interview with Flemming Funch

Flemming Funch is the founder of the New Civilization Network and the "World Transformation website." He's a man with many missions - he's a counselor, a writer, a programmer, and a visionary. He likes thinking about big things and sometimes manages to make them seem simple. He lives in Los Angeles with his wife and two children.

Tammie: "Have you always been an "idealist and incurable optimist," and what experiences in your life have most helped to shape your positive attitude?

Flemming: Actually, I've gone through a number of transformative experiences along the way. As a young kid, I was very shy and withdrawn, but was very imaginative and was writing science fiction stories and thinking about how the world might work. Then when education started teaching me to not going around imagining silly stuff, I became a shy and serious teenager. Certainly, nothing like an optimist. Rather, somebody who didn't believe in anything, and who didn't have any hope that he might leave much of an impression of the world.

I started waking up around the age of 18 or so. I started pursuing personal growth and studying metaphysics. I had several mystical experiences that pretty much changed me overnight. Like, I had the sudden realization that it was much less painful to face my fears, rather than hide from them. After that, I started to methodically pursue subjects I otherwise was afraid of, like public speaking, acting and other people-related activities. And I found that my calling very much was in dealing with people, rather than in hiding from them. I can't quite pinpoint when my pervasive positive attitude appeared. There's the intellectual realization along the way that things simply work better that way, but that doesn't quite explain it.

Tammie: You've been asked to describe the New Civilization Foundation many times before, but would you briefly describe it again and also, what needs of your own led to it's creation?

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Flemming: The New Civilization Network and the New Civilization Foundation, for me personally, grew out of my realization that I needed to expand my activities to work with groups. At the time, I was successful as a counselor, getting great results working with individuals on their personal growth issues, and having written up my techniques in a couple of books. It seemed like the next challenge would be to facilitate growth and transformation for groups and for society at large.

In the early 80s, I embraced the vision that it was possible to do something to make a whole planet work better, and that it has something to do with including all that is needed to make a world work: education, energy, food production, economy, social interaction, etc., and I really got that it was necessary to weave in all the vast diversity of human preferences and experiences. It was in the back of my mind for years that I wanted to do something with that.

The New Civilization Network is essentially a space for this kind of activity. It is a very open, very tolerant place, open to anybody who is working on anything constructive that might be part of the puzzle. It is particularly open to alternative, locally empowering, innovative, collaborative, holistic kinds of pursuits.

Tammie: You describe personal change as a journey of discovery, can you tell us a little about your own unique journey?

Flemming: As I mentioned above, my own life has changed quite dramatically along the way. An assortment of spiritual awakenings along the way have turned me quite upside down. From being a completely intellectual and materialistic person, I became somebody who orients myself mostly by what I feel and what I perceive that goes beyond the physical. From being an arrogant status-seeking know-it-all, I became much more humble, much more appreciative of the vast mysteries of the universe that I don't have much of a clue about. I began to become conformable with moving through a mysterious universe into an uncertain future. I also started doing it with greater confidence, though, and greater conviction that it all is going to work out very well.

Tammie: Do you believe that pain can be a teacher and if so, what are some of the lessons your own pain has taught you?

Flemming: I often try to pretend that I'm motivated only by positive stuff and nice possibilities. However, I must admit that it is more often the unpleasant and painful experiences I learn the most from, and it is often painful necessities that drive me to change and act. I have learned to appreciate that more. I've learned that pain, uncomfortableness and fear often hide the biggest gifts. I mean, if there's some area of life you're avoiding, there's something new to learn right there.

Tammie: You've maintained that each of us are creators of our world. Would you elaborate on that?

Flemming: You're in the center of your own life. Your actions shape what is going on around you. The way you experience things shapes the picture you have the world and how you respond to it. It is all connected. The beauty is that it doesn't matter if we look at it in terms of the physiology of brains or we look at it metaphysically. The filters of our perceptions ensure that we all experience a somewhat different world, and we act based on our perceptions, and our interpretation of those perceptions, not based on how the world really is. And it is all something that can change, something we can master. Anything is possible. How we think and feel and act will shape the world. What we expect and what we project around us is generally speaking what we get. The tricky part is that it also includes all our subconscious stuff. We will often create the stuff we fear. We need to become more conscious of all parts of ourselves so we can be more in alignment with ourselves.

Tammie: What's a holon?

Flemming: It's a word coined by Arthur Koestler. Essentially, it is something that can be regarded as either a whole or as a part of a whole, depending on what perspective we take. Like, a body consists of organs that consists of cells that consists of molecules, etc. Each one would be a holon, and the structure they form is a "holoarchy". We could study a cell as a whole, or as a part of something bigger. This kind of stuff is part of the study of whole systems - understanding more about how life and the universe works, without having to cut it all into separate little pieces.

Tammie: What would your definition of wholeness be?

Flemming: Embracing all parts and aspects of what is. Not having to sweep anything under the carpet. Wholeness is beyond polarities. As long as we have to exclude anything, we're not talking wholeness. There's a simplicity and peace that comes from discovering wholeness. Wholeness is the natural state of things. Stuff only gets complicated and confusing and conflicted when we humans deny the natural wholeness.

Tammie: If your life is your message, then what message do you see your life being?

Flemming: Well, I'm not quite sure yet. I'm still living it, so it is hard to step back and analyze it in the middle. It might very well be something quite different from what I thought it was, once everything is said and done. At this point, though, I'd like to think that my message is one of embracing all perspectives, of honoring the diversity of life, of finding freedom in individual creativity, and comfort in the inter-connectedness of all things."

next:K.j. Reynolds on "The Spirit"

List of triggers that may cause switching of personalities in Dissociative Identity Disorder.

Training Instructor Bethesda PsycHealth Institute 1990

• something someone says
• past perpetrator
• people who look like past perpetrator (someone that holds same kind of job as perpetrator same location or venue (similar) mannerism or laugh is similiar)
• certain times of the year
• objects
• things
• colors/textures
• smells
• sounds
• pulling memory too fast in therapy
• while in therapy, and working on memory
• lack of sleep
• poor diet
• touch
• not having enough balance (fun vs. processing)
• drugs and/or alcohol

Stress: Daily Living Stressors: This is a major cause. Here are some examples:

• fighting with spouse or friend
• observing a fight
• having sexual intercourse
• paying rent
• problem solving

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next:  Tips for Managing Triggers When *YOU* Choose to Process

Shame, guilt, anger, denial over a suicide attempt prevent many families from getting the help they need to navigate the crisis.

When a child attempts suicide, these emotions hit families like a Mack truck. Some family members bury their feelings deep inside and refuse to accept the stark reality. Others spring into action and vow never again to let the child who attempted suicide out of their sight. But no matter how a family deals with the aftermath of a suicide, they are forever changed by it.

"The repercussions from a suicide attempt can go on for years," says Daniel Hoover, PhD, a psychologist with the Adolescent Treatment Program at The Menninger Clinic and associate professor in the Menninger Department of Psychiatry & Behavioral Sciences at Baylor College of Medicine Houston.

Guilt and shame over a suicide attempt prevent many families from getting the help they need to work through the crisis, Dr. Hoover continues. An estimated 30 percent of families of children who attempt suicide seek family therapy, according to a study published in the Journal of the American Academy of Child and Adolescent Psychiatry in 1997, and about 77 percent of families referred to treatment after an adolescent attempts suicide drop out according to a 1993 Journal study.

Many families don't pursue treatment because they deny or minimize their child's suicide attempt. Teenagers who attempt suicide may also not admit they tried to kill themselves.

"Even when you see a young person in the emergency room right after he or she completed an attempt, very quickly the denial kicks in," Dr. Hoover says. "She may say, 'I never meant it,' or 'it was an accident,' or denying she even made an attempt. Families do the same thing because of the intensity of the suicide issue."

Complicating matters, teenagers may attempt suicide while in treatment for mental illness, such as depression or substance abuse. Families are reluctant to put their trust in the mental health system again--feeling it failed them.

That's unfortunate, Dr. Hoover says, because families desperately need support and direction after a child attempts suicide. Depression, which leads to suicidal thinking, affects the entire family unit. To move past the tragedy, families must address the issues that the suicide caused, and continues to cause, in their lives. Chief among the issues is the family's increased sense of responsibility for the child who attempted suicide. Worried about a repeat suicide attempt, family members, and parents in particular, feel that they have to watch their child constantly—in some cases, sleeping at the foot of the child's bed every night to make sure he or she won't attempt suicide.

"Parents feel a huge obligation to watch over their child," Dr. Hoover says, "At first it may seem somewhat comforting to the child, but then the parents become so intrusive in the child's life he or she thinks, 'I can't live like this anymore."

Helping families reach that middle ground between protecting and smothering their children is the main goal for family therapy at the Menninger Adolescent Treatment Program, which treats adolescents age 12 to 17. Patients in the inpatient treatment program struggle with family, school and social difficulties because of depression, anxiety, or other psychiatric illness or substance abuse. Some patients also have attempted suicide once or multiple times.

Dr. Hoover recommends individual therapy as well as appropriate psychiatric medication for children who attempt suicide, as most are quite depressed and feel hopeless. Their parents and other children in the family may also benefit from individual therapy, especially if they found them after the attempt.

"Often siblings are just as stressed out as the parents because they find the brother after the overdose, or they are the ones in the background while Mom and Dad and the brother are having all of the conflicts," Dr. Hoover says. "So they have been traumatized by it and they need their own help."

Working with therapists at Menninger, patients in the Adolescent Treatment Program learn to develop agency, or the ability to take action and exert control, over their mental illness and suicidal feelings. They learn skills to cope, ways to self-soothe and to seek out sources of support other than their parents. They also learn to share their thoughts and feelings with their parents, and to communicate with their parents if they are feeling suicidal.

Parents, in turn, learn how to listen and not overreact.

"When parents witness that their child is handling his or her feelings better, and knows when to seek help, it lowers their anxiety so much," Dr. Hoover says.

Family therapy immediately following a suicide attempt may not be productive, Dr. Hoover says, because emotions are raw, and the suicide attempt is still fresh in the family members' minds. Once the child who attempted suicide learns how to deal with his or her hopelessness and depression, and the parents begin to deal with their own anxieties and guilty or angry feelings, then they may be ready for family therapy. Family therapy helps family members learn how to communicate better with each other and express their feelings more constructively.

more: Detailed info on suicide

Sources:

• Menninger Clinic press release (4/2007)

A meditation course designed to help implement
the philosophy based on the book by Adrian Newington

In enabling the reader of this topic to gain a more complete understanding, it is important to have a good understanding of "the Sense of Self". Rather than entangle this discourse with extended definitions of the "sense of self," it is recommended that you consider reading the short discourse on "Defining the Sense of Self". This will be most helpful if you feel that the references to the "sense of self" on this page are unclear in your mind.

Table1: The levels of Self Identification.

	Physical	Mental	Emotional	Spiritual
An illustration of the various relationships amid body, mind and spirit which help define or qualify the Sense of Self	I know I AM because of my body	I know I AM because I think I AM	I know I AM because of my feelings	I AM
	My body verifies my existence	My thoughts verify my existence	My feelings verify my existence	Pure Existence without the need for validation.
	I exist among other physical beings.	I exist in a network of intellectual associations.	I exist by feelings expressed from and for others.	I alone exist
	Physical associations bring me fulfillment	Intellectual associations bring me fulfillment	Emotional associations bring me fulfillment	Self fulfillment is inherent.

Through the various stages of a person's human, social and spiritual development, the sense of WHO a person is (that is, the inner identification where self-fulfillment, and the recognition of self-worth emanate from), should progress to new meanings as the individual experiences life more completely. I purposefully use the word "should" to indicate that many people do not necessarily progress to a more refined view of their existence beyond a basic sense of self-identification aligned with the physical or mental levels.

From the table above, we can examine each level of being and see how the human psyche matures in life. Each level of existence re-defines and matures the sense of self through relative experiences, associations, comparisons and other qualifications. These can all serve us by ultimately allowing a revelation, that one day we can cast aside the need for external qualifications and rest in the knowledge that we exist because we exist. Such an attitude is devoid of comparisons and analogies, since we see ourselves as forever being complete. Our true self is a spiritual being and to paraphrase, "we are spiritual beings on physical journey".

Let us walk through each section of the table and briefly expand on its meaning.

Physical

From day 1 of human existence, an individual grows up in a 3-dimensional world, initially learning about spatial relationships and the conditions of environment,

Examples:

• The understanding of Up, Down, In, Out, including Distance.
• The sense of the physical body reaching out and touching something.
• Things that threaten physical safety and survival.
• A sense of what is physically pleasing and comforting.

These impressions are fundamental to the understanding that "I am a living being" because my body and its sensations validate my experience as a living entity.

In various stages of life, a person can derive a sense of personal power as well as feelings of fulfilment and competency from positive physical achievements like sports and athletics. On the other hand, a negative use of physical attributes like "Bullying" may also bring about a sense of personal power or self. However, to continue the use and cultivation of on'es personal power in this way will lead to problems, as one day such a person may encounter someone stronger and more assertive. Here, the person's personal power, or sense of self, would be taken away.

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Mental

As a person grows physically and develops mental faculties, a more refined view of existence evolves as powers of perception and reasoning mature. To gain the understanding that Self-identification can be obtained through intellectual pursuits, advances the person into a more meaningful understanding of one's humanity and potential.

Once again, in various stages of life, a person can derive a sense of personal power and feelings of fulfilment and competency from successful use of logic and intelligence. But mental abilities can fade, or people with grander capacities can be encountered, possibly leading to feelings of inadequacy. Such a thing could also take away personal power, or a sense of self.

Emotional

Having experienced 2 distinct aspects of human development, the encounter of emotional involvement and attachment to both people and objects further defines and matures the sense of self in the individual. From the experience of joy derived from something simple, like a favourite toy, to the deeper connections to living things like a pet or more importantly people, a still higher sense of self arises from the experience of: "I know I exist because of the feelings I have for things and people, along with the feelings that people have for me". A person's sense of self matures into something higher.

Further to this, the experience of love and more importantly un-conditional love brings a degree of release to the "sense of self" derived from the physical and mental experience linked to external dependence. From the experience of true or un-conditional love, the need for external validation from physical attributes greatly dissipates.

Yet again, in various stages of life, a person can derive a sense of personal power and feelings of fulfilment and competency from the experience of being loved by another. This, too, is vulnerable should the love or other emotional support of others not be forthcoming anymore.

Spiritual

Finding a "sense of self" from the spiritual experience is the goal of humanity. YOUR GOAL!

It is here that the noblest attainment of the inner human experience can be found. Serene and confident. Compassionate yet assertive. Self assured but humble. Wise and profound yet simple of heart and uncomplicated.

How can such an attainment be secured?

By purposeful contemplation of our spiritual nature.

And now, The Meditation

In this meditation course, we strive to cultivate, nurture and permanently attain a sense of self which has an identification in our spiritual nature. It is not the purpose of this exercise to deny the "sense of self" built up from an identification of our physical, mental and emotional nature rather, we proceed to embrace them and bring them to unity with the spiritual nature. So long as we do not distort these identifications and allow them to be nurtured or maintained by external circumstances, we will not become dependant on them. They will not lead us, but rather we will lead them... we will lead them to wholeness.

The fundamental principle of this Meditation is based on the technique of Mantra Repetition, but with the cultivation of a high degree of awareness of its meaning.

"I am the Heart"
"I am the Heart"
"I am the Heart"
"I am the Heart"

Over and over, but always cultivating remembrance for the meaning of the phrase. This is absolutely vital for without that remembrance, the Mind will find no real motivation to seek and explore an elevated level of consciousness. It is vital that your understanding of the phrase "I am the Heart" has been prepared in your mind by the reading of my book, "I am the Heart".

This book is purposefully rich in metaphor and parable and delivers a lengthy yet absorbing discourse to prepare you for the journey of self discovery.

The word Mantra means, "That which protects the Mind". The ancient and time proven technique of mantra repetition serves to keep the individual focused on the object of the Mantra, (that being a conscious awakening to the true self). This leads to mental purification and elevation, from the utilisation of concentration empowered by the higher ideal of love of self.

The "protection" afforded by mantra repetition serves to assist in the elevation of consciousness into a more clearer and illuminated realm. This illumination is the ability to perceive spiritual realities which come in the form of insights, inner knowing, and more importantly, the goal of this meditation, the revelation of the intimate connection with God we all have, and that "God dwells within you as you"

It then makes beautiful sense to say "I am the Heart".

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There are some other important points to keep in mind about this repetition.

• When I say that the phrase "I am the Heart" is to be repeated over-and-over, I do not necessarily mean constant and without rest, or at a rapid fire pace. Sufficient is a cycle of repetition whereby you can allow for the all important remembrance of the meaning of what you are saying.
• By all means, incorporate this form of meditation whilst into traditional forms of meditative techniques as adopted by followers of yoga and other eastern traditions.
• Even whilst walking down the street or in the park or riding on a bus, choose the remembrance of your essential nature and say,
  "I am the Heart".

Consider these also:

Are you feeling afraid? "I am the Heart".
Are you feeling lost? "I am the Heart".
Are you feeling weary? "I am the Heart".
Are you feeling sad? "I am the Heart".
Are you feeling happy? "I am the Heart".

This, and your duty, is all you have to remember.

Also, keep in mind these points.

• Do not be distracted away from what is your daily duty,
  for in duty there is concentration, and all concentration is meditation.
• It is vital to maintain a high awareness of any thoughts you are about to express, as you consider using a sentence starting with the words "I Am".

For whatever period of time (weeks, months) that you are going to practise the meditation of "I am the Heart", activate your awareness and do not say such things as "I am sad," "I am happy," "I am lonely," "I am (whatever)".

Rather than say such things as "I am sad," replace it with "there is sadness". This dis-empowers the potential of negative enforcement to swell in your consciousness, without the denial of your current state of being, (the truth that is yours for that time). Replacing such a thought with "there is sadness", protects the mind from illusive thinking. To also finish off that train of thought with "I am the heart", helps maintain the upward journey you are choosing.

Have periods of contemplation and look into yourself and gauge how you are progressing.

Do not become too anxious about your progress, but rather, know that success will be assured by your persistence. Please be patient with yourself. You are in the process of rising above a lifetime of conditional behaviour and worldly thinking. Your brave and dedicated efforts will not go unrewarded.

Pray for assistance and guidance of this mighty and very noble task.

Believe in the noble thought of wanting to attain an intimate union with God.

THIS ENTIRE WEB SITE IS TESTIMONY TO MY SELF EFFORT
AND THE PRECEEDING REVEALATIONS
THAT HAVE UPLIFTED MY MIND, HEART, SOUL...
AND, OF COURSE, MY LIFE.
I AM NEW BECAUSE I HAVE FOUND AND KNOWN MYSELF.

I NOW KNOW WITHOUT ANY SHADOW OF A DOUBT THAT

I A M T H E H E A R T

next: I Am the Heart Download

By Lynn Grabhorn
Author of Excuse Me, Your Life is Waiting

There are only three states of being we run around in all day long. If we could be even a little more aware of which one we're wearing during each moment of the day, we'd have a big leg up to changing our vibrations.

Victim Mode
This is the oh-dear-they're-doing-it-to-me-again-and-there's-nothing-I-can-do-about-it frame of mind where we go nowhere but around in negative circles, forever magnetizing the same old same old.

Flat-Lining Mode
In the Flat-Lining Mode, we're neither down nor up, just bumping along on second-rate gas. We're not flowing our energy to anything, and surely not attracting anything. In Flat-Lining we're not only living the results of our own erratic flowing of energy, but that of everybody else's. (Like attracts likes, remember?) Very unpleasant! And what most of us do most of the time.

Turned On Mode
Now you're up! You're on! Your high frequencies are no longer attracting the negative vibes of others. You're fueled with the pure positive energy of well-being, vibrating in harmony with your Expanded Self, flowing positive energy out and pulling positive events in while being wrapped in unsurpassed safety and security.

Victim Mode, Flat-Lining, or Turned On, we will always find ourselves in one of the three. Our goal, of course, is to make it the Turned On Mode as often and as long as we can, which is why we look to the high, high energy of appreciation.

The vibration of appreciation is the most profoundly important frequency we can hold, for it is the closest thing to cosmic love that exists. When we're appreciating, we're in perfect vibrational harmony with our Source energy, or God energy -- call it what you will.

You can jump-start it, or you can jam straight to the feeling, it makes no difference. What's important to know is that one minute of flowing the intense energy of appreciation overrides thousands of hours spent in Victim or Flat-Lining Modes.

But take care! No fair just thinking appreciation. That won't wash. Thinking is out, feeling is in. You can't just make a decision that you're going to appreciate something and let it go at that. There has to be that surge of significant emotion flowing up from the depths of your being for this to work.

But neither does that mean you have to have just been saved from a life-threatening incident by 911 rescue workers to feel deep appreciation. In fact, flowing appreciation is really no big deal. You can flow it intensely to a street sign if you want. Don't laugh, I do that all the time to stay in shape. Like any skill, flowing energy requires constant practice, and there's something so absurdly satisfying about flowing buckets of love, adoration, and appreciation to "SLOW: MEN AT WORK." I flow it to stoplights, billboards, birds overhead, a tree stump, a dead animal, a winter storm, and of course, to people.

Sometimes in the supermarket, I'll pick the meanest-looking person I can find and just open up and douse the unsuspecting soul with the highest vibration I can muster. Maybe it's appreciation, maybe it's honest-to-God love. One time I did that to an elderly lady who looked like she'd rather eat me than let me pass. I blasted her, and in that very moment, she wheeled around, searching angrily for whatever she felt hit her, while I smiled back in pure innocence.

I play a game where I envision myself and a perfect stranger on the street (or wherever) rushing into each other's arms like we were old best friends who hadn't seen each other for ages. You just see -- and deeply feel -- the two of you joyfully recognizing each other and flying together in this gigantic bear hug as profound love surges between you. I don't know how many people I've done that with while walking down a street, and watched them turn around to look for whatever it was they felt.

The vibration of appreciation is also the highest, fastest vibration we can use for attraction. If we would shoot appreciation at anything and everything . . . all day long . . . we'd be guaranteed to have heaven on earth in no time, living happily ever after with more friends, more money, more beautiful relationships, in total safety, and closer to the God of our Being than it's possible to fathom.

Reprinted from Excuse Me, Your Life is Waiting: The Astonishing Power of Feelings by Lynn Grabhorn. Copyright © 2000 Lynn Grabhorn. Published by Hampton Roads Publishing Company. March 2003; 978-1-57174-381-7.

About the author: Lynn Grabhorn was a long-time student of the way in which thoughts and feelings format our lives. Raised in Short Hills, New Jersey, she began her working life in the advertising field in New York City, founded and ran an audio-visual educational publishing company in Los Angeles, and owned and ran a mortgage brokerage firm in Washington State.

Lynn's books, which also include The Excuse Me, Your Life is Waiting Playbook and Beyond the Twelve Steps, have received high acclaim from all corners of the world. Her last book was Dear God! What's Happening to Us?

Lynn passed away in 2004 at her home in Olympia, Washington. We all miss her.

ADHD expert, Dr. Nikos Myttas, discusses the myth of ADHD and bad parenting, the history of ADHD, and the diagnosis and treatment of childhood ADHD.

Key Points

• ADHD is a genetically determined, neuropsychiatric condition.
• ADHD constitutes a major educational, social, cognitive and emotional handicap for those affected.
• The major symptoms of ADHD persist throughout life in most people who are affected. People with ADHD run a high risk of alcohol and substance abuse, criminal behaviour, poor psychosocial functioning and psychiatric disorders.
• Early intervention and treatment significantly reduces the risk of further psychosocial complications.

The Myth of ADHD and Bad Parenting

A distinct group of children exists who have trouble staying with any task for any length of time unless they receive constant feedback, stimulation and reward or have close, one-to-one supervision.

• They fleet from activity to activity, hardly ever completing any.
• They are either distractible or hyperfocused and they lose their train of thought easily.
• They get muddled up and they have difficulty getting back on track.
• They daydream, they appear not to listen, they lose or misplace their things and they forget instructions.
• They procrastinate, avoiding tasks that demand attention and sustained concentration.
• They have a poor sense of time and priorities.
• They are moody and constantly complaining of boredom, yet they have trouble initiating activities.
• They are full of energy as if 'driven by a motor', restless, constantly fidgeting, tapping, touching or fiddling with something and they may have difficulty getting off to sleep.
• They speak and act without thinking, they cut across the conversations of others, they have difficulty waiting for their turn, they shout out in class, they disrupt others and they rush through their work making careless mistakes.
• They misjudge social situations, they dominate their peers, and they are loud and act silly in crowds to the embarrassment of their parents.
• They are demanding and cannot take 'no' for an answer. Putting off immediate rewards for delayed, but larger, ones sets them off in a spin.

These children are repeatedly described as 'lazy', 'underachievers', 'not reaching their potential', 'unpredictable', 'disorganized', 'erratic', 'loud', 'unfocused', 'scatterbrained', 'undisciplined' and 'uncontained'. Their teachers' reports are testimony to these labels. At the same time, they can be bright, creative, articulate, lateral thinkers, imaginative and loving.

What is often implied but not stated is that their parents are to blame. These parents are thought to be ineffective, uncontaining of their children, with pathological attachment, unable to exercise discipline or teach manners, harboring unconscious repressed feelings of hatred against their children, often the result of their own deprived childhood. Yet the same parents may be bringing up several other children with no signs of distress or maladjustment in them. Guilt is almost synonymous with parenthood and it is extremely rare that a parent will resist such an attack and challenge it, especially if it comes from a professional.

History of ADHD

The restless, overactive and fidgety child who stands out from his peers has been around, presumably, as long as children have been around. The first known reference to a hyperactive child or one with attention deficit hyperactivity disorder (ADHD) occurs in the poems of the German physician Heinrich Hoffman, who in 1865 described 'fidgety Philip' as one who 'won't sit still, wriggles, giggles, swings backwards and forwards, tilts up his chair... growing rude and wild'.

In 1902 the paediatrician, George Still, presented a series of three lectures to the Royal Society of Medicine describing 43 children from his clinical practice who were often aggressive, defiant, resistant to discipline, excessively emotional or passionate, who showed little inhibitory volition, had serious problems with sustained attention and could not learn from the consequences of their actions. Still proposed that the deficits in inhibitory volition, moral control and sustained attention were causally related to each other and to the same underlying neurological deficit. He speculated that these children had either a low threshold for response inhibition or a cortical disconnection syndrome where intellect was dissociated from will, possibly due to nerve cell changes. The children described by Still, and by Tredgold (1908) soon after, would today be diagnosed as suffering from ADHD with associated oppositional defiant disorder or conduct disorder.

Clinical presentation of Childhood ADHD

Although ADHD is a heterogeneous condition occurring along a continuum of severity, a fairly typical presentation is a child who has been difficult to handle, often since birth and certainly before school entry. As infants, some may have been extremely difficult to settle at night. They may have had their parents pacing up and down the room for hours while holding them, in order for them to fall asleep. Their parents may even have taken them in the car and driven them around to get them to sleep. Many would sleep in short bursts, be full of energy upon waking, extremely demanding of constant stimulation and needing to be picked up and held for long periods of time.

As soon as these children can walk they may be into anything, sometimes clumsily. They climb, run about and get into accidents. At preschool they stand out as restless. They are unable to sit down during story time, they fight with others, spit, scratch, take unnecessary risks without a sense of fear and fail to respond to punishment.

At the start of formal education they might be, in addition to the above, messy and disorganized with their work, overtalkative in class and forgetful. They may interrupt the lesson and interfere with the work of others, get up from their seats, walk about, rock on their chairs, make noises, constantly fiddle, be unable to pay attention or be in a daze. During playtime they may have difficulty sharing and negotiating relationships with their classmates. They tend to dominate the game, be inflexible and particularly loud, and break up the games of others if not allowed in. Some would have such difficulty making and keeping friendships and they would rarely get invited to parties, if at all.

At home they may wind up their brothers or sisters, refuse to help out or comply with demands, complain of boredom, get into mischief, set fires or engage in other dangerous activities in the pursuit of excitement.

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Diagnosis of ADHD in Children

Although there is no clear demarcation between temperamentally impulsive, active and inattentive children and those who suffer from ADHD, those children whose behaviour interferes with their learning, social adjustment, peer relationships, self-esteem and family functioning warrant a thorough investigation. Arriving at a diagnosis is a lengthy and painstaking process based on a systematic, comprehensive, thorough and detailed neuropsychiatric work up, observation of the child in the school setting, and exclusion of medical conditions or circumstances that might produce a similar picture or exacerbate pre-existing ADHD. The symptoms must not be better accounted for by other psychiatric conditions (such a mood, anxiety, personality or dissociative disorders).

The definition and criteria for diagnosing ADHD are similar, but not identical, in both the international classification of diseases (ICD-10) (WHO, 1994) and the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association, 1994). The list of criteria for inattentiveness, overactivity and impulsivity is short but comprehensive. It is stipulated that the symptoms must have had an early onset (mean age is 4 years) and must have been present for more than 6 months, occurring across situations and falling along a continuum (deviant from age-based standards).

Co-morbidity: ADHD Plus Other Psychiatric Disorders

All too often the unitary approach to diagnosing neuropsychiatric conditions prevails, and other co-morbid conditions are either overlooked or not paid sufficient attention. Because ADHD is a significant educational, social and emotional handicap, it is exceptional rather than the rule that it exists in pure form. Over 50% of sufferers will have either one or more of the following conditions at the same time (Bird et al, 1993):

• Specific learning difficulties
• Conduct disorder
• Oppositional defiant disorder
• Anxiety disorder
• Affective disorder
• Substance abuse
• Developmental language delay
• Obsessive-compulsive disorder
• Asperger syndrome
• Tic disorder
• Tourette's syndrome

The degree of impairment depends on the type and number of co-existing conditions, which may require different or additional treatment. Co-morbidity does not explain causality; it merely states that two or more conditions are present at the same time.

Epidemiology of ADHD

The prevalence of ADHD used to be considerably different in the US and the UK, partly because of individual rigidity in applying clinical standards and partly owing to national practices. Historically, UK clinicians have been suspicious of ADHD as a primary condition and, therefore, approaches to diagnostic assessment vary widely between practitioners and centres. A rapprochement between the US and UK has emerged lately, made possible by the convergence of the diagnostic criteria of the ICD-10 and DSM-IV. This new consensus estimates prevalence in the UK at 6-8% of the child population, compared with 3-5% of UK children.

As with most neuropsychiatric conditions, the ratio of boys to girls is 3:1, with no social, economic or ethnic group bias in the general child population. However, in mental health clinics the ratio rises to between 6:1 and 9:1 (Cantwell, 1996) owing to referral bias (boys get referred more because they are more aggressive).

DSM-IV Distinguishes Three Types of ADHD:

1. Predominantly hyperactive-impulsive
2. Predominantly inattentive
3. Both hyperactive-impulsive and inattentive combined

The prevalence ratio is 3:1:2 in clinic populations and 1:2:1 in diagnosed community samples (Mash and Barkley, 1998). This suggests that the purely inattentive type is least likely to be identified and that screening for a possible diagnosis of attention deficit disorder (ADD) also occurs less often.

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ADHD with Hyperactivity

ADD is much less common (possibly about 1%). It is likely to be an entity distinct from ADHD, perhaps more akin to a learning difficulty. ADD sufferers are mostly girls, characterized by anxiety, sluggishness and daydreaming. They are less aggressive, overactive or impulsive, better at making and keeping friendships and their academic performance is worse in tests that involve perceptual-motor speed. Because they do not display the degree of behavioural disturbance boys do, they do not get referred as often as they should. When they do, they are more likely to be misdiagnosed.

Current Aetiological Theories

No evidence exists to suggest that ADHD is caused by other than neurobiological malfunctioning. Although environmental factors may influence the course of the disorder over a lifetime, they do not bring the condition about. The significance of several anatomical and neurochemical abnormalities is still unclear. These include deficits in dopamine-decarboxylase in the anterior frontal cortex, leading to reduced dopamine availability and diminished focusing and attention; more symmetrical brains; smaller-sized brains in the area of the prefrontal cortex (caudate, globus pallidus); duplication polymorphism in the DRD4 and DAT genes.

The prevailing theory that tries to explain ADHD implicates the frontal cortex and its importance in response inhibition. ADHD sufferers have difficulty in suppressing impulse. Therefore, they respond to all impulses, being unable to exclude those that are unnecessary for the situation. Rather than failing to pay attention, they pay more attention to more cues than the average person, and are unable to stop the relentless flow of information. These people fail to pause, to consider the situation, options and consequences before exercising volition. Instead they act without thinking. They frequently report that they function best when caught 'in the thrill of it all' whatever the 'all' may be.

There is strong evidence for a genetic predisposition to ADHD with a concordance rate in monozygotic twins ranging from 75-91% (Goodman and Stevenson, 1989). One third of affected individuals have at least one parent who suffers from the same condition. Non-genetic factors that have been found to predispose people to developing ADHD are low birth weight (<1500g), environmental toxins, tobacco, alcohol and cocaine abuse during pregnancy (Milberger et al, 1996).

ADHD Across the Lifespan

Children with ADHD do not grow out of it. Between 70-80% carry the condition into their adult life to a varying degree (Klein and Mannuzza, 1991). Early identification and multimodal treatment reduces the risk of developing further complications such as antisocial behaviour, abuse of alcohol, tobacco and illicit substances, poor academic and social functioning, and further psychiatric morbidity.

About the author: Dr. Myttas is a Consultant Child and Adolescent Psychiatrist, Finchley Memorial Hospital, London.

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References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. APA, Washington DC.
Biederman J, Faraone SV, Spencer T, Wilens TE, Norman D, Lapey KA, Mick E, Kricher B, Doyle A 91993) Patterns of psychiatric comorbidity, cognition and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry 150(12): 1792-8
Bird HR, Gould MS Stagezza BM (1993) Patterns of psychiatric comorbidity in a community sample of children aged 9 through 16 years. J Am Acad Child Adolesc Psychiatry 148: 361-8
Cantwell D (1996) Attention deficit disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 35: 978-87
Goodman R, Stevenson JA (1989) Twin study of hyperactive II. The etiological role of genes, family relationships and prenatal adversity. J Child Psychol Psychiatry 5: 691
Klein RG, Mannuzza S (1991) Long-term outcome of hyperactive children: a review. J Am Acad Child Adolesc Psychiatry 30: 383-7
Mash EJ, Barkley RA (1998) Treatment of Childhood Disorders, 2nd edn. Guilford, New York
Milberger S, Biererman J, Faraone SV, Chen L, Jones J (1996) Is maternal smoking a risk factor for attention deficit hyperactivity disorder in children? Am J Psychiatry 153: 1138-42
Still GF (1902) Some abnormal psychical conditions in children Lancet 1: 1008-12, 1077-82, 1163-68
Tredgold AF (1908) Mental Deficiency (Amentia). W Wood, New York
World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. WHO, Geneva.

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If you are in an abusive relationship, that is, if you are being abused, physically or emotionally, please take the following suggestions very seriously. The following article may not be what you want to hear, but it is what you NEED to know!

SHOCKING FACTS: Over 1,300 women are killed each year by their husbands, ex-husbands, or boyfriends! An estimated three to four million women each year silently endure abuse or travel to hospital emergency rooms following an assault by their husbands or partners. In Canada, 1 woman is killed every 3 days by a man known to her. (Source: 2/93 Congressional Quarterly, Inc. report and the Canadian "Men 4 Change" website).

Nationwide, every 15 seconds a woman is beaten, every three minutes a woman is raped, every six hours a woman is killed. In Arizona, in 1999, there were 21,931 crisis-shelter calls of domestic violence. Fourteen percent of all homicides were domestic violence related. (Source: Arizona Republic, December 6, 2000). Domestic violence is the #1 cause of emergency-room visits by women nationwide. Eighty-eight percent of women in prison are victims of domestic violence. More than 3 million children witness acts of domestic violence nationwide every year. Children of abused mothers are six times as likely to attempt suicide and 50 percent more likely to abuse drugs and alcohol. (Source: Arizona Foundation for Women).

A national crime survey revealed that once a woman is battered, her risk of being a victim again is very high. In the six-month period after a domestic violence incident, about one woman in three is victimized again.

(Source: Research in Science & Theology, July/August 2002).

There is hope. . . and there are actions you must take if you are the victim of an abusive relationship. Nothing happens until you do something.

When anyone physically abuses you, you must know that they are taking out the rage they feel within. . . on you! It's not about YOU. It's about THEM! What is upsetting to them now goes much deeper than what they are really angry about and causes them to demonstrate their anger by physical or emotional abuse.

Physical and emotional abusive behavior is sick. Physical and emotional abuse are never acceptable and every human being has a right to be safe and respected.

Therapy is always a wise choice when (not if) recovery is intended (not just talked about or desired). The sad truth is, an abuser usually does not stop. They say they will. They will promise you anything; "I need you. I'm sorry, please don't leave. It will never happen again. This time, I really mean it. I promise."

Some of you have heard those words before. They are destined to only be broken promises. How sad. Experience shows that this type of behavior is not likely to change and in most cases will only get worse.

If you are in an abusive relationship, you need help. So do they. . . and THEY must be responsible for getting help for themselves. You know the relationship is over when one partner REFUSES to work on the relationship.

YOU must take responsibility for getting help for you and your children. You cannot help an abuser except by removing yourself and your children (if any) from this extremely unhealthy atmosphere.

By the way, never believe an abuser who tells you that THEIR behavior is YOUR fault! It is simply not true. It is not triggered by anything that YOU do. It has nothing to do with you and EVERYTHING to do with THEM. This behavior is sick.

WARNING: Any kind of physical or emotional abuse is never a GOOD reason to stay in a relationship. NEVER! You MUST leave the relationship and the sooner the better!

I am of the belief that divorce court can be your best friend!

When you love someone, you treat them with RESPECT. Physically or mentally abusive behavior demonstrates the highest level of disrespect.

For what GOOD reason would you want to stay with someone who treats you like that? I'm sure that you love them, but for your own safety and the safety of your children, I encourage you to leave the relationship. You can love someone and not be with them.

YOU WILL HAVE TO LEARN HOW TO DEAL WITH IT. Dealing with it is leaving the relationship.

The hardest thing you will ever have to do is to leave. If you think you can't make it on your own, take my word for it, YOU CAN! Many women in your situation have felt the same way and they have survived. The National Domestic Violence Hotline can offer suggestions. Some of the links at the bottom of this page also offer important information and support. They can handle all forms of abuse.

Please never let anyone ever tell you that YOU have to change in order to prevent him from abusing you, it is simply not going to work. Abusers are not reasonable people or they would not abuse you in this way.

We all do things that anger our love partners from time to time, but reasonable people can talk about those things and don't have to throw a temper tantrum, scream and holler, call the their partner names, beat them, or whatever they do.

Hang in there! You are a precious human being and you do not deserve to be mistreated. You deserve only the very best! And to have it. . . you must BELIEVE it!

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Emotional abuse is just as damaging as physical abuse. The only difference between the two is with physical abuse you are wearing it on outside for the world to see and the other is felt deep inside. Your feelings will fester and grow into resentment, anger, depression and cause you to feel as insecure as they really are. People cannot see the bruises on your heart. Don't allow an abuser to drag you down to their level.

You don't NEED a relationship be be a whole person, you only need yourself. When need goes away, choice shows up. When you are needy, you have no choice. Your best choice is to leave before they have left permanant scars on you and your children.

Believing that someone who keeps on hurting you will have a change of heart and see the error of his ways, is like hanging a sign on your basement wall, "All rodents stay out," and hoping they will read it and obey! Guy Finley, author, The Secret of Letting Go.

Take this quick quiz.

• Does your partner intimidate you through looks or actions, destroy your property or display weapons?
• Does your partner continually put you down, call you names or humiliate you?
• Does your partner control what you do, who you see and talk to, and where you go, limiting your involvement outside the relationship?
• Are you made to feel guilty about the children, or has your partner threatened to take the children away?
• Has your partner prevented you from getting or keeping a job, made you ask for money, taken your money from you, or refused you access to family income?
• Does your partner treat you like a servant, making all the decisions?
• Has your partner threatened to kill you or commit suicide if you leave?
• Has your partner forced you to drop assault charges against him or made you participate in illegal activity?
• Has your partner ever hit you causing injury, bruises, broken bones, or other injuries that reportedly result from "accidents?"

If you answered "Yes!" to several of the above questions, I urge you to pick up the phone right now and call the National Domestic Abuse Hotline: 800-799-SAFE (800-799-9233). It's a FREE call. They have interpreters available to translate in 139 languages. It's time to take care of YOU! They can offer alternatives for living arrangements, suggestions about how to receive therapy in your area and more. Therapy is always a wise choice. Do it NOW!

I strongly recommend you read the following books:

"The Verbally Abusive Relationship: How to Recognize it and How to Respond" and
"Verbal Abuse Survivors Speak Out On Relationship and Recovery" by Patricia Evans.

Read "Women Who Love Too Much: When You Keep Wishing and Hoping He'll Change" and "Answers to Letters from Women Who Love Too Much" by Robin Norwood. They are available in Larry's Book Store by clicking on the book title or from other fine bookstores everywhere.

If you are the victim of emotional abuse, you must read: Setting Yourself Free: Breaking the Cycle of Emotional Abuse in Family, Friendships, Work and Love by SaraKay Smullens.

From the National Foundation for the Prevention and Treatment of Multiple Personality

• Victims of multiple personality disorder (MPD) are persons who perceive themselves, or who are perceived by others, as having two or more distinct and complex personalities. The person's behavior is determined by the personality that is dominant at a given time.
• Multiple personality disorder is not always incapacitating. Some MPD victims maintain responsible positions, complete graduate degrees, and are successful spouses and parents prior to diagnosis and while in treatment.
• A MPD victim (a multiple) suffers from "lost time," amnesia or "black-out spells," which lead the victim to deny his/her behavior and to "forget" events and experiences. This may result in accusations of lying and manipulation and may cause severe confusion for the undiagnosed multiple.
• More than 75% of MPD victims report having personalities in their system who are under 12 years of age. Personalities of the opposite sex or with differing styles are also common. Personalities within a multiple system often hold conflicting values and behave in ways that are incompatible with one another.
• 97% of MPD victims report a history of childhood trauma, most commonly a combination of emotional, physical and sexual abuse.
• Multiple personality disorder can be reduced or prevented by early diagnosis and treatment of traumatized children and by working to eliminate abusive environments.
• While usually not diagnosed until adulthood, 89% of MPD victims have been mis-diagnosed include: depression, borderline and sociopathic personality disorder, schizophrenia, epilepsy and manic depressive illness.
• When they first enter treatment, most MPD victims are not aware of the existence of other personalities.
• MPD victims require treatment techniques which specifically address the unique aspects of the disorder. Standard psychiatric interventions used in the treatment of schizophrenia, depression and other disorders are ineffectual or harmful in the treatment of MPD.
• Appropriate treatment results in a significant improvement in the quality of life for the MPD victim. Improvements commonly include reduction or elimination of: confusion, feelings of fear and panic, self- destructive thoughts and behavior, internal conflicts and stressful periods of indecision.
• Multiple personality disorder has been recognized by physicians since the 17th century. While often confused with the relatively new diagnosis of schizophrenia throughout most of the 20th century, MPD is again being understood as a legitimate and discrete disorder.

Multiple personality disorder IS treatable!

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next:   Dissociation Self-Test

Daughters of Ambition

Let us now praise famous women. And consider the high cost of their achievements.

Take chemist Marie Curie. Or poets Elizabeth Barrett Browning and Emily Dickinson. Or world leaders, from Queen Elizabeth I to Catherine the Great to Indira Gandhi. Or feminists from Susan B. Anthony to Simone de Beauvoir. Or the female issue of eminent men, from Alice James to the daughters of Freud, Marx, Darwin, and Einstein.

The great women of history had a few things very much in common with many young women today, finds Brett Silverstein, Ph.D.--namely, a high incidence of disordered eating, depression, and physical ills such as headache and insomnia. In short, body-image problems.

After scouring medical-history texts and the biographies of 36 women who achieved greatness, Silverstein has come to some startling conclusions:

Body-image problems have been around at least since Hippocrates.

They have to do with breaking out of traditional gender roles in a personal or cultural climate that so discourages female achievement as to make ambitious women feel conflicted about being female.

"Women who attempt to achieve academically, and probably professionally, are more likely than other women to develop the syndrome," Silverstein reports. His research shows it is a disorder that is most likely to hit during periods of changing gender roles, such as the 1920s and now.

This disorder has always been here, whether it was called chlorosis, neurasthenia, hysteria, or "the disease of virgins" by Hippocrates, says the City College of New York associate professor of psychology. The historical connection was lost when modern diagnostic manuals dropped outdated terminology, he insists.

Writers Emily Bronte, Elizabeth Browning, and Virginia Woolf, for example, were deemed by their biographers to have been anorexic. Charlotte Bronte and Emily Dickinson exhibited disordered eating. Caught between their own personal powers and mothers who led very limited lives, these women, says Silverstein, all expressed regret about being born female.

"To me it seems a very terrible thing to be a woman," wrote pioneering social scientist Ruth Benedict, one of Silverstein's notables, who suffered from an eating disorder during adolescence. Elizabeth I was reported by her physician to be so thin "that her bones could be counted." In addition, Silverstein has also found that the symptoms afflict daughters of extremely eminent men whose wives are virtually invisible. "Just when their bodies are turning into their mothers', they find it hard to identify with the mother."

At this point in history, it's a disorder of epidemic proportions, he says, because there are many more women who, afforded new educational and professional opportunities, are not identifying with their mothers' lives. Unquestionably, our generation's formidable challenge is to reverse a trend that is apparently as old as civilization itself.

next: Eating Disorders: Nutrition Education And Therapy
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teenage sex

Take our "ready for sex" test below

Sexuality is a natural and normal part of life. And so is sex. Having sex play - from masturbation to flirting, from kissing to petting, from oral sex to intercourse - is a big decision. It involves many feelings and responsibilities.

Almost 3 in 10 young people were disappointed by first-time sex.

Choosing to be in an ongoing sexual relationship is another big decision. There is a lot to consider.

Figuring out when you're ready for sex continues through life. People need to make decisions about sex in their teens, 20s, 30s, 40s, 50s, and beyond - every time a sexual situation develops.

Personal Values and Goals

Sexy images are everywhere. We see sex on television, the Internet, and in books, magazines, and movies. We hear about it in songs. Sex is used in ads to sell products. The messages we get can be confusing and hard to sort out.

Think about your values by answering these questions:

• What messages have you gotten from your family about sex?
• What are your religious, spiritual, or moral views about sex?
• Do you want a committed relationship before you have sex?
• Will having sex now affect your plans for the future?

If having sex supports your personal values and goals, rather than conflicts with them - you may be ready.

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Emotional Risks of Sex

Having sex can be wonderful - whether or not it includes intercourse. But it can make people feel very vulnerable, and they can get hurt.

Think about how it may make you feel:

• Will having sex make you feel differently about yourself? If so, how?
• How might your feelings about your partner change?
• Will you expect more commitment from your partner? What if you don't get it?
• What if having sex turns out to be different than you expect?
• What if having sex ends your relationship?
• What if having sex changes your relationship to your family and friends?

If you understand and can accept the emotional risks of having sex, you may be ready.

Physical Risks of Sex

Having sex with a partner can be a meaningful way to express yourself. But there are two important physical risks - sexually transmitted infection and unintended pregnancy.

Do you know how to reduce the risks?

• I know how to reduce the risk of infection with safer sex.
  [ ] Yes - [ ] No
• I have condoms - and know how to use them.
  [ ] Yes - [ ] No
• I know how to prevent pregnancy.
  [ ] Yes - [ ] No
• I have reliable birth control and know how to use it.
  [ ] Yes - [ ] No
• I know how I would handle an infection or unintended pregnancy.
  [ ] Yes - [ ] No
• I know how my partner would feel about an unintended pregnancy.
  [ ] Yes - [ ] No
• I will go for check-ups for sexually transmitted infections when I take risks.
  [ ] Yes - [ ] No
• I have discussed these issues with my partner.
  [ ] Yes - [ ] No

If you are ready to protect yourself and your partner from physical risks, you may be ready.

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Pressure to Have Sex

It may seem as though everyone your age is having sex - especially intercourse. This can make you feel that you should be, too. But the truth is that only about half of high school students have ever had intercourse. Far fewer have it on a regular basis. Many kids who have had sex wish that they had waited.

How do you feel about these reasons for having sex - whether it means intercourse or not?

• I feel like the only "virgin" in my group of friends.
  [ ] Yes - [ ] No
• I want to just "get it over with."
  [ ] Yes - [ ] No
• My partner will break up with me if I don't have sex.
  [ ] Yes - [ ] No
• Having sex will make me popular.
  [ ] Yes - [ ] No
• I'll feel more mature if I have sex.
  [ ] Yes - [ ] No
• I want to get back at my parents.
  [ ] Yes - [ ] No

If you let yourself be persuaded by any of these negative reasons, you may not be ready.

Being Clear

It is important to let your partner know what you want - and what you don't want - before things get sexual. This may not be easy. Maybe it seems like having sex is something that should "just happen."
In fact, you need to be clear about what you want. Your partner can't read your thoughts. Talking with your partner is very important.

Are you ready to do that?

• I'm embarrassed to talk with my partner about safer sex or birth control.
  [ ] Yes - [ ] No
• It's easier to talk to my partner when I use alcohol or other drugs.
  [ ] Yes - [ ] No
• I don't know how to say "no" to my partner.
  [ ] Yes - [ ] No
• Saying "no" will hurt my partner's feelings.
  [ ] Yes - [ ] No
• I'm uncomfortable about letting my partner know what kind of sex play I do and do not like.
  [ ] Yes - [ ] No
• I'd feel awkward telling my partner what I like or what doesn't feel good.
  [ ] Yes - [ ] No

If you're not ready to talk openly with your partner about having sex, you may not be ready to have sex.

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Your Relationship

People who care about and trust each other become intimate - close. But sex is just one part of a whole relationship. It is just one way to be intimate.

How about the other aspects of your relationship?

• Do you treat each other as equals?
  [ ] Yes - [ ] No
• Do you trust each other?
  [ ] Yes - [ ] No
• Are you honest with each other?
  [ ] Yes - [ ] No
• Do you respect each other's needs and feelings?
  [ ] Yes - [ ] No
• Do you care about each other's pleasure?
  [ ] Yes - [ ] No
• Do you share similar interests and values?
  [ ] Yes - [ ] No
• Do you have fun together?
  [ ] Yes - [ ] No
• Are you ready to protect each other?
  [ ] Yes - [ ] No
• Do you both accept responsibility for what you do?
  [ ] Yes - [ ] No
• Do you both want to have sex at this time?
  [ ] Yes - [ ] No

If these things are true about your relationship, you may be ready to have sex.

We all have sexy feelings. But we don't always have sex when we have them. When to have sex is a personal choice. Often the decisions we make in life aren't perfect. But we usually make better decisions when we think through the possible benefits and the risks.

Sometimes it's helpful to talk things through with someone you trust - a parent, a friend, a professional counselor, or someone else who cares about you and what will be good for you.

A good sex life is one that keeps in balance with everything you're about - your health, education and career goals, relationships with other people, and your feelings about yourself.

next: Virginity: A Very Personal Decision