• Watch the video on Common Professions of the Narcissist

The narcissist naturally gravitates towards those professions which guarantee the abundant and uninterrupted provision of Narcissistic Supply. He seeks to interact with people from a position of authority, advantage, or superiority. He thus elicits their automatic admiration, adulation, and affirmation - or, failing that, their fear and obedience.

Several vocations meet these requirements: teaching, the priesthood, show business, corporate management, the medical professions, politics, and sports. It is safe to predict that narcissists would be over-represented in these occupations.

The cerebral narcissist is likely to emphasize his intellectual prowess and accomplishments (real and imaginary) in an attempt to solicit supply from awe-struck students, devoted parishioners, admiring voters, obsequious subordinates, or dependent patients. His somatic counterpart derives his sense of self-worth from body building, athletic achievements, tests of resilience or endurance, and sexual conquests.

The narcissistic medical doctor or mental health professional and his patients, the narcissistic guide, teacher, or mentor and his students, the narcissistic leader, guru, pundit, or psychic and his followers or admirers, and the narcissistic business tycoon, boss, or employer and his underlings - all are instances of Pathological Narcissistic Spaces.

This is a worrisome state of affairs. Narcissists are liars. They misrepresent their credentials, knowledge, talents, skills, and achievements. A narcissist medical doctor would rather let patients die than expose his ignorance. A narcissistic therapist often traumatizes his clients with his acting out, rage, exploitativeness, and lack of empathy. Narcissistic businessmen bring ruin on their firms and employees.

Moreover, even when all is "well", the narcissist's relationship with his sycophants is abusive. He perceives others as objects, mere instruments of gratification, dispensable and interchangeable. An addict, the narcissist tends to pursue an ever-larger dose of adoration, and an ever-bigger fix of attention, while gradually losing what's left of his moral constraints.

When his sources become weary, rebellious, tired, bored, disgusted, repelled, or plainly amused by the narcissist's incessant dependence, his childish craving for attention, his exaggerated or even paranoid fears which lead to obsessive-compulsive behaviours, and his "drama queen" temper tantrums - he resorts to emotional extortion, straight blackmail, abuse, or misuse of his authority, and criminal or antisocial conduct. If these fail, the narcissist devalues and discards the very people he so idealized and cherished only a short while before.

As opposed to their "normal" colleagues or peers, narcissists in authority lack empathy and ethical standards. Thus, they are prone to immorally, cynically, callously and consistently abuse their position. Their socialisation process - usually the product of problematic early relationships with Primary Objects (parents, or caregivers) - is often perturbed and results in social dysfunctioning.

Nor is the narcissist deterred by possible punishment or regards himself subject to Man-made laws. His sense of entitlement coupled with the conviction of his own superiority lead him to believe in his invincibility, invulnerability, immunity, and divinity. The narcissist holds human edicts, rules, and regulations in disdain and human penalties in disdain. He regards human needs and emotions as weaknesses to be predatorily exploited.

next: Misdiagnosing Narcissism - The Bipolar I Disorder

• Watch the video on Can Narcissist Feel Love?

Narcissists "love" their spouses or other significant others - as long as they continue to reliably provide them with narcissistic supply (in one word, with attention). Inevitably, they regard others as mere "sources", objects, or functions. Lacking empathy and emotional maturity, the narcissist's love is pathological. But the precise locus of the pathology depends on the narcissist's stability or instability in different parts of his life.

From "The Unstable Narcissist":

(I have omitted below large sections. For a more elaborate treatment, please read the FAQ itself).

"Narcissists belong to two broad categories: the "compensatory stability" and the "enhancing instability" types.

I. Compensatory Stability ("Classic") Narcissists

These narcissists isolate one or more (but never most) aspects of their lives and "make these aspect/s stable". They do not really invest themselves in it. The stability is maintained by artificial means: money, celebrity, power, fear. A typical example is a narcissist who changes numerous workplaces, a few careers, a myriad of hobbies, value systems or faiths. At the same time, he maintains (preserves) a relationship with a single woman (and even remains faithful to her). She is his "island of stability". To fulfil this role, she just needs to be there physically.

The narcissist is dependent upon "his" woman to maintain the stability lacking in all other areas of his life (=to compensate for his instability). Yet, emotional closeness is bound to threaten the narcissist. Thus, he is likely to distance himself from her and to remain detached and indifferent to most of her needs. Despite this cruel emotional treatment, the narcissist considers her to be a point of exit, a form of sustenance, a fountain of empowerment. This mismatch between what he wishes to receive and what he is able to give, the narcissist prefers to deny, repress and bury deep in his unconscious. This is why he is always shocked and devastated to learn of his wife's estrangement, infidelity, or divorce intentions. Possessed of no emotional depth, being completely one track minded - he cannot fathom the needs of others. In other words, he cannot empathise.

II. Enhancing Instability ("Borderline") Narcissist

The other kind of narcissist enhances instability in one aspect or dimension of his life - by introducing instability in others. Thus, if such a narcissist resigns (or, more likely, is made redundant) - he also relocates to another city or country. If he divorces, he is also likely to resign his job. This added instability gives these narcissists the feeling that all the dimensions of their life are changing simultaneously, that they are being "unshackled", that a transformation is in progress. This, of course, is an illusion. Those who know the narcissist, no longer trust his frequent "conversions", "decisions", "crises", "transformations", "developments" and "periods". They see through his pretensions and declarations into the core of his instability. They know that he is not to be relied upon. They know that with narcissists, temporariness is the only permanence."

We are, therefore, faced with two pathological forms of narcissistic "love".

One type of narcissist "loves" others as one would attach to objects. He "loves" his spouse, for instance, simply because she exists and is available to provide him with narcissistic supply. He "loves" his children because they are part of his self-image as a successful husband and father. He "loves" his "friends" because - and only as long as - he can exploit them.

Such a narcissist reacts with alarm and rage to any sign of independence and autonomy in his "charges". He tries to "freeze" everyone around him in their "allocated" positions and "assigned roles". His world is rigid and immovable, predictable and static, fully under his control. He punishes for "transgressions" against this ordained order. He thus stifles life as a dynamic process of compromising and growing - rendering it instead a mere theatre, a tableau vivant.

The other type of narcissist abhors monotony and constancy, equating them, in his mind, with death. He seeks upheaval, drama, and change - but only when they conform to his plans, designs, and views of the world and of himself. Thus, he does not encourage growth in his nearest and dearest. By monopolizing their lives, he, like the other kind of narcissist, also reduces them to mere objects, props in the exciting drama of his life.

This narcissist likewise rages at any sign of rebellion and disagreement. But, as opposed to the first sub-species, he seeks to animate others with his demented energy, grandiose plans, and megalomaniacal self-perception. An adrenaline junkie, his world is a whirlwind of comings and goings, reunions and separations, loves and hates, vocations adopted and discarded, schemes erected and dismantled, enemies turned friends and vice versa. His Universe is equally a theatre, but a more ferocious and chaotic one.

Where is love in all this? where is the commitment to the loved one's welfare, the discipline, the extension of oneself to incorporate the beloved, the mutual growth?

Nowhere to be seen. The narcissist's "love" is hate and fear disguised - fear of losing control and hatred of the very people his precariously balanced personality so depends on. The narcissist is egotistically committed only to his own well-being. To him, the objects of his "love" are interchangeable and inferior.

He idealizes his nearest and dearest not because he is smitten by emotion - but because he needs to captivate them and to convince himself that they are worthy sources of supply, despite their flaws and mediocrity. Once he deems them useless, he discards and devalues them similarly cold-bloodedly. A predator, always on the lookout, he debases the coin of "love" as he corrupts everything else in himself and around him.

next:  The Professions of the Narcissist

Laws regarding school exclusion in the UK (suspending or expelling a student).

The 1993 Education Act changed the law on exclusions - the official term for being suspended or expelled.

Now only two kinds of exclusion are permitted:

A fixed term exclusion for a specific number of school days. Under this option a pupil cannot be excluded for a period totalling more than fifteen school days in one term.

A permanent exclusion The 1993 Act abolished the category of indefinite exclusion. A headteacher can also send your child home from school - perhaps because of the way your child is dressed or because your child is sick. This is not the same as an exclusion.

Although the Education Act is clear on the kinds of exclusions which can take place, there is no law which says which offences lead to an exclusion. This is left to the judgement of individual head teachers. The law does not set out school rules, so each school has its own.

Each school should have a set Behaviour Policy and a set Exclusion Policy which should be available to all parents to view or copies available if parents wish to take a copy home.

In a school the people finally responsible for behaviour are the headteacher and the governors. (School rules must not infringe the 1976 Race Relations Act and the 1975 Sex Discrimination Act.)

According to the Department for Education and Skills (DfES) guidelines, exclusions should be used sparingly, in response to serious breaches of school policy or law. Permanent exclusion must be used as a last resort. All the facts should be taken into account including the pupil's age, previous record, health and other relevant issues before the head teacher makes a decision to exclude someone.

The guidelines also specify the following:

Exclusion is not appropriate if pupils dress in a certain way for religious or cultural reasons. 'To exclude in such circumstances might constitute unlawful indirect discrimination under the Race Relations Act 1976'.

Exclusion is not appropriate for things like not doing homework or not bringing dinner money (if this happens on an occasional basis).

Exclusion is not an appropriate response to non-attendance - in other words truancy. If your child fails to attend school regularly the school should work closely with the Education Welfare Service to sort out the problem without excluding your child.

Pregnancy is not a reason to exclude a pupil. It may be advisable to have a period of education away from school (e.g. home tuition), but this is not related to an exclusion.

Schools can detain pupils after school finishing time without the consent of a parent, but are required to give at least 24 hours written notice.

If a headteacher wants to exclude your child, there are certain procedures he or she must follow.

Essay on the personal impact of the internet.

While there are those who understandably complain that the net provides a forum for hate groups and makes pornographic material accessible to children, the information highway has also proven to be a tremendous resource for both global and personal transformation. In numerous instances, it has made the world both smaller and, at the same time, broader.

The net, a world without geographic borders, has made it possible for people from all over the world with diverse spiritual and political backgrounds to connect with one another. Michael and Ronda Haubon, authors of, "Netizens: On the History and Impact of Usenet and the Internet," observe,

"Easy connection to people and ideas from around the world has a powerful effect. Awareness that we are members of the human species, which spans the entire globe, changes a person's point of view."

On the net prospective employees and employers are brought together, parents, professionals, activists, and special interest groups network, buyers and sellers hook up, those in need are linked to resources, and the displaced are united with old friends, while countless individuals make new ones every day.

The old clichés, "let your fingers do the walking" and, "the world is at your finger tips" take on a whole new meaning on the internet. Once on the world wide web, a student is able to locate information for a school report, a patient can become better informed about his illness, an employee might discover new tools to improve her job performance, an investor is able to receive updates on the stock exchange, and a new mother possesses access to a vast number of resources for parents.

In this fast paced and complicated world complete with numerous challenges that confront us on a daily basis the internet provides information, explanations, and potential solutions. The intention of this column is to point you to some of the best resources available on the web that address issues that concern you. Has the internet touched your life? If it has, we would love to hear about it. If it hasn't yet, just give us, and it a little more time.

June 1999 Edition

From Columbine to Columbia to Any Town USA

Like so many Americans, I'm still attempting to come to terms with the unfathomable tragedy that struck without warning at Columbine High, a school not so unlike our own schools here in Columbia. The residents of Littleton shared the same civic pride in community accomplishments as we do here in the Midlands . Before April 20th, 1999 what distinguished us from Littleton was largely a matter of geography and demographics. Today we are worlds apart.

We can't begin to comprehend the horror and grief that has devastated Littleton, Colorado. We can respond with heart-felt sympathy and deep compassion for their suffering, but we can't possibly know how the residents of Littleton feel. Still, as fellow citizens of the United States, we do share with Littleton a chilling distinction. Our schools have witnessed more mass murders perpetrated by students than any where else in the world.

There have been numerous explanations rendered as to why in at least nine separate instances during the past twelve months American students have murdered fellow students. Many have concluded that parents aren't involved enough with their children, guns are too accessible, and that the violence is a reaction to child abuse and neglect, or to the massive amount of violence portrayed in the movies and on television. Other explanations include that teens are feeling increasingly alienated and empty, schools are too crowded and understaffed, families are too stressed, and that we're failing to provide adequate role models, and to pass on proper morals and values to our children. The list of "why's" goes on and on and on.

Shawn Hubler in a thought provoking piece for the Los Angeles Times entitled, "A Shooting that Burst the Suburban Bubble," observed, "...these massacres have less to do with public policy than with private pain." I very much agree with Ms. Hubler, the actions of Harris and Klebold may very well have had far more to do with a private pain that was manifested all too publicly and horrifically rather than with public policy. However, I would like to suggest another possibility as well. Bill Moyers once observed that, "the largest party in America today isn't the democrats or the republicans, it's the party of the wounded." He's right I think, we've all been wounded. Wounded by a barrage of bad news, political scandals, jobs that so often feel futile, and the signs that surround us of dying cultures, dying children, dying species, and maybe even a dying earth. It's my humble opinion that children have always acted out not only their own pain, but also the pain of the adults in their lives.

Like so many of us, Hubler searches for "any good to be gleaned from this latest sorrow." Is it possible that the tragedy that occurred at Columbine high might lead us as a society to examine what it is that we truly need to do in order to begin as a culture to heal from the collective wounds that haunt us? Wounds that I sadly believe just happened to be manifested this time in Littleton?

We can blame parents, blame the schools, blame anyone or anything that we want to. Still, I believe that no amount of finger pointing should ultimately distract us from accepting our shared responsibility, a responsibility placed squarely on the shoulders of members of a culture whose primary messages for far too many years have been predominantly echoes of "buy me" " and "shoot em up".

While we grapple with possible explanations in an attempt to make sense of this recent absurdity, and consider solutions that all too often merely address symptoms, perhaps it's time that we revisit the basics. Our children require love, guidance, and our focused attention. It's difficult to adequately provide them with the former when so many of us are rushing around attempting to keep up with the numerous details and obligations that make up our lives. Why are we in such a hurry? Why are we working so hard? Will a newer model car, larger house, or more expensive tennis shoes make our children or ourselves happy? "Of course not!" we answer. Is the accumulation of more and more possessions we then spend untold hours paying for and maintaining ultimately what our lives are all about? What are our actions teaching our children? And what about the often repeated question, "whose watching the children?" According to a recent article in the local newspaper, library staff are overseeing a significant number of our offspring when school doors close. The library or the streets are more attractive options to far too many of our youngsters than returning to empty houses..

It's parents I suspect who are taking the toughest questions to heart right now. How can we protect our children? How can we best keep the lines of communication open? How do we assist our children in making sense of this tragedy? How do we best provide our children with the skills and tools they need to cope with this complicated world? And while I strongly believe that the full weight of these issues should not reside on the shoulders of parents alone, I recognize that as a parent I need to be prepared to carry a significant share of the load.

The internet, while certainly no panacea, offers some helpful information and resources for parents who are looking for some guidance and support. Still, I feel the need to make one last comment to those of you who are childless. From my perspective, you're not entirely off the hook, because guess whose waiting in line to be in charge when you're old and helpless...

Helpful Articles:

Parenting Teens: Are we Having Fun Yet?***

How to Get Your Teens Talking***

How to HelpYour Child Avoid Violent Conflicts

Learning How to Recognize the Warning Signs***

Plain Talk About Dealing with the Angry Child***

Respecting the Children in Our Care***

Can We predict Teen Violence?***

Helpful Hints for Healthy Parenting***

Violence and Discipline Problems in US Public Schools

Recommended Websites:

Connect For Kids: Guidance for Grown ups***

The Family Education Network***

Family.Com

Fathermag.com

Father's World

National Fatherhood initiative

The Parents Place

Parents Talk

Parent Time***

Mom's Online***

next: A Room with a View

Parenting a depressed child can be very difficult. Here are suggestions for helping your child with depression.

Parenting is already a tough job. Parenting a child with depression is even tougher. Keep in mind that depression is a medical condition. Your child is not acting this way on purpose.

Here's what you can do to help your child with depression:

Honor your child's feelings. It is difficult to see your child sad and in pain. Your first response might be to try to cheer him or her up. Don't. Trying to make depressed children and teens happy makes them feel like depression can be willed away. It is more helpful to listen. Acknowledge their feelings, and take them seriously.

Use encouraging statements rather than punishment. Instead of yelling, "Turn that television off! You haven't done your homework yet!" say "When you finish your homework, you can watch television."

Separate the deed from the doer. If your child constantly forgets to take his or her lunch money to school, don't say, "You are so forgetful! You can't remember a simple thing like your lunch money!" Instead, say something that focuses on the behavior, not your child, like "I know it has been hard for you to remember your lunch money. What can we do to make sure it gets put in your book bag every morning?"

Focus on consequences rather than punishment. For example, if your child breaks a lamp during a temper tantrum, use a logical consequence (like having your child help glue the lamp back together or use his or her allowance to have the lamp repaired) rather than issuing an unrelated punishment (like sending your child to his or her room for the rest of the evening).

Help your child build a "feeling vocabulary." Many people have difficulty finding the words to describe how they are feeling. Helping children and teens to label their feelings gives them a vocabulary that will enable them to speak about feelings. For children, posters and coloring pages that contain lists or drawings of various emotions can be helpful.

Show unconditional love and support. Many depressed children and teens feel unloved and unlovable. Say, "I love you" often. Hug or pat him or her on the back. With young children, be sure to cuddle together.

Encourage your child to engage in activities. Consider the activities your child enjoys and suggest doing those together. But don't force, threaten, or bribe him or her to do so. If your child is not feeling well enough to participate, honor that feeling.

Create good sleeping habits. Children and teens with depression often have difficulty sleeping. This leads to more irritability and exhaustion. Sticking to a consistent bedtime, stopping caffeine intake, and getting regular exercise can improve the quality and quantity of sleep.

Understand that depression is a medical condition. Although it is often difficult to keep your cool when your child is acting out, it is important not to punish or say hurtful things. Your child can't help feeling and behaving the way he or she does. You can be angry at the depression while still feeling love and concern for your child who is hurting

Sources:

• Families for Depression Awareness

I met an old friend who was a severe alcoholic and addict like I was. I was hanging out with him one day during the Spring Break from college. He was detoxing very badly. He had convulsions and nausea. He was in real bad shape. I really wanted to help him.

We went down to the city to get his drugs and my booze. We then went back to his apartment. I felt his pain when I saw him lying on his couch complaining that he didn't have enough to stop his nausea and shakes. I wanted to help him so bad because I could not stand to see him suffer like that.

The only thing that came to mind was the AA meetings (Alcoholics Anonymous) I had been to. I knew those people were living happily. I thought of some of the things that they had told me at the meetings. I wanted to pass the information onto my friend so he, too, could get healthy. But there I sat, in the middle of it all, with a drink in my hand. I was just as bad as him on many occasions. I, too, looked like that but I could not see myself. I sat there with a drink and could do nothing but be on display as a bad example of someone who tried to quit drinking.

 I had very little alcohol left to keep me going for that day. I mixed my vodka with water and tried to cure some of the shakes and anxiety from the withdrawal of the earlier drinking spree. I sat there in my room alone and drank my last drink. It was vodka and water. It was 8 years, 11 months, and 2 days after my very first drink.

Both the very first and the very last drink were mixed vodka concoctions, both were alone in my room, and both were on a Spring break from school. Was this coincidence or something to start me thinking along the lines of "spiritual awakening"? After all I had been through with the police, the jails, the courts, the withdraws, the rehabs, I still did not hit my bottom.

Only now, I finally hit bottom when I saw that guy on his couch just as sick as I was and I could not help him. I was worthless, useless, helpless, hopeless, and powerless!! But I knew there was a way out. I went to an AA meeting by myself for the first time. I walked through the doors and when I did, I took that first step. STEP 1:We admitted we were powerless over alcohol--that our lives had become unmanageable.

next: Chapter 7: The Beginning of a Spiritual Awakening
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~ all addictions articles

Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment.

Drug addiction is a complex illness. It is characterized by compulsive, at times uncontrollable drug craving, seeking, and use that persist even in the face of extremely negative consequences. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence.

The path to drug addiction begins with the act of taking drugs. Over time, a person's ability to choose not to take drugs can be compromised. Drug seeking becomes compulsive, in large part as a result of the effects of prolonged drug use on brain functioning and, thus, on behavior.

The compulsion to use drugs can take over the individual's life. Addiction often involves not only compulsive drug taking but also a wide range of dysfunctional behaviors that can interfere with normal functioning in the family, the workplace, and the broader community. Addiction also can place people at increased risk for a wide variety of other illnesses. These illnesses can be brought on by behaviors, such as poor living and health habits, that often accompany life as a drug addict, or because of toxic effects of the drugs themselves.

Because drug addiction has so many dimensions and disrupts so many aspects of an individual's life, treatment for this illness is never simple. Drug treatment must help the individual stop using drugs and maintain a drug-free lifestyle, while achieving productive functioning in the family, at work, and in society. Effective drug abuse and addiction treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences.

Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment. Extensive data document that drug addiction treatment is as effective as are treatments for most other similarly chronic medical conditions. In spite of scientific evidence that establishes the effectiveness of drug abuse treatment, many people believe that treatment is ineffective. In part, this is because of unrealistic expectations. Many people equate addiction with simply using drugs and therefore expect that addiction should be cured quickly, and if it is not, treatment is a failure. In reality, because addiction is a chronic disorder, the ultimate goal of long-term abstinence often requires sustained and repeated treatment episodes.

Of course, not all drug abuse treatment is equally effective. Research also has revealed a set of overarching principles that characterize the most effective drug abuse and addiction treatments and their implementation.

To share the results of this extensive body of research and foster more widespread use of scientifically based treatment components, the National Institute on Drug Abuse held the National Conference on Drug Addiction Treatment: From Research to Practice in April 1998 and prepared this guide. The first section of the guide summarizes basic overarching principles that characterize effective treatment. The next section elaborates on these principles by providing answers to frequently raised questions, as supported by the available scientific literature. The next section describes the types of treatment and is followed by examples of scientifically based and tested treatment components.

Alan I. Leshner, Ph.D.
Director
National Institute on Drug Abuse

Source: National Institute of Drug Abuse, "Principles of Drug Addiction Treatment: A Research Based Guide."

next: Principles of Effective Drug Treatment
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A short essay on the importance of creating family rituals and what rituals mean to children.

Life Letters

Every year since you were a little tyke, we've made baked goods and chocolates together for friends and neighbors during the Holidays. Your expectations of Christmas always include our goody making ritual as well as Dad's chocolate mint cake.

Tucking you into bed used to involve a rather lengthy and specific ritual; there was a story, a witch chasing ceremony, a little back rub, and always a glass of apple juice placed beside your bed in the event that you got thirsty. Even now, bedtime almost always concludes with an "I love you," from me, and an "I love you more," from you.

Rituals are as old as the earliest civilization. They can mark occasions by utilizing a special event to represent a far grander scheme. They help to create meaning and they foster lasting memories. They can solidify, celebrate, commemorate, validate, and comfort.

There are numerous benefits to rituals. Perhaps the greatest reason that I want to engage in them with you is that they offer us the opportunity to make a connection that may very well span both space and time. Whether I'm physically present or not, I can hope to be a part of many of your special occasions, if I can manage to create special times now that you find worthy of remembering later.

We don't engage in them as often as we used to - you've gotten older and more discriminating, and I've gotten busier and more distracted. Still in this uncertain and unpredictable world, children need rituals to help them feel safe, contained, and cared for. They don't have to be complicated, and yet those few moments we invest may provide our children with gifts to carry with them for a lifetime.

You're growing so fast and changing so quickly. New clothes, perfume, jewelry, and posters have replaced the toys that used to greet you on Christmas morning. But you still demand the chocolate mint cake, and you continue to be excited about delivering our goodies. So while I'm required to give up a little more each year, I can still count on certain special activities that have become an integral part of our lives together. And more importantly, you can count on them too.

Love, Mom

next:Life Letters: On Fear

Dear Stanton

Where can I find information about drug use and social stratification? More specifically, where can I find information on what types of drugs are used within specific social classes?

Belinda Dodge

Dear Belinda:

One of the most common myths is that drug abuse and alcoholism are "equal opportunity" destroyers. This is not true. Sometimes, in making this claim, the claimant points to overall prevalence figures, which often show that white, middle-class people use drugs as frequently—or more so—than lower socioeconomic status groups and minorities.

But these data always end up showing more unhealthy usage patterns among lower SES groups. Perhaps the best illustration of this pattern is drinking. Higher SES groups both drink more often—and drink more often without problems. Put alternately, lower SES groups have fewer drinkers, but a higher percentage of this smaller number drinks problematically.

Nonetheless, popular claims that the middle class is more endangered by drugs than lower SES groups remain prominent. And yet it is obvious how silly this claim is. Is it more common in the suburbs or inner cities to find drug assassinations and violence, children abused by drug users, people incapacitated by drugs and alcohol, and so on? The logic often used to undercut these truisms is that people with greater resources are simply better able to hide their dysfunctional drug use. But if addiction is characterized by loss of control of drug use, is this statement not self-contradicting?

There are certain exceptions to the trend towards greater addiction/substance abuse problems in less privileged groups. These are areas of special concern to middle class people—or the better access of the middle class to the objects of the addiction. Thus, middle class people are more likely to have bulimia or exercise addictions, because these reflect particularly middle-class concerns. Likewise, middle-class people will more likely be addicted to antidepressants and tranquilizers, since prescription drugs are more in the province of employed, insured people.

However, the simple equation that greater resources — more drug use is self-evidently disproven by the most widely abused drug—cigarettes. I remember speaking at a prominent Canadian animal research center (Concordia University, where Roy Wise works). I asked the assembled whether middle class or lower class people are more likely to smoke. Several researchers actually claimed that smoking was more prevalent among those better-off economically. This is in fact incorrect; there is an inverse correlation between social class and smoking. Although people better-off economically could more readily afford cigarettes, they are prevented from smoking by greater health consciousness and enabled to avoid cigarette addiction by better control of their environments and the availability for them of more alternatives.

Best,
Stanton

next: How Do I Manage Withdrawal from Clonidine?
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by Dr. Kimberly S. Young and Robert C. Rodgers
University of Pittsburgh at Bradford

ABSTRACT

This study investigated personality traits of those considered dependent users of the Internet utilizing the 16PF. Results showed that 259 cases of Dependents were classified based upon modified DSM-IV criteria for Pathological Gambling. Dependents ranked high in terms of self-reliance, emotional sensitivity and reactivity, vigilance, low self-disclosure, and non-conformist characteristics. This preliminary analysis discusses how such traits may act as triggers of addiction in order to fulfill an unmet psychological need through on-line stimulation.

INTRODUCTION

The Internet has been touted as a revolutionary technology among politicians, academicians, and businessmen. However, among a small but growing body of research, the term addiction has extended into the psychiatric lexicon that identifies problematic Internet use associated with significant social, psychological, and occupational impairment (Brenner, 1996; Egger, 1996; Griffiths, 1997; Morahan-Martin, 1997; Thompson, 1996; Scherer, 1997; Young, 1996a, Young, 1996b, Young 1997). Because the Internet is a highly promoted tool, detection and diagnosis of addiction is often difficult. Therefore, it is essential that the skilled clinician understand the characteristics which differentiate normal from pathological Internet use (PIU). Proper diagnosis is often complicated by the fact that there is currently no accepted set of criteria for addiction much less Internet addiction listed in the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV; American Psychiatric Association, 1995). Of all the diagnoses referenced in the DSM-IV, Pathological Gambling was viewed as most akin to the pathological nature of Internet use (Brenner, 1996; Young, 1996a). By using Pathological Gambling as a model, Young (1996a) defined PIU as an impulse-control disorder which does not involve an intoxicant. This research developed an eight-item questionnaire to use as a screening instrument for PIU which modified criteria for pathological gambling (see Appendix 1).

Participants in off-line and on-line surveys were considered "addicted" when answering "yes" to five (or more) of the questions and when their behavior could not be better accounted for by a Manic Episode. Young (1996a) stated that the cut off score of "five" was consistent with the number of criteria used for Pathological Gambling and was seen as an adequate number of criteria to differentiate normal from pathological addictive Internet use. It should be noted that while this scale provides a workable measure of Internet addiction, further study is needed to determine its construct validity and clinical utility. It should also note that a patient's denial of addictive use is likely to be reinforced due to the encouraged practice of utilizing the Internet for academic or employment related tasks (Young, 1997b). Therefore, even if a patient meets all eight criteria, these symptoms can easily be masked as "I need this as part of my job," "Its just a machine," or "Everyone is using it" due to the Internet's prominent role in our society.

Subsequent research on PIU which used on-line survey methods showed that self proclaimed "addicted" users often looked forward their next net session, felt nervous when off-line, lied about their on-line use, easily lost track of time, and felt the Internet caused problems in their jobs, finances, and socially (e.g., Brenner, 1996; Egger, 1996; Thompson, 1996). Two campus-wide surveys conducted at the University of Texas at Austin (Scherer, 1997) and Bryant College (Morahan-Martin, 1997) have further documented that pathological Internet use is problematic for academic performance and relationship functioning. Treatment centers have even initiated Computer/Internet Addiction Recovery Services such as at McLean Hospital in Belmont, Massachusetts.

Despite the increased awareness that PIU is a legitimate concern, little has been researched about the characteristics linked to "at risk" populations causing such a dependence upon the Internet (Loytsker & Aiello, 1997). These authors utilized a multiregression analysis and found that higher levels of boredom proneness, loneliness, social anxiety and private self consciousness all predict Internet addition as it was operationalized in their research. This present study attempted to expand this work to assess personality traits associated with incidence of PIU by utilizing the Sixteen Personality Factor Inventory (16PF). This investigation hopes to yield a further understanding of the personality dynamics associated with the development of PIU.

METHODS

PARTICIPANTS

Participants were volunteers who responded to: (a) nationally and internationally dispersed newspaper advertisements, (b) flyers posted among local college campuses, (c) postings on electronic support groups geared towards Internet addiction for electronic respondents (e.g., the Internet Addiction Support Group, the Webaholics Support Group), and (d) those who searched for the keywords "Internet" or "addiction" on popular Web search engines (e.g., Yahoo).

MEASUREMENTS

An exploratory survey consisting of both open-ended and closed-ended questions was constructed for this study that could be administered by electronic collection. The survey initially administered the Young's (1996a) eight-item questionnaire to classify subjects as addicted (Dependents) or non-addicted Internet users (Non-Dependents). As part of a larger study, respondents were administered the Sixteen Personality Factor Inventory (16PF). Finally, demographic information about the respondent such as gender, age, the number of years of education, and vocational background (classified as none, blue-collar, non-tech white collar, high-tech white collar) was also gathered.

PROCEDURES

The survey electronically existed as a World-Wide Web (WWW) page implemented on a UNIX-based server which captured the answers into a text file. The WWW location of the survey was submitted to several popular search engines and newgroups available to assist on-line users in finding Web pages of interest. On-line users entering keyword searches using "Internet" or "addiction" would find the  survey and have the option to follow the link to the survey in order to fill it out. Answers to the survey were sent in a text file directly to the principal investigator's electronic mailbox for analysis. Respondents who answered "yes" to five or more of the questions were deemed Dependent. All valid profiles, regardless of their score completed the entire on-line survey. The data from both sets of respondents were kept for future research which will compare responses from both groups. The qualitative data gathered were then subjected to content analysis to identify the range of characteristics, behaviors and attitudes found.

RESULTS

A total of 312 surveys were collected with 259 valid geographically dispersed profiles from Dependents. The sample included 130 males with a mean age of 31; and 129 females with a mean age of 33. Educational background was classified as 30% high school degree or less, 38% obtained an Associates or Bachelors degree, 10% obtained a masters degree or doctorate, and 22% were still in school. Vocational background was classified as 15% none (e.g., homemaker or retired), 31% students, 6% blue-collar employment (e.g., factor worker or auto mechanic), 22% non-tech white collar employment (e.g., school teacher or bank teller), and 26% high-tech white collar employment (e.g., computer scientist or systems analyst).

Results from the 16PF are listed in Table 1. Analysis of means and standard deviations show Dependents to rank high in terms of being self-reliant, a strong preference for solitary activities, and tend to restrict their social outlets. Dependents were abstract thinkers who appear less conforming to social convention and more emotionally reactive towards others. Results also show that Dependents tended to be sensitive, vigilant, and private individuals.

DISCUSSION

There are several limitations involved in this study which must first be addressed. Initially, the sample size of 259 Dependents is relatively small compared to the estimated 56 million current Internet users (IntelliQuest, 1997). Furthermore, this study has inherent biases present in its methodology by utilizing an expedient group of self-selected Internet users coupled with the questionable accuracy of on-line responses. Therefore, the generalizability of results must be interrupted with caution and continued research should include larger sample sizes to yield more accurate results. Future research efforts should also attempt to randomly select samples off-line in order to eliminate the methodological limitations of an on-line survey and to improve the clinical utility of the information gathered.

However, this preliminary analysis yields initial data which can be utilized to draw several hypotheses to use in further investigations. On-line users who pre-morbidly demonstrate highly developed abstract thinking skills may develop addictive patterns of Internet use as they are drawn to the mental stimulation offered through the infinite databases and information available. On-line users who tend to lead a more solitary and socially inactive lifestyle may be at greater risk for pathological Internet use. Shotton (1991) was the first to hypothesize that those who suffered from computer dependency were more likely to maintain a schizoid lifestyle and feel comfortable with prolonged periods of social isolation. Thus, it is equally as likely that those who suffer from Internet addiction do not experience the same feelings of alienation others feel when spending long periods of time sitting alone. Additionally, the Internet's interactive capabilities may help the on-line user to feel a sense of connectness among other users despite being physically alone.

Similar to research conducted on CB radio operators (e.g., Dannefer & Kasen, 1981), anonymous communication utilizing "handles" allows individuals to talk on-line with one another in unique ways. Gender, ethic background, socioeconomic status, geographic location, and marital status are hidden behind text-based interactions. On-line handles can even be used to alter one's presence via descriptions which are false such as "Rambo" for a petite woman or "Lusty Female" for a married man. Through such anonymous interaction, Internet users can engage in free expression, develop new on-line personas, and flame others (i.e., often unfiltered rude remarks). Prior research has speculated that specific applications appeared to play a significant role in the development of pathological Internet use (Young, 1996a). Dependents were less likely to control their use of highly interactive features than other on-line applications. It is possible that a unique reinforcement exists that such anonymous on-line relationships gathered from such interactive applications have the ability to provide fulfillment of unmet real life social needs (Young, 1997b).

Guarded individuals may experience more intimidation in their initial face-to-face meetings and have greater difficulty trusting others. Naturally vigilant and private persons may drawn to such anonymous interactive features of the Internet as this allows them to converse with others in uninhibited ways and form new relationships with greater ease than in real life circumstances. Anonymous electronic communication may also attract less conforming individuals who use the medium to rant radical ideologies or discuss taboo social belief systems they maintain, yet in real life either self-inhibit or find few others who share those views. If these individuals also display emotionally reactive tendencies, they may draw upon such a medium to emote in ways that are restricted by social convention. Outbursts of anger, over-sexualized comments, or blunt remarks which are typically self-monitored thoughts in real life may form the basis of typed messages to fellow on-line users in interactive forums. These specific personality traits may place an individual at a greater risk to develop PIU because the on-line world created inside their screens becomes the only outlet for such expression.

In general, these results show a discrepancy from the stereotypic profile of an "Internet addict" as an introverted, computer-savvy male (Young, 1996b) and suggests that specific personality traits may predispose an individual to develop PIU. Future research should continue to examine how personality traits influence PIU and how such interactive applications lead to addictive patterns of behavior. While it is unclear how PIU compares to other established addictions, future research should investigate if a similar personality profile may be an etiologic factor in the development of any addictive syndrome, whether to alcohol, gambling, or the Internet. Finally, these results do not clearly indicate whether these personality traits preceded the development of such Internet abuse or if it was a consequence. Young (1996a) showed withdrawal from significant real life relationships is a consequence of PIU, which could explain the high scores indicated on the 16PF for solitary activity. Therefore, further experimentation with a more comprehensive level of statistical analysis is necessary to examine cause and effect.

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References

American Psychological Association (1995). Diagnostic and Statistical Manual of MentalDisorders - Fourth edition. Washington, DC: Author

Brenner, V. (1996). An initial report on the on-line assessment of Internet addiction: The first 30 days of the Internet usage survey. http://www.ccsnet.com/prep/pap/pap8b/638b012p.txt

Dannefer, D. & Kasen, J. (1981). Anonymous exchanges. Urban Life, 10(3), 265-287.

Egger, O. (1996). Internet and addiction. http://www.ifap.bepr.ethz.ch/~egger/ibq/iddres.htm

Thompson, S. (1996). Internet Addiction Survey. http://cac.psu.edu/~sjt112/mcnair/journal.html

Griffiths, M. (1997). Does Internet and computer addiction exist? Some case study evidence. Paper presented at the 105th annual meeting of the American Psychological Association, August 15, 1997. Chicago, IL.

Loytsker, J., & Aiello, J.R. (1997). Internet addiction and its personality correlates. Poster presented at the annual meeting of the Eastern Psychological Association, Washington, DC, April 11, 1997.

Morahan-Martin, J. (1997). Incidence and correlates of pathological Internet use. Paper presented at the 105th annual meeting of the American Psychological Association, August 18, 1997. Chicago, IL.

Scherer, K. (In press). College life on-line: Healthy and unhealthy Internet use. The Journal of College Student Development. vol. 38, 655-665.

Shotton, M. (1991). The costs and benefits of "computer addiction." Behaviour and Information Technology. 10(3), 219 - 230.

Young, K. S. (1996a). Internet addiction: The emergence of a new clinical disorder. Paper presented at the 104th annual meeting of the American Psychological Association, August 11, 1996. Toronto, Canada.

Young, K. S. (1996b). Pathological Internet Use: A case that breaks the stereotype. Psychological Reports, 79, 899-902.

Young, K. S. & Rodgers, R. (1997a). The relationship between depression and Internet addiction. CyberPsychology and Behavior, 1(1), 25-28.

Young, K. S. (1997b). What makes on-line usage stimulating? Potential explanations for pathological Internet use. Symposia presented at the 105th annual meeting of the American Psychological Association, August 15, 1997. Chicago, IL.

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