Elderly persons with depression have poor chances of full recovery, especially if they are older than 75, according to a study published in this month's issue of the Archives of General Psychiatry.

The study's primary goal was to analyze the natural history of late-life depression, systematically comparing those who did with those who did not fulfill rigorous diagnostic criteria.

Aartjan T. F. Beekman, M.D., Ph.D., of the department of psychiatry at Vrije University in Amsterdam, and colleagues studied the natural history of depression among elderly men and women aged 55 to 85 over a six-year period. They studied data from 277 participants in the Longitudinal Aging Study Amsterdam, a 10-year study of the well being and functioning of the elderly in the Netherlands.

The patients chosen were previously diagnosed with depression. The average age for participants was 71.8 years, and about 65 percent were female.

Depression is a common disorder among the elderly but has not been well studied, according to the study.

The study's findings appeared in the article, The Natural History of Late-Life Depression, a 6-Year Prospective Study in the Community, which indicated that although depression is generally regarded to be highly treatable throughout the life cycle, most elderly persons with depression remain untreated.

"This is an alarming finding, since it shows that a lot of older persons suffer from this condition over a very long time," Brenda Penninx, Ph.D., associate professor of geriatrics and director of the Geriatric Research Center at Wake Forest University School of Medicine, told MHW. "The majority of persons in this study did not seek treatment for their depressive condition."

Penninx, one of the researchers, continued, "Indeed, it can be expected that appropriate treatment (which could be antidepressant medication, psychotherapy, exercise, social activity or combinations of these) could have reduced the chronicity of depressive symptoms," she said. "However, this was not studied in this longitudinal cohort study."

Researchers conducted interviews at the beginning of the study, at three years and at six years. In between interviews, participants completed questionnaires sent through the mail every five months for the first three years and every six months for the last three years.

During each interview, the participants' form of depression was identified using the Diagnostic Interview Schedule, a common test in epidemiological research of the elderly. Four types emerged: subthreshold depression (207 participants), dysthymia (a mild, chronic form of depression) (25 participants); major depressive disorder (MDD) (23 participants); and a combination of dysthymia and MDD (22 participants).

The researchers analyzed remission in the four diagnostic subgroups, which revealed that persons with sub-threshold depression were most likely to have recovered by the end of the study. Those with a combination of dysthymia and MDD faced the most serious prognosis -- few elderly persons who were diagnosed with this disorder recovered within the six-year period. Also, persons who were 75 to 85 years old at the beginning of the study had more severe and persistent symptoms than younger participants.

After analysis of the severity and duration of symptoms over the six-year period, researchers found that 23 percent of participants had true remissions, 12 percent had remission with a few recurrences, 32 percent had more than one remission followed by a persistent recurrence of symptoms, and 32 percent had chronic depression.

According to Penninx, a lot of older depressed persons may not receive appropriate treatment because their depression is not recognized, which may be due to "... ignorance of physicians or more focus on other somatic conditions, which could leave less time for addressing emotional health," she said.

Seniors may feel that depression is affiliated with aging or does not deserve a physician's attention, Penninx added.

"The implications of the study are that the burden of depression for elderly persons in the community is even more severe than previously thought," the researchers said. "The data clearly demonstrate the need for interventions that are helpful, acceptable and economically feasible to be performed on a larger scale."

Source: Mental Health Weekly 12(28):3-4, 08/2002. © 2002 Manisses Communications Group, Inc.

next: Depression in Seniors Often Ignored
~ depression library articles
~ all articles on depression

Eating Disorders among African American Women

Abstract: A review of published studies reveals a serious deficit in scope of eating disorders among African American women. While the "Prevalence of Eating Disorders Among African American Women" (Mulholland & Mintz, 2001), and "A Comparison of Black and White Women With Binge Eating Disorder" (Pike, Dohm, Stiegel-Moore, Wilfley, & Fairburn, 2001) offer substantial findings in an area of under representation, the findings of these studies leave many vacancies in the true picture of eating disorders among African American women. Sufficient examination of the relationship of familial roles, cultural influences, and unique stressors to African American women are not prevalent in the available studies and are not evaluated as substantial influences on maladaptive eating regulation responses.

The exclusion of women from prominent research studies, such as research on heart disease, cancer, and aging, has been well documented. This exclusion has resulted in the development of research and clinical studies, which specifically concentrate on women. When examining studies conducted on eating disorders, there is a major focus on infants, children, and adult women, Caucasian women.There is a deficit of research studies, which evaluate the prevalence of eating disorders among African-American women.  Upon evaluation of the literature, there is reason to question if a true picture of eating disorders among African-American women has been identified.

Principles and Practice of Psychiatric Nursing (Stuart & Laraia, 2001) defines eating disorders as the use of food "... to satisfy unmet emotional needs, to moderate stress, and to provide rewards or punishments". Further, "the inability to regulate eating habits and the frequent tendency to overuse or under use food interferes with biological, psychological, and sociocultural integrity" (Stuart & Laraia, 2001, p. 526-527). Anorexia nervosa, bulimia nervosa, and binge eating disorder are illnesses associated with maladaptive eating regulation responses and are most commonly seen in women. Decisive factors for anorexia nervosa established by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) include extreme weight loss, fear of fat, and loss of menstruation. Bulimia nervosa is defined by self-esteem that is unduly influenced by weight and shape and both binge eating and inappropriate compensatory behaviors (e.g., self-induced vomiting) at specified frequencies. Binge eating disorder not otherwise specified (EDNOS) is appropriate for "disorders of eating that do not meet the criteria for any specific Eating Disorder" (American Psychiatric Association, 1994, p. 550). DSM-IV (1994) lists six examples of EDNOS, including meeting all the criteria for anorexia except loss of menstruation, meeting all the criteria for bulimia except frequency, use of inappropriate compensatory behaviors after eating small amounts of food, and binge eating in the absence of inappropriate compensatory behaviors (binge-eating disorder). Eating disorders in the United States is experienced about the same among Hispanics and whites, is more common among Native Americans, and is less common among blacks and Asians (Stuart & Laraia, 2001). Because many women do not meet diagnostic criteria, yet are symptomatic by occasionally engage in behaviors characteristic of eating disorders, including self-induced vomiting, use of laxatives, and binge eating, it is important to evaluate women who are symptomatic of eating disorders.

In "Prevalence of Eating Disorders Among African American Women" (Mulholland & Mintz, 2001), a significant study was conducted at a large public university in the Midwestern United States that identified two percent (2%) of African American women participants as eating disordered. In contrast, "A Comparison of Black and White Women With Binge Eating Disorder" (Pike, Dohm, Stiegel-Moore, Wilfley, & Fairburn, 2001) evaluates differences in Caucasian and African American women with an eating disorder; the research showed that the women differ in all aspects of binge eating disorder. Further inspection of these clinical studies is necessary to evaluate whether eating disorders in African American women exists, and whether significant support is available to identify prevalence of eating disorders among this subgroup.

Even though very few studies have been conducted on African American women and eating disorders, there is a significant push to cover the prevalence of eating disorders among minority women. Amy M. Mulholland, and Laurie B. Mintz (2001) conducted a survey to examine the effect of maladaptive eating regulation responses among African American women. Their study's purpose was "... to examine prevalence rates of anorexia, bulimia, and especially EDNOS" as well as ..." prevalence rates for women considered symptomatic (i.e., those that had some symptoms but no actual disorders)" (Mulholland & Mintz, 2001). The sample of the survey was obtained from African American females attending a predominantly Caucasian university in the Midwestern United States. The results of the survey was reported in "Prevalence of Eating Disorders Among African American Women" (Mulholland & Mintz, 2001) and identified that two percent (2%) of the 413 viable participants were classified as eating disordered with all of the eating disordered women having one of the four types of EDNOS. Twenty-three percent (23%) of non-eating disordered participants were symptomatic and seventy-five percent (75%) were asymptomatic. The findings are reflective of a group of African American women who are a minority in their environment.

According to The Journal of Blacks in Higher Education (2002), which collects statistics bearing on the relative status of blacks and whites, the number of African Americans enrolled in college was 1,640,700 in 1999. Currently, African Americans represent only eleven percent (11%) of all undergraduates (U.S. Department of Education). Therefore, a true representation of the sample of African American women in the Mulholland & Mintz study is minimal to the broader population of African American women in the United States. The study does recognize "... findings of less eating-disorder symptoms among African American women at predominantly Black versus predominantly Caucasian universities" (Gray et al., 1987; Williams, 1994), but without acknowledging the probable effects of acculturation of those women surveyed. If the African American women surveyed sought to assume the values, attributes, and behavior of their Caucasian peers in order to become an accepted members of the culture, in this case the University, then how can a true prevalence of the eating disorders among the African American subgroup be identified? The small percentage of African American women identified as being eating disordered (2%) and those non-eating disordered participants identified as symptomatic (23%) may have been influenced by the activities of their Caucasian peers who are eating disordered.

The study excludes external influences that African Americans face; it does not address the day-to-day discrimination African American women face in American society. Further study is needed to examine how stressors such as racism, classism, and sexism influence maladaptive eating regulation responses among African American women and other minorities. As the study implies, there is vast emerging literature on the unique factors associated with eating disorders among African Americans women, which needs to be shared with young women.

As "A Comparison of Black and White Women With Binge Eating Disorder" (Pike et al., 2001) has identified when surveying women diagnosed with binge eating disorder, African American women reported less concern with body shape, weight, and eating than their Caucasian counterparts. This study identified that African American culture impacts attitudinal concern of body image among African American women; African American society is more accepting of larger body shapes and less concerned with dietary restraint. The women recruited for the study were limited; "exclusion criteria were age over 40 and under 18 years, physical conditions know to influence eating habits or weight, current pregnancy, presence of psychotic disorder, not being white or black, or not being born in the United States" (Pike et al., 2001). The study identified that the African American women surveyed experienced higher weight and more frequent binge eating; however, sources of the stressors which stimulate binge eating was not identified. An evaluation of degree of acculturation and other stressors such as racism, classism, and sexism on African American women and their eating disorder was identified by the study as an area of further investigation though not evaluated in the comparison.

Women have been consistently excluded from research studies, and the impact of this phenomenon on African American women is substantial. African American culture is steeped in family and has a strong matriarch thread. African American women are demonstrative and favor conveying love through food. Meals and times of breaking bread are avenues of socialization in African American families and communities.

As African Americans enter mainstream American via work and school, the acculturation phenomenon invades the most sacred of African American culture--food. The prevalence of eating disorders among African American women has not reached epidemic proportions; however, the potential is there. African American women face stressors tri-fold; racism, classism, and sexism have long been recognized as stressors unique to African American women compared to their Caucasian counterparts. The research must then follow to examine how African American women respond, and if maladaptive eating regulation responses are identified then counseling programs need to be available to African American women--the barriers to healthcare must be superceded to empower African American women to nourish future generations of physically sound men and women.

next: Eating Disorders on Rise in Asia
~ eating disorders library
~ all articles on eating disorders

A self-administered depression scale for those over 65.

CHOOSE THE BEST ANSWER FOR HOW YOU FELT THIS PAST WEEK

*Appropriate (nondepressed) answers=yes.
All others=no
or count number of CAPITALIZED (depressed) answers

Score: _____ (Number of "depressed" answers - ones that are capitalized)

Note: This is a self-report inventory. The validity of the result depends entirely on your honesty.

next: Seniors With Late Life Depression May Not Recover
~ depression library articles
~ all articles on depression

The INDEX

Listowner: Dr. Sam Vaknin

Click on the title to go to the relevant section of the index:

• Narcissism The Pathology
• Narcissists and their Emotions
• Narcissists and their Supply Sources
• Narcissists in Therapy
• How to Cope with a Narcissist?
• Narcissists and Women
• The Narcissist and His Mate /Colleague / Partner / Spouse / Family
• Narcissists in the Workplace
• Narcissism and Historical Figures
• Co-Morbidity (Narcissism with other Mental Health Disorders) and Dual Diagnosis (Narcissism with Substance Abuse)
• Our Narcissistic Culture
• Sam Vaknin, NPD
• My Journals (First Published on Suite101)

Narcissism The Pathology

Archive 1 Excerpt 5: Epidemiology of Narcissism
Archive 1 Excerpt 13: Self Defeating and Self Destructive Behaviors
Archive 1 Excerpt 16: The vocations of Narcissist
Archive 1 Excerpt 17: Lazy Narcissists
Archive 2 Excerpt 3: Narcissistic Identity
Archive 2 Excerpt 4: Narcissists, Right and Wrong
Archive 2 Excerpt 6: Narcissists have Tables of Emotional Resonance
Archive 2 Excerpt 7: Contradictory Behaviors of Narcissists
Archive 2 Excerpt 10: Narcissists and Manipulation
Archive 3 Excerpt 1: Narcissists and Chemical Imbalances
Archive 3 Excerpt 7: NPD and Dual Diagnoses
Archive 3 Excerpt 9: From "Narcissism and the Search for Interiority" by Donald Kalsched
Archive 4 Excerpt 3: Narcissistic Self Absorption
Archive 5 Excerpt 3: Narcissism as Self-definition
Archive 5 Excerpt 6: Devaluing the Significant Other
Archive 5 Excerpt 7: Should the Narcissist be Held Accountable for his Actions?
Archive 5 Excerpt 13: The Internalized Voice of the Narcissist
Archive 6 Excerpt 1: Narcissists and Ego Dystony
Archive 6 Excerpt 8: Degrees of Narcissism
Archive 6 Excerpt 14: Unified Dysfunction Theory
Archive 7 Excerpt 4: The Enemy
Archive 7 Excerpt 6: Narcissists as Drug Addicts
Archive 7 Excerpt 7: Alexander Lowen
Archive 7 Excerpt 15: Narcissistic Myths
Archive 8 Excerpt 1: Do Infants Trigger their Own Abuse?
Archive 8 Excerpt 4: Superego
Archive 8 Excerpt 7: The Human Machine
Archive 8 Excerpt 8: Conscience
Archive 9 Excerpt 3: Inverted Narcissism
Archive 10 Excerpt 1: The Exposure of the Narcissist
Archive 10 Excerpt 3: Narcissists, Disagreements and Criticism
Archive 10 Excerpt 4: Unresolved Conflicts
Archive 10 Excerpt 10: Fortress Narcissism
Archive 10 Excerpt 11: Inverted Narcissists
Archive 11 Excerpt 1: The Productive Narcissist
Archive 11 Excerpt 8: Self Confidence and Real Achievements
Archive 12 Excerpt 1: The Narcissist and Total Institutions
Archive 12 Excerpt 3: The Denial Mechanisms of the Narcissist
Archive 12 Excerpt 5: Traumas and Personality Disorders
Archive 12 Excerpt 8: The Narcissist a Gift to Humanity
Archive 12 Excerpt 10: Forms of Aggression
Archive 12 Excerpt 11: Narcissist the Sadist
Archive 12 Excerpt 12: Somatic versus Cerebral Narcissists
Archive 13 Excerpt 1: The Formation of a Narcissist as a Reaction to His Narcissistic Parents
Archive 13 Excerpt 3: Narcissism The Individualist's Reaction
Archive 14 Excerpt 1: Abusive Parents
Archive 14 Excerpt 3: Narcissistic Regression versus NPD
Archive 14 Excerpt 8: Narcissism and Genetics
Archive 15 Excerpt 1: Money and the Narcissist
Archive 15 Excerpt 6: Sexual Abuse
Archive 17 Excerpt 4: Narcissism as an Adaptive Strategy
Archive 17 Excerpt 5: The Zombie Narcissist
Archive 18 Excerpt 2: Narcissism is an Addiction
Archive 18 Excerpt 4: Emotional Investment in Pathology and Healing
Archive 18 Excerpt 5: The Emergence of the True Self
Archive 18 Excerpt 6: Bonding with "God"
Archive 18 Excerpt 7: Group Sex as seen by the Narcissist
Archive 18 Excerpt 8: Overt and Covert
Archive 19 Excerpt 2: Hating Love
Archive 19 Excerpt 5: Cognitive Distortions and the Narcissist
Archive 19 Excerpt 6: Sexual versus other forms of Abuse
Archive 19 Excerpt 7: The Narcissist and his Dead Ones
Archive 20 Excerpt 1: There is no Goal
Archive 20 Excerpt 2: Inverted Narcissists Once More
Archive 20 Excerpt 3: Losing Control
Archive 20 Excerpt 10: The Pleasures of the Somatic Narcissist
Archive 21 Excerpt 1: Narcissistic Healing through LOVE or through PAIN?
Archive 21 Excerpt 4: Inverted Narcissists ARE Narcissists
Archive 21 Excerpt 6: Fulfilling Others' Dreams
Archive 22 Excerpt 4: Narcissists and Control
Archive 22 Excerpt 6: Is Narcissism Learned? Can it be Unlearned?
Archive 23 Excerpt 2: Vindictive Narcissists
Archive 23 Excerpt 4: The Good Enough Mother
Archive 24 Excerpt 1: The Restrained Narcissist
Archive 24 Excerpt 9: Narcissism
Archive 24 Excerpt 10: Addicted
Archive 24 Excerpt 11: False Self
Archive 24 Excerpt 12: Worth and Grandiosity
Archive 27 Excerpt 1: Types of Narcissists
Archive 28 Excerpt 2: Eye Contact
Archive 28 Excerpt 3: Narcissism Forming
Archive 28 Excerpt 5: More about the False Self and the True Self
Archive 30 Excerpt 4: Narcissists ARE Appearances
Archive 30 Excerpt 7: The Rational Narcissist
Archive 31 Excerpt 1: Euphoria and Dysphoria
Archive 31 Excerpt 3: On the Move
Archive 31 Excerpt 5: N-magnets a Bad Metaphor
Archive 31 Excerpt 6: Ideas of Reference
Archive 33 Excerpt 1: Mirror Gazing
Archive 33 Excerpt 2: More on the Grandiosity Gap
Archive 33 Excerpt 3: Self-Awareness and Healing
Archive 33 Excerpt 4: Narcissistic Vulnerability
Archive 34 Excerpt 2: When can a Classic Narcissist become an Inverted Narcissist?
Archive 34 Excerpt 3: The Forms of Abuse
Archive 34 Excerpt 4: The Psychopath and the Narcissist
Archive 34 Excerpt 7: Amelioration of Narcissism
Archive 34 Excerpt 8: Inside, Outside
Archive 35 Excerpt 2: Can Narcissists be Helped by Hypnosis?
Archive 35 Excerpt 3: Predicting the Narcissist
Archive 36 Excerpt 2: Pathological Narcissism Under-diagnosed

Narcissists and their Emotions

Archive 2 Excerpt 1: A Letter to a Narcissist
Archive 3 Excerpt 8: Narcissists imitating Emotions
Archive 4 Excerpt 5: PDs and Self-Mourning
Archive 4 Excerpt 9: Self Pity and Grief
Archive 5 Excerpt 2: Pathological Envy
Archive 5 Excerpt 4: Narcissistic Ups and Downs
Archive 5 Excerpt 9: Narcissists put on a show regarding their "emotions"?
Archive 6 Excerpt 11: I am Very Sad
Archive 7 Excerpt 2: My Shame
Archive 8 Excerpt 5: Emotional Daltonism
Archive 11 Excerpt 9: Communicating Emotions
Archive 11 Excerpt 10: Possessive Jealousy
Archive 13 Excerpt 4: Somatizing Our Emotions
Archive 13 Excerpt 5: The "Love" of the Narcissist
Archive 14 Excerpt 2: Hatred and Anger
Archive 16 Excerpt 3: Narcissists Feel Deceitful
Archive 17 Excerpt 6: Imitated Empathy
Archive 17 Excerpt 7: Narcissism and Self Loathing
Archive 17 Excerpt 9: The Deception that is the Narcissist
Archive 21 Excerpt 3: Being IN LOVE and LOVING
Archive 21 Excerpt 7: Not to Feel Anything
Archive 23 Excerpt 5: Vindicating One's Self Loathing
Archive 25 Excerpt 1: Resistance is Futile?
Archive 25 Excerpt 4: Fight!
Archive 25 Excerpt 7: Falling in Love with Ourselves
Archive 26 Excerpt 4: Aggression
Archive 26 Excerpt 5: To Live and to Grieve
Archive 26 Excerpt 6: Anticipatory Panic
Archive 26 Excerpt 7: My Warden
Archive 26 Excerpt 8: Love, this Bastard
Archive 30 Excerpt 1: Narcissists are Never Happy
Archive 30 Excerpt 3: Being Embarrassed
Archive 30 Excerpt 6: People are Tired
Archive 32 Excerpt 4: Loving and Believing that You Love

Narcissists and their Supply Sources

Archive 1 Excerpt 1: Why does the narcissist devalue his source of secondary narcissistic supply?
Archive 5 Excerpt 8: Narcissists Getting Tired of their Sources of Supply
Archive 6 Excerpt 12: The Narcissistic Hunt
Archive 6 Excerpt 15: Humbling Oneself
Archive 10 Excerpt 2: Could Negative Input be Narcissistic supply?
Archive 10 Excerpt 5: The Narcissist wants to be liked?
Archive 10 Excerpt 6: Old Sources of Narcissistic Supply (NS)
Archive 14 Excerpt 5: Deleting Past Sources of Narcissistic Supply
Archive 17 Excerpt 8: In Pursuit of Narcissistic Supply
Archive 24 Excerpt 3: Myself as a Source of Narcissistic Supply to Others, or: The Existence of Others
Archive 24 Excerpt 5: Is there an Ideal Source of Supply?
Archive 24 Excerpt 8: You are a Source of Supply
Archive 29 Excerpt 2: Human Supply
Archive 32 Excerpt 2: From Desperation to Happiness
Archive 32 Excerpt 3: Internal Combustion and External Propulsion
Archive 32 Excerpt 5: The Art of Un-Being
Archive 32 Excerpt 6: The Narcissist's Refrigerator

Narcissists in Therapy

Archive 1 Excerpt 2: Narcissistic Mental Health Professionals
Archive 1 Excerpt 4: NPD Treatments SSRI
Archive 1 Excerpt 9: Cultural Sensitivity of Therapists
Archive 1 Excerpt 11: Psychodynamic versus Cognitive-Behavioral Treatments
Archive 1 Excerpt 14: Narcissism not curable?
Archive 3 Excerpt 7: NPD and Dual Diagnoses
Archive 4 Excerpt 8: Psychodynamic Therapies
Archive 5 Excerpt 10: Narcissists Facing their Diagnosis
Archive 6 Excerpt 7: Narcissists and Group Therapy
Archive 7 Excerpt 1: Can Narcissists be Cured?
Archive 11 Excerpt 11: Pessimism versus Realism in the Treatment of Narcissists
Archive 12 Excerpt 4: Therapy
Archive 12 Excerpt 6: Narcissists and Medication
Archive 12 Excerpt 13: The Narcissist and the Therapist
Archive 24 Excerpt 6: Destruction and Construction
Archive 26 Excerpt 9: Going to Therapy
Archive 26 Excerpt 10: Official Psychology and NPD

How to Cope with a Narcissist?

Archive 1 Excerpt 3: How to Cope with a Narcissist
Archive 3 Excerpt 3: Should I leave him?
Archive 6 Excerpt 15: Humbling Oneself
Archive 7 Excerpt 3: Luring a Narcissist
Archive 15 Excerpt 2: Treating your Narcissist
Archive 15 Excerpt 4: What to tell your Narcissist?
Archive 19 Excerpt 4: Leaving a Narcissist
Archive 20 Excerpt 5: How to Assuage a Narcissist
Archive 21 Excerpt 2: The Narcissist in Court
Archive 31 Excerpt 7: Fighting Back
Archive 34 Excerpt 9: How does the Narcissist Perceive my Indifference to his Abuse?

Narcissists and Women

Archive 5 Excerpt 12: Male Narcissists and Women
Archive 6 Excerpt 6: Narcissists are Misogynists
Archive 9 Excerpt 4: Narcissists and Women
Archive 13 Excerpt 6: Misogynism Once More ...
Archive 26 Excerpt 1: Women

The Narcissist and His Mate / Colleague / Partner / Spouse / Family

Archive 1 Excerpt 6: Rescue Fantasies
Archive 1 Excerpt 7: Loving a Narcissist
Archive 2 Excerpt 2: Narcissists in the Family
Archive 3 Excerpt 3: Should I leave him?
Archive 3 Excerpt 4: Significant Others, Significant Roles
Archive 3 Excerpt 6: Humans as Instruments
Archive 4 Excerpt 4: Narcissists as Friends
Archive 5 Excerpt 11: Narcissists and Happy Marriages
Archive 5 Excerpt 16: The Narcissist as Body Snatcher
Archive 6 Excerpt 2: VoNPD (Victims of NPD)
Archive 6 Excerpt 3: Surrounded by Inferiors
Archive 6 Excerpt 4: Narcissists Hurting Others
Archive 6 Excerpt 12: The Narcissistic Hunt
Archive 6 Excerpt 13: WHY?
Archive 6 Excerpt 15: Humbling Oneself
Archive 7 Excerpt 3: Luring a Narcissist
Archive 7 Excerpt 5: Victim or Survivor?
Archive 8 Excerpt 3: Disinterested Narcissists
Archive 8 Excerpt 12: Accusing the Victims
Archive 9 Excerpt 5: Narcissists and their Ex's
Archive 9 Excerpt 6: Narcissists Victimize
Archive 10 Excerpt 7: Hurting Others
Archive 10 Excerpt 8: Narcissists and Intimacy
Archive 11 Excerpt 2: Abandoning the Narcissist
Archive 11 Excerpt 3: Unloving the Sick or Needy Spouse
Archive 11 Excerpt 4: Moving On
Archive 11 Excerpt 5: Inspirational Messages
Archive 11 Excerpt 6: The Phases of Mourning
Archive 11 Excerpt 7: Forgiving Enemies, Forgetting Friends
Archive 12 Excerpt 7: NPD Son
Archive 12 Excerpt 14: Being Nice to Others
Archive 13 Excerpt 2: The Test of Archaic Chinese
Archive 14 Excerpt 4: Narcissists and Abandonment
Archive 15 Excerpt 2: Treating your Narcissist
Archive 15 Excerpt 4: What to tell your Narcissist?
Archive 15 Excerpt 5: Narcissists Hate Happy People
Archive 16 Excerpt 4: Healing through Hatred
Archive 18 Excerpt 3: You are not to Blame!
Archive 19 Excerpt 3: Living with a Narcissist
Archive 19 Excerpt 4: Leaving a Narcissist
Archive 20 Excerpt 5: How to Assuage a Narcissist
Archive 20 Excerpt 6: Don't Kiss Me without Permission
Archive 20 Excerpt 8: Love as Domination
Archive 21 Excerpt 8: The Presumption of Understanding the Narcissist A Piece of Irony
Archive 22 Excerpt 5: Meaningful to Who?
Archive 23 Excerpt 6: The Narcissist as a Meaningful Other
Archive 24 Excerpt 7: Punishing Others
Archive 25 Excerpt 2: Narcissists as Vampires
Archive 25 Excerpt 3: The Need to be Hopeful
Archive 25 Excerpt 5: The Narcissist as Predator
Archive 25 Excerpt 6: Seeking Help
Archive 26 Excerpt 2: Do not be Afraid
Archive 26 Excerpt 11: Loving Narcissism
Archive 27 Excerpt 3: Love
Archive 27 Excerpt 4: It is not What you DO
Archive 27 Excerpt 5: You know what you have to DO
Archive 27 Excerpt 6: Presumptions
Archive 27 Excerpt 7: Humanizing the Beast
Archive 28 Excerpt 4: The Human Maelstroms
Archive 28 Excerpt 6: Detoxifying
Archive 30 Excerpt 2: The Off-Handed Narcissist
Archive 30 Excerpt 5: Personal Incompatibility
Archive 31 Excerpt 2: Saying Goodbye
Archive 31 Excerpt 4: Creating Dependence
Archive 31 Excerpt 5: N-magnets a Bad Metaphor
Archive 31 Excerpt 7: Fighting Back
Archive 32 Excerpt 1: How to Protect my Son from Narcissism?
Archive 33 Excerpt 5: Narcissists, Violence and Domestic Abuse
Archive 34 Excerpt 1: Follies a Deux
Archive 34 Excerpt 6: The Professional Victims
Archive 35 Excerpt 1: How to Leave a Narcissist
Archive 35 Excerpt 4: Narcissists and Children

Narcissists in the Workplace

Archive 2 Excerpt 11: The Narcissist Employer

Narcissism and Historical Figures

Archive 1 Excerpt 8: Hitler and Narcissism
Archive 1 Excerpt 12: Bill Clinton a Narcissist?

Co-Morbidity (Narcissism with other Mental Health Disorders) and Dual Diagnosis (Narcissism with Substance Abuse)

Archive 4 Excerpt 1: HPD (Histrionic Personality Disorder) and Somatic NPD
Archive 4 Excerpt 2: Narcissists and Depression
Archive 4 Excerpt 6: DID and NPD
Archive 4 Excerpt 7: NPD and ADHD
Archive 4 Excerpt 11: BPD, NPD and other Cluster B PDs
Archive 7 Excerpt 8: NPDs and other PDs
Archive 7 Excerpt 9: Incest without Sex?
Archive 7 Excerpt 10: NPD and DID
Archive 7 Excerpt 11: Plasticity
Archive 8 Excerpt 2: Narcissism, Wife Beating and Alcoholism
Archive 8 Excerpt 9: BPD and NPD
Archive 8 Excerpt 10: The Personality Disordered
Archive 8 Excerpt 11: Robert Hare
Archive 8 Excerpt 13: Multiple Diagnoses and NPD
Archive 9 Excerpt 2: Schizotypal Personality Disorder
Archive 12 Excerpt 9: Co-dependents and Narcissists
Archive 12 Excerpt 11: Narcissist the Sadist
Archive 19 Excerpt 1: The Hated-Hating Personality Disordered
Archive 20 Excerpt 4: The Borderline Narcissist A Psychotic?
Archive 20 Excerpt 7: The Root of Evil
Archive 21 Excerpt 5: Masochism and Narcissism
Archive 22 Excerpt 1: Narcissists and Sexual Perversions
Archive 22 Excerpt 3: Hysteroid Dysphoria
Archive 23 Excerpt 7: On the Irrelevance of Labeling
Archive 27 Excerpt 2: The Inverted Narcissist A Masochist?
Archive 28 Excerpt 7: NPD, AsPD
Archive 34 Excerpt 5: The Diagnostic and Statistics Manual (DSM)

Our Narcissistic Culture

Archive 1 Excerpt 10: NPD, culture and normalcy
Archive 1 Excerpt 15: Narcissism and Culture
Archive 1 Excerpt 16: The vocations of Narcissists
Archive 2 Excerpt 5: In Defense of Narcissists
Archive 2 Excerpt 8: From "The Alchemist" by Paulo Coelho
Archive 2 Excerpt 9: Narcissism's Gifts to Humanity
Archive 3 Excerpt 5: Lasch, the Cultural Narcissist
Archive 4 Excerpt 10: Should we License Parents?
Archive 5 Excerpt 1: Jeffrey Satinover on the Myth of Narcissus
Archive 5 Excerpt 5: Narcissists and the Order of the World
Archive 6 Excerpt 5: Narcissists and Art
Archive 6 Excerpt 9: Narcissism and Evil
Archive 6 Excerpt 10: Why do Narcissists Exist?
Archive 7 Excerpt 12: A Core of Values?
Archive 7 Excerpt 13: Licensing Parents (continued)
Archive 7 Excerpt 14: Nations as Patients
Archive 8 Excerpt 6: Atheism
Archive 9 Excerpt 1: Love and Sex
Archive 10 Excerpt 9: Personality Disorders are Culture-Dependent?
Archive 12 Excerpt 2: The Cultural Roots of one Narcissist
Archive 12 Excerpt 15: Prostituting our Selves
Archive 14 Excerpt 7: Narcissism and Nihilism
Archive 15 Excerpt 7: Punishing Evil
Archive 15 Excerpt 8: Psychology
Archive 18 Excerpt 1: Linear Time, Cyclical Time
Archive 18 Excerpt 9: Oh, God
Archive 23 Excerpt 3: Narcissistic Thoughts about Humanity
Archive 36 Excerpt 1: Politicians as Narcissists

Sam Vaknin, NPD

Archive 3 Excerpt 2: Personal Anecdote
Archive 3 Excerpt 10: Sam Vaknin, NPD
Archive 5 Excerpt 14: My Role in the List
Archive 5 Excerpt 15: This Paradoxical List...
Archive 6 Excerpt 11: I am Very Sad
Archive 6 Excerpt 16: The Time before Narcissism
Archive 7 Excerpt 2: My Shame
Archive 14 Excerpt 6: Realizations
Archive 15 Excerpt 3: Forgetting my Self
Archive 16 Excerpt 1: Self Destructing Narcissists
Archive 16 Excerpt 2: The Fear of Being Loved
Archive 17 Excerpt 1: Interview with a Narcissist
Archive 17 Excerpt 2: Another One ... (Interview)
Archive 17 Excerpt 3: Email Exchange in preparation for an interview granted to Bob Goodman of "Natterbox"
Archive 20 Excerpt 9: My Guardian Angel
Archive 22 Excerpt 2: I Hate Birthdays
Archive 23 Excerpt 1: Interview at Amazon UK
Archive 24 Excerpt 2: About Myself (what else?)
Archive 24 Excerpt 3: Myself as a Source of Narcissistic Supply to Others, or: The Existence of Others
Archive 24 Excerpt 4: Right Now I am Enraged
Archive 26 Excerpt 3: The Information Addict
Archive 28 Excerpt 1: The Digital Narcissist (SEX)
Archive 29 Excerpt 1: Here you are, Madam
Archive 29 Excerpt 2: Human Supply
Archive 29 Excerpt 3: The Time of the Narcissist
Archive 29 Excerpt 4: Abuse
Archive 29 Excerpt 5: Success
Archive 29 Excerpt 6: Rejection
Archive 35 Excerpt 5: Why do I Write Poetry?
Archive 36 Excerpt 3: Interview The Narcissist as an Author
Archive 37 Excerpt 1: Application to the Media
Archive 37 Excerpt 3: Second Interview with Amazon
Archive 37 Excerpt 4: Interview to JustViews
Archive 37 Excerpt 5: Revisiting Myself
Archive 37 Excerpt 6: Interview to Independent Success!
Archive 38 Excerpt 1: Interview with Babel Magazine
Archive 39 Excerpt 1: Interview with Inscriptions Magazine
Archive 39 Excerpt 2: Correspondence with the New York Times
Archive 39 Excerpt 3: Interview with Writing Tips
Archive 41 Excerpt 1: Interview with New York Press
Archive 41 Excerpt 2: Interview with Modern Author

next: Born Aliens

The term "Adonis Complex" is not a medical term. It is being utilized to describe a variety of body image concerns which have been plaguing boys and men especially through the last decade. It does not describe any one body image problem of men, rather all the distortions collectively.

The term was extracted from Greek mythology which depicted Adonis as half man and half god who was considered the ultimate in masculine beauty. Adonis' body, according to sixteenth-century perspectives, was representative of the ultimate in male physique. According to mythology so beautiful was his body that he won the love of Aphrodite, queen of all gods.

One of the most famous renderings of Adonis was depicted by the Renaissance painter Titian. His painting shows Adonis with Aphrodite clut

ching his body with her arms. In Titan's painting Adonis looks heavy and out of shape in comparison to the men's physiques today which are seen splashed on the covers of magazines, in advertisements, and at gyms. (It could also be noted that Aphrodite, queen of the gods for the sixteenth century, appears quite full figured in comparison to what is considered the "ideal body" women today are striving for.)

This painting dramatically illustrates the fluidity of society over the ages with respect to its varying thoughts of the "ideal" or the "beautiful" human body. The development of the "Adonis Complex" shows that men are being targeted as vigorously as women have been for decades creating destructive obsessional disturbances concerning their own bodies. Men's body image concerns range from minor annoyances to serious and sometimes even life-threatening obsessions. They can present as manageable dissatisfaction at one end of the spectrum to extreme psychiatric body image disorders.

In the past decade the "Adonis Complex" has been seen in increasing numbers of boys and men who have become fixated on achieving a perfect, Adonis-like type body. The authors of The Adonis Complex, The Secret Crises of Male Body Obsession, term this fixation "Muscle Dysmorphia" as an excessive preoccupation with body size and muscularity. Men who find themselves caught up in these obsessions soon discover their lives can begin spiraling out of control. Their lives often are dramatically affected by these obsessions jeopardizing careers as well as relationships with friends and loved ones.

next: Eating Disorder in Males
~ eating disorders library
~ all articles on eating disorders

Many caregivers forget about themselves and their needs and eventually burn out. Here are some helpful suggestions for those caring for the mentally ill.

Supporting Someone with Bipolar - For Family and Friends

Dedicated to those family members and friends who are primary caregivers of a loved one or friend with a mental illness.

1. Be gentle with yourself.
2. Remind yourself that you are a loving helper, not a magician. None of us can change anyone else - we can only change the way that we relate to others.
3. Find a place where you can be a hermit - use it every day - or when you need to.
4. Learn to give support, praise and encouragement to those about you - and learn to accept it in return.
5. Remember that in the light of all the pain we see around us, we are bound to feel helpless at times. We need to be able to admit this without shame. Just in caring and in being there, we are doing something important.
6. Learn to vary your routine often and to change your tasks whenever possible.
7. Learn to know the difference between complaining that relieves tension and the complaining that reinforces it.
8. On your way home from work, focus on one good thing that happened during the day.
9. Become a resource to yourself! Be creative and open to new approaches to old things.
10. Use the support you give to others or a "buddy" system regularly. Use these as a support, for reassurance and to redirect yourself.
11. Avoid "shop talk" during your breaks or when you are socializing with colleagues.
12. Learn to use the expression "I choose to..." rather than expressions like "I have to...," "I ought to..." or "I should..."
13. Learn to say "I won't..." rather than "I can't..."
14. Learn to say "no" and mean it. If you can't say "no," what is your "yes" worth?
15. Aloofness and indifference are far more harmful than admitting to an inability to do more.
16. Above all else - learn to laugh and to play

next: When A Close Friend Has A Mental Illness
~ bipolar disorder library
~ all bipolar disorder articles

Interview with Cliff Bostock

Cliff Bostock, MA, is a doctoral student in depth psychology at Pacifica Graduate Institute and a practitioner of soulwork, a post-Jungian modality of personal growth which is based on the archetypal psychology of James Hillman. His work has been featured in Common Boundary Magazine. He lives in Atlanta where he also authors a weekly dining column and a psychology column. For more information about him consult his website, Soulwork.

Tammie: "How do you describe "Soulwork?"

Cliff: It's a facilitated process of learning to live from a place of deep imagination, in a fully embodied way. It is an aesthetic psychology in which images are treated as autonomous expressions of soul. To follow the image, to use the phrase employed by James Hillman, is to discover the "telos," direction of the soul's path, its destiny. This telos is also clearly illuminated in the body, which is also a metaphorical field.

Tammie: What led you to soulwork?

Cliff: My destiny, basically. As a kid, I couldn't decide whether to be a writer or a doctor. I chose to be a writer, an artist. Then, during my recovery from addictions, I became very interested in transpersonal psychology. I went back to school and got an MA in psychology and trained at the nation's only residential center for transpersonal treatment. Thus, I began to move toward the coalescence of my two childhood impulses --as writer and healer. After a few years of supervised practice as a psychotherapist, I began to feel completely disenchanted with transpersonal and humanistic psychology. They either spiritualized all issues or reduced them to family systems outcomes. I then discovered the soul-based archetypal psychology of James Hillman. My effort, since then, has been to develop a praxis based on his work but one that includes more attention to body and spirit.

Tammie: You maintain that inhibitions and blocks to personal growth are more than personal symptoms but are symptoms of the world in which we live. Will you elaborate on that?

Cliff: I mean that what we call pathology is a global or community disorder borne by the individual. Hillman uses the example of eating disorders, I think. They are really "food" disorders. We live in a world in which food is distributed inequitably, in which people are needlessly starving. So-called "eating disorders" to my mind are expressions of that. If you send a compulsive overeater as part of his treatment to do volunteer work in a soup kitchen, the person makes a radical transformation.

The apparent increase of violence among children is, I think, an expression of the way children are hated in this culture. Isn't it bizarre that members of the middle class fill therapy offices to work on the "inner child" while child abuse rages? If you want to work on your "inner child," go do some work with real children. The idealization of the inner child is a kind of reaction formation to anger about the reality of childhood -- which is NOT a state of innocence, which is NOT a time when we usually get what we need. Another example: ADD is an expression of the mania culture requires to sustain capitalism. Also: Borderline disorder, where the self is completely projected outward, is a symptom of the profound relatavizing of postmodern culture.

Tammie: What is deep imagination?

Cliff: This is really an expression of depth psychology -- penetration of the psyche's depths to the archetypal field. In the depths of the psyche, images live autonomously, awaiting personification. When they remain unconscious, they tend to make themselves known as symptoms. The gods are archetypal processes of the imagination in its depths. When they were banished, as Jung said, they became diseases, or symptoms, what we call pathology.

Tammie: You've bravely shared (and received a great deal of angry protests from therapists) that you're disenchanted with psychotherapy. Why is that?

Cliff: This would take a book. Modern psychotherapy -- the praxis developed 100 years ago -- contained two conflicting impulses. One was scientific and the other was aesthetic. Freud was a scientist (as was Jung) but he regarded the narratives of his patients as "healing fictions". Freud recognized the symbolizing and metaphorizing character of the psyche and Jung extended this even further as his career proceeded.

In the time since then, psychology as a healing practice, has fallen increasingly under the influence of science, medicine. Thus, what was recognized by Freud and Jung as metaphorical -- such as unlikely tales of satanic cult abuse, etc. -- has become increasingly literalized in modern practice. "The reality of the psyche is lived in the death of the literal," said Gaston Bachelard. Conversely, the more symptoms are treated as literal, the more soul, psyche, is driven into materialism and compulsion (and the more it has to be medicated). The tragedy of modern psychological praxis is this loss of imagination, the understanding that the psyche by its nature fictionalizes through the exercise of the fantasy we call memory.

My experience with clients, and as a client, has been that psychotherapy reduces symptoms to predictable causes. This is in the "air," so to speak, no matter how much you try to avoid it. Clients come in with their own diagnoses -- from ADD to PTSD and "low self esteem" to "sexual addiction." I am sure that these diagnoses and their prescribed treatment have some merit, but quite honestly I just haven't seen people who tell themselves the narratives of these disorders making much progress.

When I began working with people in my Greeting the Muse workshops for blocked writers and artists, I saw them making rapid progress through the active engagement of the imagination. In these, pathology is viewed as the natural expression of the soul -- the way into the soul. There is no "healing" in the traditional sense, just deepening of awareness, experience, appreciation. The best metaphor is probably alchemy -- where a "conjunction" of opposites is sought, not a displacement of the symptom with something. Jung spoke of the transcendent function, where two opposites are held and transcended. There is no sacrifice of the original quality of the "wound," but its transcendence holds it differently.

I made a personal decision to stop calling myself a psychotherapist because of this experience. On the other hand, I have learned that my work is NOT for everyone. People with dissociative disorders, for example, do not do well in work that uses a lot of active imagination. Nor do I mean to suggest, in the least, that medications aren't of value for many people. But I do MY best work outside the paradigm of medical science. I even regard medication as alchemy.

Tammie: What does "growing down" into life mean to you?

Cliff: It means the rooting of soul in the "underworld." We live in an over-spiritualized culture. Although I value the spiritual, our problem is learning the way our symptoms and our pathology, our shadow motivations, reveal our destiny. The spiritual has become one of our time's greatest means of repression.

Tammie: How does the spiritual repress?

Cliff: Of course, I don't mean that the spiritual inherently represses. It's just my experience that in many forms of religiosity, especially so-called New Age spirituality, problems become spiritualized and not dealt with. The classic example, of course, is the way anger is demonized as everything from sin to "toxicity" when in practice, as you know, its expression is a necessary step toward forgiveness, resolution of grief and any other problem in which the client feels disempowered. Another problem is the way people develop a "things are as they should be" kind of thinking which sabotages activism. Fundamentalism, which has become a political movement the world over, is another example of subsuming authoritarian, controlling agendas in religious dogma.

I hasten to say that, in my view, this is a misdirection of the religious impulse -- a repression, not a bonafide expression of it. Were the spiritual allowed authentic expression in all areas of life, the world would certainly be very different.

Tammie: What would your definition of wholeness be?

Cliff: It would probably be pretty consistent with Jung's idea of individuation -- the shadow brought into consciousness. In all honesty, though, "wholeness" is one of those words that suggests something false to me. My whole point here is that our soul, our nature, is revealed in our wound. I think this is why the "freak" has held such fascination and created such awe in every culture throughout time. I asked a client once who she wanted to be marooned with on a dessert island -- Doris Day or Bergman. The tormented" personality is the one who offers us the most richness and stimulation ---opportunity for soulmaking -- in life.

Tammie: Do you believe that pain is a valuable teacher and if so, what has your own pain taught you?

Cliff: I have done Buddhist meditation practices for years, and I think I mainly follow Buddhism's lead. I do not think there is any INHERENT value in suffering. On the other hand, as the Buddha said, life IS suffering. So one is left wanting to avoid needless suffering but knowing that a lot of suffering is inevitable. So, you have the choice of how you imagine your suffering. You can call it a teacher but you don't have to call it inherently a good thing. I am thinking of Viktor Frankl. He might say his experience in the death camps taught him something but he'd never say the Holocaust was of inherent value. I think this distinction is really important. Something of value can be (but isn't always) constellated in your relationship to suffering, but it doesn't make suffering a good thing.

And yet, ultimately and crazily, you can end up in the curious place of thanking the gods for your suffering. -- if you transcend it (and I REALLY want to make the point that some suffering simply cannot be transcended). This idea was unimaginable to me even five years ago. My childhood was very unhappy and lonely. I dealt with it by retreating into my imagination and this fed the part of me that later became a successful writer. I would NEVER tell a parent that to encourage his child's artistic talent he reject and isolate the kid. But I do know this fed my own creativity. It could have severely damaged someone else -- and perhaps had I not had the opportunities I did, it might have damaged me more.

I think it's dangerous, to say nothing of hubris-filled, to ever tell anyone they should appreciate their suffering. One can only hold the space for that possibility. It is not everyone's fate.

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

Cliff: I spent a great deal of my life's energies worried about being an outsider, being unconventional. If my life illuminates anything for people, I hope it's that -- as I said earlier -- these wounds and symptoms, these things we call pathologies that make us different, really are the marks of our character and our soul's path."

next:Kris Raphael on "Soul Urges."

An important phase of my recovery program has been learning to love myself. Loving myself means I have given up the futile and endless search for a source of love outside of me, based on or drawn from external people or things. Self-love has meant discovering the limitless Source of love within me. I am no longer dependent upon externals to supply an unhealthy neediness for love, worth, or validation.

(In this context, love is broadly defined as unconditional acceptance and nurturing of myself and others.)

Ironically, part of what drove my neediness for love was shame. My shame grew from my acute awareness of my neediness. Because I was ashamed, I therefore did not perceive myself as being a lovable or worthwhile person. My shame, in turn, resulted in low self-esteem and deeper shame.

A significant breakthrough occurred when I finally admitted my shame about my feelings of low self-worth (both to myself and to another person). Admitting the shame liberated me from it.

Previously, I had worked very hard to deny both my shame and my low self-worth, because I desperately wanted to deny that low self-worth was one of my core issues. Because of the denial, my shame and my low self-worth persisted—one feeding endlessly on the other. By denying my shame and my low self-worth, I remained bound to it. By admitting my shame and my low self-worth, and more importantly, accepting both as a part of myself, I released myself from the shame, freed myself to accept myself unconditionally, and gave myself permission to start loving and esteeming all of me.

Continued belief in myself as a lovable and worthwhile person no longer depends upon an external source or upon external affirmation. I no longer "need" another person to constantly affirm my worth or relieve my shame by loving me (i.e., since no one loves me, I must not be worth loving). I can give myself all the affirmation and love I need. Since my need for love and external affirmation is no longer an issue, the shame associated with my low self-worth is gone.

I am a lovable and worthwhile person!

Now I can affirm it and truly believe it. Equally important, I now have an abundance of genuine self-love, which I can draw upon and give away love to others.

To use an analogy, it's just as if I had an empty account in my "love" bank. I was erroneously waiting and longing for someone else to make the needed deposits, unaware that I could have been making huge deposits for myself all along. Now I have an abundance of love to give away. Because I have love to give away, I am truly a love-able person. I am no longer needy; I am healthy, and thus, even more lovable. By embracing and accepting my shame and my low self-worth, I empowered myself to change. I have an infinite Source and reserve of love and self-esteem for myself.

The paradox of learning self-love is this—the more love I give myself, the more love I have to give away. The love account is never depleted. I can now give healthy love from the abundance of my own love and my own wholeness. True recovery is about giving clean, healthy, unconditional love, not getting love. My life is now characterized by an ever-expanding circle of love, rather than a downward spiral deeper into shame.

Finally, all this healthy self-love unlocks the door to true self-esteem. Self-esteem and self-love are co-requisite. Because I am able to love myself and others unconditionally, I esteem myself; I hold myself in high regard; I value myself; I perceive myself as an able-to-give-love, worthwhile person. The abundance of my self-love is the clean, healthy gift of unconditional love I can now bring to all my relationships.

next: Detachment

ADD coaches, where to find them and are they qualified?

There are certification training programs that train coaches to work with ADDers specifically.

As far as qualifications are concerned, be careful. They are basically self-appointed 'certifiers. The profession is too new and unregulated. Furthermore, we all know professionals who have credentials all over their walls, who we would never recommend. So, either interview coaches or seek a recommendation.

The largest and most complete source of all coaches is The ICF (International Coaches Federation). They have a website http://www.coachfederation.com/ that you can screen to find ADD coaches. You simply stipulate the criteria you want and the coaches with those parameters are then contacted by ICF. The coaches then will respond to ICF and ICF will then forward them to you. This method assures your confidentiality.

Their web address is http://www.coachfederation.com/ go to the bottom of the home page and click on "Find a Coach" button.

Tip for selecting an ADHD coach:

10 Questions to Ask When Selecting a Coach

1. What direct experience do you have regarding what I need to accomplish or resolve? Who else have you coached in a similar situation, and what happened with them?
2. If I was a client, what is the type of suggestions or strategies you would offer regarding what I've explained thus far about my situation?
3. What is your general philosophy or approach when it comes to coaching a client to become more successful?
4. What is your personal style? Aggressive or passive? Patient or driven? Loving or challenging?
5. What is your biggest strength, and why? How will it help me?
6. What do you not do well, or not want to do with me as a client? Why?
7. What are you hearing in how I've presented my situation or in how I am communicating with you? Any observations? Any changes I would need to make immediately?
8. Would you want to work with me? Why? How do you know?
9. What question should I have asked you that I did not?
10. Is there anything else you'd like me to know?

I hope this is helpful.

Coach Harv

About the author: Coach Harv (Harvey Kravetz) is a certified ADHD coach in the UK.

In light of our busy and cluttered lives, here's short essay on appreciating precious gifts, like our children and nature.

Life Letters

I need to make a confession. For far too long, I never related to the worn out phrase, "children are a gift." A gift? I had to work pretty hard and just about all of the time for mine. A gift? The only phrase that even came close to children being a gift that I could relate to was one from the military, "the toughest job you'll ever love." And I wasn't even sure if I bought that. Yes, Being a parent could be rewarding, important, and sometimes fulfilling. But let's face it, raising children is hard, messy, frustrating, often thankless work. It was only a few days ago that I was hit with the full force of the meaning, "children are a gift."

You have been on school vacation for the past two weeks, and today is your last day home. I was returning from dropping you off to visit a friend, when it occurred to me that we hadn't done a single thing I'd planned for us to do together. Not one. I'd been too busy, too distracted, too stressed. You could wait. I'd find the time later, maybe tomorrow or the next day, heck we had two long weeks! Not anymore. All of the sudden, we had one day to be together, and you'd chosen to spend it with a school-mate. I didn't blame you. I sure hadn't been any fun to be around lately.

Not so long ago, you went where I went. Your whole world consisted of the places I brought you. I was your primary caretaker, your playmate, your best friend. You went to bed when I put you there, and were always right where I left you in the morning. I would reach down into your crib to pull you out, and look into those big golden eyes as you reached out to hug me. Every morning I was greeted by a tiny smiling face and loving little arms. I had no competition. You were all mine. You belonged to me and with me. You were my gift, only I didn't exactly know it then.

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Oh, I loved you with all of my heart, treasured you even, but still I took you for granted. You were mine - along with the dirty diapers, dirty laundry, dirty kitchen, and broken toys. You needed me, demanded from me, delighted me and tormented me. What I didn't recognize amidst all the soil and clutter, was that sooner than I could possibly imagine, you'd be leaving me.

When I think of the meaning of a gift, I generally consider it as something given without expectations; I don't have to pay for it, and it's mine for good. The air I breathe, wildflowers in a field, sunshine, life itself - all gifts. I didn't have to earn these, nor do I need to maintain them. But the truth of the matter is that we are given many precious gifts in our lifetime that require our care, our efforts and our commitment, in order to preserve them. And some gifts, (perhaps the most precious of all) are only loaned to us. We won't enjoy perfect health always, no matter how well we take care of ourselves. We won't have our children with us forever either, no matter how much we love them. They come into our lives, even take over our lives, only to some day leave their space vacant.

You'll be eleven soon. You aren't as messy as you used to be. I no longer have to change your diapers and you feed yourself. Now, I have to keep after you to clean up your messes, do your homework, turn off the tv., get off the phone, hurry up, and shut out the lights. You no longer pull the dog's tail, write on the walls, or throw temper tantrums in the grocery store. Now, you do new and different things that make me crazy.

You're too big to rock before you go to sleep, but you still want me to tuck you in. Every night you hold me close and tell me that you love me. Someday, there will be times when I won't even know where you're sleeping. For now, I still need to wake you up each morning to get ready for school while I make your breakfast. You kiss my cheek faithfully each day before heading out the door. Not so long from now, I'll be starting each morning without you.

Precious child of mine, there's too little time to be taken for granted. I must savor and appreciate you. You're still my responsibility, still require and demand much from me, but not forever. And while you'll always be my child, you'll never be mine again quite the way you were when you were a baby. And in such a short time, you'll be even less mine than you are now.

I need to appreciate you for your sake. I've known since the beginning that I must show you that you're precious, important, and a gift. But I recognize now, that I need to appreciate you for my sake too. My time with you is short, and I owe it to me as much as I do you to treasure my priceless gift.

Love Mom,

Ps, have you cleaned your room?

next: Life Letters: A Second Look At Co-dependency