyl lay on her back, Morfyd over her, trying her best to get Annwyl to stop being a ten year old. “If you just let me—” “No! Get that centaur shit away from me, you demon bitch!” “Annwyl, I’m not letting you go home to my brother looking like that. You look horrific.” “He’ll have to love me in spite of it. Now get off!” ... “Ow!” “Crybaby.” No, this isn’t what Talaith expected. Annwyl the Blood Queen was supposed to be a vicious, uncaring warrior bent on revenge and power. She let her elite guard rape and and pillage wherever they went, and she used babies as target practice while their mothers watched in horror. That’s what she was supposed to be and that’s what Talaith expected to find. Instead, she found Annwyl. Just Annwyl. A warrior who spent most of her resting time reading or mooning over her consort. She was silly, charming, very funny, and fiercely protective of everyone. Her elite guard, all handpicked by Annwyl, were sweet, vicious fighters and blindingly loyal to their queen.

Perhaps this war will make it simpler for us to go back to some of the old ways we knew before we came over to this land and made the Big Money. Perhaps, even, we will remember how to make good bread again. It does not cost much. It is pleasant: one of those almost hypnotic businesses, like a dance from some ancient ceremony. It leaves you filled with peace, and the house filled with one of the world's sweetest smells. But it takes a lot of time. If you can find that, the rest is easy. And if you cannot rightly find it, make it, for probably there is no chiropractic treatment, no Yoga exercise, no hour of meditation in a music-throbbing chapel, that will leave you emptier of bad thoughts than this homely ceremony of making bread.

By the time you have reached adulthood, your brain has decided how the world works–how a table looks and feels, how liquids and authority figures behave, how scary are rats. It has made countless billions of little insights and decisions. It has made its mind up. From then on in, its treatment of any new information that runs counter to those views can sometimes be brutal. Your brain is surprisingly reluctant to change its mind. Rather than going through the difficulties involved in rearranging itself to reflect the truth, it often prefers to fool you. So it distorts. It forgets. It projects. It lies.

It's as if people -- normal people -- are made of silver. Shiny to start with, but tarnished by time, by ill-treatment. Luca... Luca is gold. Nothing in the world could ever make him shine less brightly.

Now, I learned a long time ago how to be quiet on the outside while I'm freaking on the inside. How to turn away like I don't see all the things that need to be seen, just to keep peace. How to lie low and act like I want nothing, expect nothing, and hope for nothing so I don't become more trouble than I'm worth. I'm five months short of eighteen and I know how to be cursed and ignored and left behind, how to swallow a thousand tears and ignore a thousand delibarate cruelties, but it's two in the morning on New Year's Eve and I'm mad and scared and bone tired and really, really sick of acting like I'm grateful to be staying on a hairy, sagging, dog-stained couch in a junky, mildewed trailer with a fat, dangerous, volatile drunk who sweats stale beer and wallows in his own wastewater, and who doesn't think there's one thing wrong with taking his crap life out on his dog, who comes bellying back for forgiveness every single time, no matter how rotten the treatment-

At one time, the treatment for a certain kind of psychosis had been to push an ice pick up through the orbit of the eye, into the frontal lobe; the ice pick was then stirred around until it reduced the problematic brain tissue to non-functioning porridge.

If a child stays quiet in the context of extroverted friends, or even prefers time alone, a parent may worry and even send her to therapy. She might be thrilled— she’ll finally get to talk about the stuff she cares about, and without interruption! But if the therapist concludes that the child has a social phobia, the treatment of choice is to increasingly expose her to the situations she fears. This behavioral treatment is effective for treating phobias — if that is truly the problem. If it’s not the problem, and the child just likes hanging out inside better than chatting, she’ll have a problem soon. Her “illness” now will be an internalized self-reproach: “Why don’t I enjoy this like everyone else?” The otherwise carefree child learns that something is wrong with her. She not only is pulled away from her home, she is supposed to like it. Now she is anxious and unhappy, confirming the suspicion that she has a problem.

One of the paradoxical and transformative aspects of implicit traumatic memory is that once it is accessed in a resourced way (through the felt sense), it, by its very nature, changes. Out of the shattered fragments of her deeply injured psyche, Jody discovered and nurtured a nascent, emergent self. From the ashes of the frantically activated, hypervigilant, frozen, traumatized girl of twenty-five years ago, Jody began to reorient to a new, less threatening world. Gradually she shaped into a more fluid, resilient, woman, coming to terms with the felt capacity to fiercely defend herself when necessary, and to surrender in quiet ecstasy.

I hope you'll know more than I did. That you'll never fear justice. Never misinterpret the fight for equality as a war between the sexes. That you'll never believe that a woman doesn't deserve the same rights or freedoms or chances that you do. I hope you'll know that, above all, most people are not looking for special treatment, most people don't want everything to be the same for everyone, most people just want things to be FAIR for everyone. I hope you'll get that, way faster than I did. And I hope that you'll never get it into your head that just because a woman deserves every opportunity you do, you have to stop holding the door open for her when you can. That you'll never think it's impossible to be equals and behave like a gentleman at the same time. Because, as your grandmothers will teach you, that's rubbish.

When others seem to take advantage of you, do not retaliate by trying to take advantage of them. Use your power in improving yourself, so that you can do better and better work. That is how you are going to win in the race. Later on, those who tried to take advantage of you will be left in the rear. Remember, those who are dealing unjustly with you or with anybody are misusing their mind. They are therefore losing their power, and will, in the course of time, begin to lose ground; but if you, in the mean time, are turning the full power of your mind to good account, you will not only gain more power, but you will soon begin to gain ground. You will gain and continue to gain in the long run, while others who have been misusing their minds will lose mostly everything in the long run. That is how you are going to win, and win splendidly regardless of ill treatment or opposition.

Her face is silting up, like a pond; layers are accumulating. Every once in a while, when she can afford the time, she spends a few days at a spa north of the city, drinking vegetable juice and having ultrasound treatments, in search of her original face, the one she knows is under there somewhere; she comes back feeling toned up and virtuous, and hungry.

The second thing which made speechless--a state my dad would have found amusing--was the fact Mr. Hunky gave me a masculine grin--a naughty one which made me cream my panties--and said in a velvety baritone, “Run along, sweetheart. I’ve got this.” Me, one of Hell’s most successful bounty hunters, dismissed with a smile and a wave of his hand. His treatment made me want to tear his pants off and ride him like a cowgirl--I mean, he’d called me sweetheart, how hot was that?--while at the same time making me see red. I’m gonna wipe the smirk off his face. Then I’m gonna kiss him. Then..

On those days when we are not ready to stop being offended, not ready to forgive, still determined to dish out the silent treatment, what we are actually saying is, 'Thanks, but I don't want to become more like the Savior today. Maybe tomorrow, but not today.' Perhaps those are the times when we need to pray the hardest, the times it becomes clear that a change in behavior is not enough--that we must have a change in nature.

Almost no abuser is mean or frightening all the time. At least occasionally, he is loving, gentle, and humorous and perhaps even capable of compassion and empathy. This intermittent, and usually unpredictable, kindness is critical to forming traumatic attachments. When a person, male or female, has suffered harsh, painful treatment over an extended period of time, he or she naturally feels a flood of love and gratitude toward anyone who brings relief, like the surge of affection one might feel for the hand that offers a glass of water on a scorching day. But in situations of abuse, the rescuer and the tormentor are the very same person.

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

health, social life, job, house, partners, finances; leisure use, leisure amount; working time, education, income, children; food, water, shelter, clothing, sex, health care; mobility; physical safety, social safety, job security, savings account, insurance, disability protection, family leave, vacation; place tenure, a commons; access to wilderness, mountains, ocean; peace, political stability, political input, political satisfaction; air, water, esteem; status, recognition; home, community, neighbors, civil society, sports, the arts; longevity treatments, gender choice; the opportunity to become more what you are that's all you need

It is true that women have seldom been aggressive in de- manding their rights and so have cooperated in their own enslavement. This was true of the black population for many years. They submitted to oppression, and even condoned it. But women are becoming aware, as blacks did, that they can have equal treatment if they will fight for it, and they are starting to organize. To do it, they have to dare the sanctions that society imposes on anyone who breaks with its traditions. This is hard, and especially hard for women, who are taught not to rebel from infancy, from the time they are first wrapped in pink blankets, the color of their caste.

You don’t have to spend much time with the elderly or those with terminal illness to see how often medicine fails the people it is supposed to help. The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver’s chance of benefit. These days are spent in institutions—nursing homes and intensive-care units—where regimented, anonymous routines cut us off from all the things that matter to us in life.

One would never defeat one's circumstances by working and saving one's pennies; one would never, by working, acquire that many pennies, and, besides, the social treatment accorded even the most successful Negroes proved that one needed, in order to be free, something more than a bank account. One needed a handle, a lever, a means of inspiring fear. It was absolutely clear that the police would whip you and take you in as long as they could get away with it, and that everyone else—housewives, taxi-drivers, elevator boys, dishwashers, bartenders, lawyers, judges, doctors, and grocers—would never, by the operation of any generous human feeling, cease to use you as an outlet for his frustrations and hostilities.

The will of little girls is stifled by Islam. By the time they menstruate they are rendered voiceless. They are reared to become submissive robots who serve in the house as cleaners and cooks. They are required to comply with their father's choice of a mate, and after the wedding their lives are devoted to the sexual pleasures of their husband and to a life of childbearing.

That woman’s got it in for the Ministry of Magic!” said Percy furiously. “Last week she was saying we’re wasting our time quibbling about cauldron thickness, when we should be stamping out vampires! As if it wasn’t specifically stated in paragraph twelve of the Guidelines for the Treatment of Non-Wizard Part-Humans —” “Do us a favor, Perce,” said Bill, yawning, “and shut up.

HUMAN BILL OF RIGHTS [GUIDELINES FOR FAIRNESS AND INTIMACY] I have the right to be treated with respect. I have the right to say no. I have the right to make mistakes. I have the right to reject unsolicited advice or feedback. I have the right to negotiate for change. I have the right to change my mind or my plans. I have a right to change my circumstances or course of action. I have the right to have my own feelings, beliefs, opinions, preferences, etc. I have the right to protest sarcasm, destructive criticism, or unfair treatment. I have a right to feel angry and to express it non-abusively. I have a right to refuse to take responsibility for anyone else’s problems. I have a right to refuse to take responsibility for anyone’s bad behavior. I have a right to feel ambivalent and to occasionally be inconsistent. I have a right to play, waste time and not always be productive. I have a right to occasionally be childlike and immature. I have a right to complain about life’s unfairness and injustices. I have a right to occasionally be irrational in safe ways. I have a right to seek healthy and mutually supportive relationships. I have a right to ask friends for a modicum of help and emotional support. I have a right to complain and verbally ventilate in moderation. I have a right to grow, evolve and prosper.

Misery is like an animal, it needs food to survive—so starve it. Surround yourself with art and beauty that brightens your darkest days. Listen to music and poetry that always fill the cracks of your broken heart. Read quotes and passages that can soothe and motivate you when you feel the most discouraged. Spend time with people who make you laugh and distract you from your troubles. Nourish your soul and hopefully the mind will follow. However, if you find you can't help yourself, there's no shame in asking others for help. Sometimes asking for help is just as heroic as giving it. There are treatments and therapies and counselors that you could benefit from—but no one finds answers if they're too afraid to ask the questions. Don't let your pride tell you otherwise.

Although, in principle, the psychoanalytical theory of borderlines is not punitive, in practice 'borderline' is almost always used to indicate that the patient is hostile, demanding, unpleasant, manipulative, attention-seeking, and prone to regression and dependency if admitted to hospital; in other words patient is a witch by Malleus Maleficarum criteria. The term 'borderline' functions to rationalize sadistic counter-transference, and to legitimize rejecting triaging decisions within the health-care system. Actually, most of the time, in my experience, the splitting is coming from the staff, not the patient, and it is the mental-health professionals who are using projection and denial. This is an example of 'blaming the victim,' which is a fundamental borderline psychodynamic.

Psychology’s service to U.S. national security has produced a variant of what the psychiatrist Robert Lifton has called, in his study of Nazi doctors, a “Faustian bargain.” In this case, the price paid has been the American Psychological Association’s collective silence, ethical “numbing,” and, over time, historical amnesia. 3 Indeed, Lifton emphasizes that “the Nazis were not the only ones to involve doctors in evil”; in defense of this argument, he cites the Cold War “role of …American physicians and psychologists employed by the Central Intelligence Agency…for unethical medical and psychological experiments involving drugs and mind manipulation.” 4

I remember going to the British Museum one day to read up the treatment for some slight ailment of which I had a touch – hay fever, I fancy it was. I got down the book, and read all I came to read; and then, in an unthinking moment, I idly turned the leaves, and began to indolently study diseases, generally. I forget which was the first distemper I plunged into – some fearful, devastating scourge, I know – and, before I had glanced half down the list of “premonitory symptoms,” it was borne in upon me that I had fairly got it. I sat for awhile, frozen with horror; and then, in the listlessness of despair, I again turned over the pages. I came to typhoid fever – read the symptoms – discovered that I had typhoid fever, must have had it for months without knowing it – wondered what else I had got; turned up St. Vitus’s Dance – found, as I expected, that I had that too, – began to get interested in my case, and determined to sift it to the bottom, and so started alphabetically – read up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight. Bright’s disease, I was relieved to find, I had only in a modified form, and, so far as that was concerned, I might live for years. Cholera I had, with severe complications; and diphtheria I seemed to have been born with. I plodded conscientiously through the twenty-six letters, and the only malady I could conclude I had not got was housemaid’s knee. ... I had walked into that reading-room a happy, healthy man. I crawled out a decrepit wreck. I went to my medical man. He is an old chum of mine, and feels my pulse, and looks at my tongue, and talks about the weather, all for nothing, when I fancy I’m ill; so I thought I would do him a good turn by going to him now. “What a doctor wants,” I said, “is practice. He shall have me. He will get more practice out of me than out of seventeen hundred of your ordinary, commonplace patients, with only one or two diseases each.” So I went straight up and saw him, and he said: “Well, what’s the matter with you?” I said: “I will not take up your time, dear boy, with telling you what is the matter with me. Life is brief, and you might pass away before I had finished. But I will tell you what is NOT the matter with me. I have not got housemaid’s knee. Why I have not got housemaid’s knee, I cannot tell you; but the fact remains that I have not got it. Everything else, however, I HAVE got.” And I told him how I came to discover it all. Then he opened me and looked down me, and clutched hold of my wrist, and then he hit me over the chest when I wasn’t expecting it – a cowardly thing to do, I call it – and immediately afterwards butted me with the side of his head. After that, he sat down and wrote out a prescription, and folded it up and gave it me, and I put it in my pocket and went out. I did not open it. I took it to the nearest chemist’s, and handed it in. The man read it, and then handed it back. He said he didn’t keep it. I said: “You are a chemist?” He said: “I am a chemist. If I was a co-operative stores and family hotel combined, I might be able to oblige you. Being only a chemist hampers me.” I read the prescription. It ran: “1 lb. beefsteak, with 1 pt. bitter beer every 6 hours. 1 ten-mile walk every morning. 1 bed at 11 sharp every night. And don’t stuff up your head with things you don’t understand.” I followed the directions, with the happy result – speaking for myself – that my life was preserved, and is still going on.

There are stages to the process of being betrayed by your society. One is jolted from a place of complacency by the discovery of difference, by hypocrisy, by inexplicable or incongruous ill treatment. What follows is a time of confusion—unlearning what one thought to be the truth. Immersing oneself in the new truth. And then a decision must be made. Some accept their fate. Swallow their pride, forget the real truth, embrace the falsehood for all they’re worth—because, they decide, they cannot be worth much. If a whole society has dedicated itself to their subjugation, after all, then surely they deserve it? Even if they don’t, fighting back is too painful, too impossible. At least this way there is peace, of a sort. Fleetingly. The alternative is to demand the impossible. It isn’t right, they whisper, weep, shout; what has been done to them is not right. They are not inferior. They do not deserve it. And so it is the society that must change. There can be peace this way, too, but not before conflict. No one reaches this place without a false start or two.

From that moment on, I was no longer a liberal, a believer in the self-correcting character of American democracy. I was a radical, believing that something fundamental was wrong in this country—not just the existence of poverty amidst great wealth, not just the horrible treatment of black people, but something rotten at the root. The situation required not just a new president or new laws, but an uprooting of the old order, the introduction of a new kind of society—cooperative, peaceful, egalitarian.

At the core of this grief is our longing to belong. This longing is wired into us by necessity. It assures our safety and our ability to extend out into the world with confidence. This feeling of belonging is rooted in the village and, at times, in extended families. It was in this setting that we emerged as a species. It was in this setting that what we require to become fully human was established. Jean Liedloff writes, "the design of each individual was a reflection of the experience it expected to encounter." We are designed to receive touch, to hear sounds and words entering our ears that soothe and comfort. We are shaped for closeness and for intimacy with our surroundings. Our profound feelings of lacking something are not reflection of personal failure, but the reflection of a society that has failed to offer us what we were designed to expect. Liedloff concludes, "what was once man's confident expectations for suitable treatment and surroundings is now so frustrated that a person often thinks himself lucky if he is not actually homeless or in pain. But even as he is saying, 'I am all right,' there is in him a sense of loss, a longing for something he cannot name, a feeling of being off-center, of missing something. Asked point blank, he will seldom deny it.

Booker T. Washington tells an anecdote told to him by Frederick Douglass, about a time he was traveling and was asked to move and ride in the baggage car because of his race. A white supporter rushed up to apologize for this horrible offense. “I am sorry, Mr. Douglass, that you have been degraded in this manner,” the person said. Douglass would have none of that. He wasn’t angry. He wasn’t hurt. He replied with great fervor: “They cannot degrade Frederick Douglass. The soul that is within me no man can degrade. I am not the one that is being degraded on account of this treatment, but those who are inflicting it upon me.

Atheism is an idea. Most often (thank God), it is an idea lived and told with blunt jumbo-crayon clumsiness. Some child of Christianity or Judaism dons an unbelieving Zorro costume and preens about the living room. Behold, a dangerous thinker of thinks! A believer in free-from-any-and-all-goodness! Fear my brainy blade! Put candy in their bucket. Act scared. Don't tell them that they're adorable. Atheism is not an idea we want fleshed out. Atheism incarnate does happen in this reality narrative. But it doesn't rant about Islam's treatment of women as did the (often courageous) atheist Christopher Hitchens. It doesn't thunder words like evil and mean it (as Hitch so often did) when talking about oppressive communist regimes. His costume slipped all the time—and in many of his best moments. Atheism incarnate is nihilism from follicle to toenail. It is morality merely as evolved herd survival instinct (non-bindng, of course, and as easy for us to outgrow as our feathers were). When Hitchens thundered, he stood in the boots of forefathers who knew that all thunder comes from on high.

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 time I took my knife and sliced off the end of a hog’s nose, just like a piece of salami. The hog went crazy for a few seconds. Then it sat there looking kind of stupid. So I took a handful of salt and rubbed it on the wound. Now that hog really went nuts. It was my way of taking out frustration. Another time, there was a live hog in the pit. It hadn’t done anything wrong, wasn’t even running around. It was just alive. I took a three-foot chunk of pipe and I literally beat that hog to death. It was like I started hitting the hog and I couldn’t stop. And when I finally did stop, I’d expended all this energy and frustration, and I’m thinking what in God’s sweet name did I do.

We will martyr ourselves, suffering under the weight of a non-reciprocal relationship until some part of us bursts in protest. Suddenly, we lose our mind, and allowing ourselves to heap all manner of nastiness, name calling, patronizing, death threats on the “deserving” jerk who has it coming after all we do for him/her! As the final insult rings across the room and we regain consciousness, we are horrified by what has come out of our mouth. After all, we LOVE these people, and we quickly move into anxious terror that this time we have gone too far . . . this time we crossed the line and they will leave us. So, we hunker back down and the martyrdom begins again. It’s a terrible cycle.

Animals are property. There are laws that supposedly protect animal interests in being treated “humanely,” but that term is interpreted in large part to mean that we cannot impose “unnecessary” harm on animals, and that is measured by what treatment is considered as necessary within particular industries, and according to customs of use, to exploit animals. The bottom line is that animals do not have any respect-based rights in the way that humans have, because we do not regard animals as having any moral value. They have only economic value. We value their interests economically, and we ignore their interests when it is economically beneficial for us to do so. At this point in time, it makes no sense to focus on the law, because as long as we regard animals as things, as a moral matter, the laws will necessarily reflect that absence of moral value and continue to do nothing to protect animals. We need to change social and moral thinking about animals before the law is going to do anything more.

Keep his mind on the inner life. He thinks his conversion is something inside him, and his attention is therefore chiefly turned at present to the state of his own mind--or rather to that very expurgated version of them which is all you should allow him to see. Encourage this. Keep his mind off the most elementary duties of directing it to the most advanced and spiritual ones. Aggravate the most useful human characteristics, the horror and neglect of the obvious. You must bring him to a condition in which he can practise self-examination for an hour without discovering any of those facts about himself which are perfectly clear to anyone who has ever lived in the same house with him or worked in the same office. 2. It is, no doubt, impossible to prevent his praying for his mother, but we have means of rendering the prayers innocuous. Make sure that they are always very 'spiritual', that is is always concerned with the state of her soul and never with her rhuematism. Two advantages will follow. In the first place, his attention will be kept on what he regards are her sins, by which, with a little guidance from you, he can be induced to mean any of her actions which are inconvenient or irritating to himself. Thus you can keep rubbing the wounds of the day a little sorer even while he is on his knees; the operation is not at all difficult and you will find it very entertaining. In the second place, since his ideas about her soul will be very crude and often erroneous, he will, in some degree, be praying for an imaginary person, and it will be your task to make that imaginary person daily less and less like the real mother--the sharp-tongued old lady at the breakfast table. In time you may get the cleavage so wide that no thought or feeling from his prayers for the imagined mother will ever flow over into his treatment of the real one. I have had patients of my own so well in hand that they could be turned at a moment's notice from impassioned prayer for a wife's or son's soul to beating or insulting the real wife or son without any qualm. 3. When two humans have lived together for many years it usually happens that each has tones of voice and expressions of face whice are almost unedurably irritating to the other. Work on that. Bring fully into the consciousness of your patient that particular lift of his mother's eyebrows which he learned to dislike in the nursery, and let him think how much he dislikes it. Let him assume that she knows how annoying it is and does it to annoy--if you know your job he will not notice the immense improbablity of the assumption. And, of course, never let him suspect that he has tones and looks which similarly annoy her. As he cannot see or hear himself, this is easily managed.

Other personalities are created to handle new traumas, their existence usually occurring one at a time. Each has a singular purpose and is totally focused on that task. The important aspect of the mind's extreme dissociation is that each ego state is totally without knowledge of the other. Because of this, the researchers for the CIA and the Department of Defense believed they could take a personality, train him or her to be a killer and no other ego stares would be aware of the violence that was taking place. The personality running the body would be genuinely unaware of the deaths another personality was causing. Even torture could not expose the with, because the personality experiencing the torture would have no awareness of the information being sought. Earlier, such knowledge was gained from therapists working with adults who had multiple personalities. The earliest pioneers in the field, such as Dr. Ralph Alison, a psychiatrist then living in Santa Cruz, California, were helping victims of severe early childhood trauma. Because there were no protocols for treatment, the pioneers made careful notes, publishing their discoveries so other therapists would understand how to help these rare cases. By 1965, the information was fairly extensive, including the knowledge that only unusually intelligent children become multiple personalities and that sexual trauma endured by a restrained child under the age of seven is the most common way to induce hysteric dissociation.

terrified of being abandoned and all narcissists need Narcissistic Supply Sources. These narcissists prefer to direct their furious rage at people who are meaningless to them and whose withdrawal will not constitute a threat to the narcissists' precariously-balanced personalities. They explode at an underling, yell at a waitress, or berate a taxi driver. Alternatively, they sulk (silent treatment). Many narcissists feel anhedonic, or pathologically bored, drink or do drugs - all forms of self-directed aggression. From time to time, no longer able to pretend and to suppress their rage, they have it out with the real source of their anger. Then they lose all vestiges of self-control and rave like lunatics. They shout incoherently, make absurd accusations, distort facts, and air long-suppressed grievances, allegations and suspicions. These episodes are followed by periods of saccharine sentimentality and excessive flattering and submissiveness towards the target of the latest rage attack. Driven by the mortal fear of being abandoned or ignored, the narcissist debases and demeans himself to the point of provoking repulsion in the beholder. These pendulum-like emotional swings make life with the narcissist exhausting.

If you tell someone you have depression, they will often say, "Oh, I've been depressed before, too." The difference lies between being depressed and having depression. Everyone's been depressed at one time or another, but these are far from being the same things. One is a passing mood. The other is a chronic illness that does not come and go, ebb and flow, is here one day and gone the next. The difference between being depressed and having depression is that one is a mood and the other is an illness. One is a momentary bout of melancholy. The other is a debilitating condition that requires medical treatment. Would you feel better about having a cancerous lesion if I likened it to the rash I had last week? The difference between being depressed and having depression is the difference between a mood that will soon pass, and a serious illness that disrupts your ability to function and will take years to treat. The difference between being depressed and having depression is the difference between Cleveland and Bangkok, or your frying pan and the surface of the sun. So, no, we (depressives) do not feel better when you tell us about your rash. We'll do our best to be polite about it, but no, it really doesn't help at all.

The truth is that The Wild One -- despite an admittedly fictional treatment -- was an inspired piece of film journalism. Instead of institutionalizing common knowledge, in the style of Time, it told a story that was only beginning to happen and which was inevitably influenced by the film. It gave the outlaws a lasting, romance-glazed image of themselves, a coherent reflection that only a very few had been able to find in a mirror, and it quickly became the bike rider's answer to The Sun Also Rises. The image is not valid, but its wide acceptance can hardly be blamed on the movie. The Wild One was careful to distinguish between "good outlaws" and "bad outlaws," but the people who were most influenced chose to identify with Brando instead of Lee Marvin whose role as the villain was a lot more true to life than Brando's portrayal of the confused hero. They saw themselves as modern Robin Hoods ... virile, inarticulate brutes whose good instincts got warped somewhere in the struggle for self-expression and who spent the rest of their violent lives seeking revenge on a world that done them wrong when they were young and defenseless.

The Correspondence-School Instructor Says Goodbye to His Poetry Students Goodbye, lady in Bangor, who sent me snapshots of yourself, after definitely hinting you were beautiful; goodbye, Miami Beach urologist, who enclosed plain brown envelopes for the return of your very “Clinical Sonnets”; goodbye, manufacturer of brassieres on the Coast, whose eclogues give the fullest treatment in literature yet to the sagging breast motif; goodbye, you in San Quentin, who wrote, “Being German my hero is Hitler,” instead of “Sincerely yours,” at the end of long, neat-scripted letters extolling the Pre-Raphaelites: I swear to you, it was just my way of cheering myself up, as I licked the stamped, self-addressed envelopes, the game I had of trying to guess which one of you, this time, had poisoned his glue. I did care. I did read each poem entire. I did say everything I thought in the mildest words I knew. And now, in this poem, or chopped prose, no better, I realize, than those troubled lines I kept sending back to you, I have to say I am relieved it is over: at the end I could feel only pity for that urge toward more life your poems kept smothering in words, the smell of which, days later, tingled in your nostrils as new, God-given impulses to write. Goodbye, you who are, for me, the postmarks again of imaginary towns—Xenia, Burnt Cabins, Hornell— their solitude given away in poems, only their loneliness kept. Galway Kinnell

The Dialectical Dilemma for the Patient The borderline individual is faced with an apparently irreconcilable dilemma. On the one hand, she has tremendous difficulties with self-regulation of affect and subsequent behavioral competence. She frequently but somewhat unpredictably needs a great deal of assistance, often feels helpless and hopeless, and is afraid of being left alone to fend for herself in a world where she has failed over and over again. Without the ability to predict and control her own well-being, she depends on her social environment to regulate her affect and behavior. On the other hand, she experiences intense shame at behaving dependently in a society that cannot tolerate dependency, and has learned to inhibit expressions of negative affect and helplessness whenever the affect is within controllable limits. Indeed, when in a positive mood, she may be exceptionally competent across a variety of situations. However, in the positive mood state she has difficulty predicting her own behavioral capabilities in a different mood, and thus communicates to others an ability to cope beyond her capabilities. Thus, the borderline individual, even though at times desperate for help, has great difficulty asking for help appropriately or communicating her needs. The inability to integrate or synthesize the notions of helplessness and competence, of noncontrol and control, and of needing and not needing help can lead to further emotional distress and dysfunctional behaviors. Believing that she is competent to “succeed,” the person may experience intense guilt about her presumed lack of motivation when she falls short of objectives. At other times, she experiences extreme anger at others for their lack of understanding and unrealistic expectations. Both the intense guilt and the intense anger can lead to dysfunctional behaviors, including suicide and parasuicide, aimed at reducing the painful emotional states. For the apparently competent person, suicidal behavior is sometimes the only means of communicating to others that she really can’t cope and needs help; that is, suicidal behavior is a cry for help. The behavior may also function as a means to get others to alter their unrealistic expectations—to “prove” to the world that she really cannot do what is expected.

Logotherapy bases its technique called “paradoxical intention” on the twofold fact that fear brings about that which one is afraid of, and that hyper-intention makes impossible what one wishes. In German I described paradoxical intention as early as 1939.11 In this approach the phobic patient is invited to intend, even if only for a moment, precisely that which he fears. Let me recall a case. A young physician consulted me because of his fear of perspiring. Whenever he expected an outbreak of perspiration, this anticipatory anxiety was enough to precipitate excessive sweating. In order to cut this circle formation I advised the patient, in the event that sweating should recur, to resolve deliberately to show people how much he could sweat. A week later he returned to report that whenever he met anyone who triggered his anticipatory anxiety, he said to himself, “I only sweated out a quart before, but now I’m going to pour at least ten quarts!” The result was that, after suffering from his phobia for four years, he was able, after a single session, to free himself permanently of it within one week. The reader will note that this procedure consists of a reversal of the patient’s attitude, inasmuch as his fear is replaced by a paradoxical wish. By this treatment, the wind is taken out of the sails of the anxiety. Such a procedure, however, must make use of the specifically human capacity for self-detachment inherent in a sense of humor. This basic capacity to detach one from oneself is actualized whenever the logotherapeutic technique called paradoxical intention is applied. At the same time, the patient is enabled to put himself at a distance from his own neurosis. A statement consistent with this is found in Gordon W. Allport’s book, The Individual and His Religion: “The neurotic who learns to laugh at himself may be on the way to self-management, perhaps to cure.”12 Paradoxical intention is the empirical validation and clinical application of Allport’s statement.

How often does it occur that information provided you on morning radio or television, or in the morning newspaper, causes you to alter your plans for the day, or to take some action you would not otherwise have taken, or provides insight into some problem you are required to solve? For most of us, news of the weather will sometimes have consequences; for investors, news of the stock market; perhaps an occasional story about crime will do it, if by chance it occurred near where you live or involved someone you know. But most of our daily news is inert, consisting of information that gives us something to talk about but cannot lead to any meaningful action...You may get a sense of what this means by asking yourself another series of questions: What steps do you plan to take to reduce the conflict in the Middle East? Or the rates of inflation, crime and unemployment? What are your plans for preserving the environment or reducing the risk of nuclear war? What do you plan to do about NATO, OPEC, the CIA, affirmative action, and the monstrous treatment of the Baha’is in Iran? I shall take the liberty of answering for you: You plan to do nothing about them. You may, of course, cast a ballot for someone who claims to have some plans, as well as the power to act. But this you can do only once every two or four years by giving one hour of your time, hardly a satisfying means of expressing the broad range of opinions you hold. Voting, we might even say, is the next to last refuge of the politically impotent. The last refuge is, of course, giving your opinion to a pollster, who will get a version of it through a desiccated question, and then will submerge it in a Niagara of similar opinions, and convert them into—what else?—another piece of news. Thus, we have here a great loop of impotence: The news elicits from you a variety of opinions about which you can do nothing except to offer them as more news, about which you can do nothing.

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 nine in our list are based on a longer list in Robert Leahy, Stephen Holland, and Lata McGinn’s book, Treatment Plans and Interventions for Depression and Anxiety Disorders. For more on CBT—how it works, and how to practice it—please see Appendix 1.) EMOTIONAL REASONING: Letting your feelings guide your interpretation of reality. “I feel depressed; therefore, my marriage is not working out.” CATASTROPHIZING: Focusing on the worst possible outcome and seeing it as most likely. “It would be terrible if I failed.” OVERGENERALIZING: Perceiving a global pattern of negatives on the basis of a single incident. “This generally happens to me. I seem to fail at a lot of things.” DICHOTOMOUS THINKING (also known variously as “black-and-white thinking,” “all-or-nothing thinking,” and “binary thinking”): Viewing events or people in all-or-nothing terms. “I get rejected by everyone,” or “It was a complete waste of time.” MIND READING: Assuming that you know what people think without having sufficient evidence of their thoughts. “He thinks I’m a loser.” LABELING: Assigning global negative traits to yourself or others (often in the service of dichotomous thinking). “I’m undesirable,” or “He’s a rotten person.” NEGATIVE FILTERING: You focus almost exclusively on the negatives and seldom notice the positives. “Look at all of the people who don’t like me.” DISCOUNTING POSITIVES: Claiming that the positive things you or others do are trivial, so that you can maintain a negative judgment. “That’s what wives are supposed to do—so it doesn’t count when she’s nice to me,” or “Those successes were easy, so they don’t matter.” BLAMING: Focusing on the other person as the source of your negative feelings; you refuse to take responsibility for changing yourself. “She’s to blame for the way I feel now,” or “My parents caused all my problems.”11

If you think about it, the public perception of funky brain chemistry has been as varied and weird as the symptoms, historically speaking. If I had been born a Native American in another time, I might have been lauded as a medicine man. My voices would have been seen as the voices of ancestors imparting wisdom. I would have been treated with great mystical regard. If I had lived in biblical times, I might have been seen as a prophet, because, let’s face it, there are really only two possibilities: either prophets were actually hearing God speaking to them, or they were mentally ill. I’m sure if an actual prophet surfaced today, he or she would receive plenty of Haldol injections, until the sky opened up and the doctors were slapped silly by the Hand of God. In the Dark Ages my parents would have sent for an exorcist, because I was clearly possessed by evil spirits, or maybe even the Devil himself. And if I lived in Dickensian England, I would have been thrown into Bedlam, which is more than just a description of madness. It was an actual place—a “madhouse” where the insane were imprisoned in unthinkable conditions. Living in the twenty-first century gives a person a much better prognosis for treatment, but sometimes I wish I’d lived in an age before technology. I would much rather everyone think I was a prophet than some poor sick kid.

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.

She helps me to the bathroom, helps me wash, then helps me put a gazillion tangles in my hair while she shampoos it. And she actually thinks we’re going to leave it that way. “I’m not going downstairs looking like a hobo,” I tell her. “We have to comb it.” “That thick mess will break this flimsy comb. Can’t you just run your fingers through it?” It’s weird to be arguing about my hair when we still haven’t discussed my wound, how I got it, and how I came to be snoring in Galen’s bed. We both seem to appreciate the bizarreness at the same time. Mom raises a brow. “Don’t think you get special treatment just because you can make a whale do the tango. I’m still your mother.” We both laugh so hard I think I feel a tiny rip in my newly dressed wound. Without warning, Mom throws her arms around me, careful to avoid touching it. “I’m so proud of you, Emma. And I know your father would be, too. Your grandfather can’t stop talking about it. You were amazing.” Ah, the bonding power of tangled hair and dancing whales. She releases me the second before it gets awkward. “Let’s get you dressed. We have a lot to discuss. And I get you’re starving. Rachel made you…uh…Upchuck Eggs.” “She gets an A for effort.

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.

During one of these lectures, our teacher imparted a morsel of clinical wisdom. This is what he told us: “You will from time to time meet a patient who shares a disturbing tale of multiple mistakes in his previous treatment. He has been seen by several clinicians, and all failed him. The patient can lucidly describe how his therapists misunderstood him, but he has quickly perceived that you are different. You share the same feeling, are convinced that you understand him, and will be able to help.” At this point my teacher raised his voice as he said, “Do not even think of taking on this patient! Throw him out of the office! He is most likely a psychopath and you will not be able to help him.” Many years later I learned that the teacher had warned us against psychopathic charm, and the leading authority in the study of psychopathy confirmed that the teacher’s advice was sound. The analogy to the Müller-Lyer illusion is close. What we were being taught was not how to feel about that patient. Our teacher took it for granted that the sympathy we would feel for the patient would not be under our control; it would arise from System 1. Furthermore, we were not being taught to be generally suspicious of our feelings about patients. We were told that a strong attraction to a patient with a repeated history of failed treatment is a danger sign—like the fins on the parallel lines. It is an illusion—a cognitive illusion—and I (System 2) was taught how to recognize it and advised not to believe it or act on it.

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.

White women—feminists included—have revealed a historical reluctance to acknowledge the struggles of household workers. They have rarely been involved in the Sisyphean task of ameliorating the conditions of domestic service. The convenient omission of household workers’ problems from the programs of “middle-class” feminists past and present has often turned out to be a veiled justification—at least on the part of the affluent women—of their own exploitative treatment of their maids. In 1902 the author of an article entitled “A Nine-Hour Day for Domestic Servants” described a conversation with a feminist friend who had asked her to sign a petition urging employers to furnish seats for women clerks. “The girls,” she said, “have to stand on their feet ten hours a day and it makes my heart ache to see their tired faces.” “Mrs. Jones,” said I, “how many hours a day does your maid stand upon her feet?” “Why, I don’t know,” she gasped, “five or six I suppose.” “At what time does she rise?” “At six.” “And at what hour does she finish at night?” “Oh, about eight, I think, generally.” “That makes fourteen hours …” “… (S)he can often sit down at her work.” “At what work? Washing? Ironing? Sweeping? Making beds? Cooking? Washing dishes? … Perhaps she sits for two hours at her meals and preparing vegetables, and four days in the week she has an hour in the afternoon. According to that, your maid is on her feet at least eleven hours a day with a score of stair-climbings included. It seems to me that her case is more pitiable than that of the store clerk.” My caller rose with red cheeks and flashing eyes. “My maid always has Sunday after dinner,” she said. “Yes, but the clerk has all day Sunday. Please don’t go until I have signed that petition. No one would be more thankful than I to see the clerks have a chance to sit …

I have another scan this week," I say lightly, hoping to reassure my loved ones that it is safe to rejoin my orbit. There is always another scan, because this is my reality. But the people I know are often busy contending with mildly painful ambition and the possibility of reward. I try to begrudge them nothing, except I'm not alongside them anymore. In the meantime, I have been hunkering down with old medical supplies and swelling resentment. I tried— haven't I tried? — to avoid fights and remember birthdays. I showed up for dance recitals and listened to weight-loss dreams and kept the granularity of my medical treatments in soft focus. A person like that would be easier to love, I reasoned. I try a small experiment and stop calling my regular rotation of friends and family, hoping that they will call me back on their own. _This is not a test. This is not a test._ The phone goes quiet, except for a handful of calls. I feel heavy with strange new grief. Is it bitter or unkind to want everyone to remember what I can't forget? Who wants to be confronted with the reality that we are all a breath away from a problem that could alter our lives completely? A friend with a very sick child said it best: I'm everyone's inspiration and and no one's friend. I am asked all the time to say that, given what I've gained in perspective, I would never go back. Who would want to know the truth? Before was better.

A humorous treatment of the rigid uniformitarian view came from Mark Twain. Although the shortening of the Mississippi River he referred to was the result of engineering projects eliminating many of the bends in the river, it is a thought-provoking spoof: The Mississippi between Cairo and New Orleans was twelve hundred and fifteen miles long one hundred and seventy-six years ago. . . . Its length is only nine hundred and seventy-three miles at present. Now, if I wanted to be one of those ponderous scientific people, and “let on” to prove what had occurred in the remote past by what had occurred in a given time in the recent past . . . what an opportunity is here! Geology never had such a chance, nor such exact data to argue from! . . . In the space of one hundred and seventy-six years the Lower Mississippi has shortened itself two hundred and forty-two miles. That is an average of a trifle over one mile and a third per year. Therefore, any calm person, who is not blind or idiotic, can see that in the Old Oolitic Silurian Period, just a million years ago next November, the Lower Mississippi River was upwards of one million three hundred thousand miles long, and stuck out over the Gulf of Mexico like a fishing-rod. And by the same token any person can see that seven hundred and forty-two years from now the lower Mississippi will be only a mile and three-quarters long. . . . There is something fascinating about science. One gets such wholesale returns of conjecture out of such a trifling investment of fact.

The next time you drive into a Walmart parking lot, pause for a second to note that this Walmart—like the more than five thousand other Walmarts across the country—costs taxpayers about $1 million in direct subsidies to the employees who don’t earn enough money to pay for an apartment, buy food, or get even the most basic health care for their children. In total, Walmart benefits from more than $7 billion in subsidies each year from taxpayers like you. Those “low, low prices” are made possible by low, low wages—and by the taxes you pay to keep those workers alive on their low, low pay. As I said earlier, I don’t think that anyone who works full-time should live in poverty. I also don’t think that bazillion-dollar companies like Walmart ought to funnel profits to shareholders while paying such low wages that taxpayers must pick up the ticket for their employees’ food, shelter, and medical care. I listen to right-wing loudmouths sound off about what an outrage welfare is and I think, “Yeah, it stinks that Walmart has been sucking up so much government assistance for so long.” But somehow I suspect that these guys aren’t talking about Walmart the Welfare Queen. Walmart isn’t alone. Every year, employers like retailers and fast-food outlets pay wages that are so low that the rest of America ponies up a collective $153 billion to subsidize their workers. That’s $153 billion every year. Anyone want to guess what we could do with that mountain of money? We could make every public college tuition-free and pay for preschool for every child—and still have tens of billions left over. We could almost double the amount we spend on services for veterans, such as disability, long-term care, and ending homelessness. We could double all federal research and development—everything: medical, scientific, engineering, climate science, behavioral health, chemistry, brain mapping, drug addiction, even defense research. Or we could more than double federal spending on transportation and water infrastructure—roads, bridges, airports, mass transit, dams and levees, water treatment plants, safe new water pipes. Yeah, the point I’m making is blindingly obvious. America could do a lot with the money taxpayers spend to keep afloat people who are working full-time but whose employers don’t pay a living wage. Of course, giant corporations know they have a sweet deal—and they plan to keep it, thank you very much. They have deployed armies of lobbyists and lawyers to fight off any efforts to give workers a chance to organize or fight for a higher wage. Giant corporations have used their mouthpiece, the national Chamber of Commerce, to oppose any increase in the minimum wage, calling it a “distraction” and a “cynical effort” to increase union membership. Lobbyists grow rich making sure that people like Gina don’t get paid more. The

Most of the time, we have to be strong, we must not show our fragility. We’ve known that since the schoolyard. There is always a fragile bit of us, but we keep it very hidden. Yet Venetian glass doesn’t apologise for its weakness. It admits its delicacy; it is confident enough to demand careful treatment; it makes the world understand it could easily be damaged. It’s not fragile because of a deficiency, or by mistake. It's not as if its maker was trying to make it tough and hardy and then - stupidly - ended up with something a child could snap, or that would be shattered by clumsy mishandling. It is fragile and easily harmed as the consequence of its search for transparency and refinement and its desire to welcome sunlight and candle light into its depths. Glass can achieve wonderful effects but the necessary price is fragility. Some good things things have to be delicate - the dish says: ‘I am delightful, but if you knock me about I’ll break, and that’s not my fault.’ It is the duty of civilisation to allow the more delicate forms of human activity to thrive; to create environments where it is OK to be fragile. And we know, really, that it is not glass which most needs this care, it is ourselves. It’s obvious the glass could easily be smashed, so it makes you use your fingers tenderly; you have to be careful how you grasp the stem. It teaches us that moderation is admirable, and elegant, not just a tedious demand. It tells us that being careful is glamorous and exciting - even fashionable. It is a moral tale about gentleness, told by means of a drinking vessel. This is training for the more important moments in life when moderation will make a real difference to other people. Being mature - and civilised - means being aware of the effect of one’s strength on others.

I've thought of myself a girl on several occasions because I like to polish shoes and find household tasks amusing. There was once even a time when I insisted on mending a torn suit with my own hands. And in winter I always light the heating stoves myself, as though this were the natural course of things. But of course I'm not a real girl. Please give me a moment to consider all this would entail. The first thing that comes to mind is the question of whether I might possibly be a girl has never, never, not for a single moment, troubled me, rattled my bourgeois composure or made me unhappy. An absolutely by no means unhappy person stands before you, I'd like to put quite special emphasis on this, for I have never experienced sexual torment or distress, for I was never at a loss for quite simple methods of freeing myself from pressures. A rather curious, that is to say, important discovery for me was that it filled me with the most delightful gaiety to imagine myself someone's servant.... My nature, then, merely inclines me to treat people well, to be helpful and so forth. Not long ago I carried with flabbergasting zeal a shopping bag full of new potatoes for a petit bourgeoise. She's have been perfectly able to tote it herself. Now my situation is this: my particular nature also sometimes seeks, I've discovered, a mother, a teacher, that is, to express myself better, an unapproachable entity, a sort of goddess. At times I find the goddess in an instant, whereas at others it takes time before I'm able to imagine her, that is, find her bright, bountiful figure and sense her power. And to achieve a moment of human happiness, I must always first think up a story containing an encounter between myself and another person, whereby I am always the subordinate, obedient, sacrificing, scrutinized, and chaperoned party. There's more to it, of course, quite a lot, but this still sheds light on a few things. Many conclude it must be terribly easy to carry out a course of treatment, as it were, upon my person, but they're all gravely mistaken. For, the moment anyone seems ready to start lording and lecturing it over me, something within me begins to laugh, to jeer, and then, of course, respect is out of the question, and within the apparently worthless individual arises a superior one whom I never expel when he appears in me....

The list of correlations to that night is as long as the Jersey coast. And so is the list of reasons I shouldn't be looking forward to seeing him at school. But I can't help it. He's already texted me three times this morning: Can I pick you up for school? and Do u want 2 have breakfast? and R u getting my texts? My thumbs want to answer "yes" to all of the above, but my dignity demands that I don't answer at all. He called my his student. He stood there alone with me on the beach and told me he thinks of me as a pupil. That our relationship is platonic. And everyone knows what platonic means-rejected. Well, I might be his student, but I'm about to school, him on a few things. The first lesson of the day is Silent Treatment 101. So when I see him in the hall, I give him a polite nod and brush right by him. The zap from the slight contact never quite fades, which mean he's following me. I make it to my locker before his hand is on my arm. "Emma." The way he whispers my name sends goose bumps all the way to my baby toes. But I'm still in control. I nod to him, dial the combination to my locker, then open it in his face. He moves back before contact. Stepping around me, he leans his hand against the locker door and turns me around to face him. "That's not very nice." I raise my best you-started-this brow. He sighs. "I guess that means you didn't miss me." There are so many things I could pop off right now. Things like, "But at least I had Toraf to keep my company" or "You were gone?" Or "Don't feel bad, I didn't miss my calculus teacher either." But the goal is to say nothing. So I turn around. I transfer books and papers between my locker and backpack. As I stab a pencil into my updo, his breath pushes against my earlobe when he chuckles. "So your phone's not broken; you just didn't respond to my texts." Since rolling my eyes doesn't make a sound, it's still within the boundaries of Silent Treatment 101. So I do this while I shut my locker. As I push past him, he grabs my arm. And I figure if stomping on his toe doesn't make a sound... "My grandmother's dying," he blurts. Commence with the catching-Emma-off-guard crap. How can I continue Silent Treatment 101 after that? He never mentioned his grandmother before, but then again, I never mentioned mine either. "I'm sorry, Galen." I put my hand on his, give it a gentle squeeze. He laughs. Complete jackass. "Conveniently, she lives in a condo in Destin and her dying request is to meet you. Rachel called your mom. We're flying out Saturday afternoon, coming back Sunday night. I already called Dr. Milligan." "Un-freaking-believable.