Lately, I've been taking care of myself by exercising. I've taken up walking and have set a goal for 2 to 3 miles every day. Rather than going to a gym, I've simply mapped out some routes through the neighborhood where I live.

It takes a solid 55 minutes for me to complete a 3-mile round trip, but it feels wonderful to work up a sweat and to know that I'm burning calories and exercising my heart. I'll be 40 in February and I've realized it's time for me to start taking better care of myself physically.

Exercise is mentally stimulating as well. It wards off depression and sluggishness. After just 1 week of regular walking, I feel better prepared to handle the stress of my work day—especially if I walk in the morning. Also, the discipline of getting up and doing something physical every morning enhances my self-esteem, which has suffered lately from work situations. I just feel better about myself when I exercise regularly.

During my walks, I've been revisiting the 12 Steps rather than listening to music or news on a radio. When I'm outside walking, it is just me and God, reflecting on how I can continue growing spiritually.

Walking is also a fantastic way to enjoy nature. I see twice as much—things I would never notice from a car. One route takes me past a canal full of aquatic birds—cranes, egrets, wild ducks—which aren't afraid of me in the least. They watch me pass by, but don't run or fly away. One evening, I noticed a gorgeous woodpecker—a black and white body and a vibrant, red head—it was like looking at an Audubon Society picture-book.

There are also endless varieties of flowers to see.

Just last night, I walked past a house which had an unusual shrub next to the mailbox. This plant was covered with tiny pink leaves. Pink flowers are not unusual, but a pink shrub? It was so unusual and so beautiful I made a point to walk past it again. This time, an older woman, whom I presume was the resident, was pruning the shrub, so I paused to ask her about it.

She was delighted I had taken notice and was obviously proud of this particular addition to her yard. She offered me a handful of the trimmings for closer inspection. Turns out she was not pruning, but making a bouquet. "Take some home with you and enjoy looking at it," she said. "It's called Snow on the Mountain."

I smiled at the poetic name, perfectly descriptive of the plant's natural beauty. I asked her if I could stop by and photograph it. Of course, she agreed.

Serenity is making the time to see the world and its natural beauty. Serenity is feeling good about our place in the world, regardless of our present circumstances. Serenity is knowing unexpected treasures and gifts await us along the path of self-discovery and healing. All we are required to do is open our hearts, start walking, and partake of the grace and love in which we are held.

Dear God, thank You for the process of self-discovery and self-growth. Thank You for teaching me valuable lessons from the little surprises You place along my path every day. Amen.

next: Walls and Bridges

Self-Therapy For People Who ENJOY Learning About Themselves

Many people scoff whenever this topic comes up. "What difference does it make now?" they ask.
"There are some people who like me now, and maybe some of them even love me." "So what, if I wasn't loved as a child!?"

That's the question I will be answering. And I'll tell you what you can do about it, too.

LOVED, LIKED, WANTED, ETC.

I am talking here specifically about whether you were loved as a child. I am not necessarily talking about whether you were liked, or wanted, or appreciated for helping the adults, or anything else.

The best way to tell if someone loves you is probably to ask yourself: "Do they often show that they are happier just by being in my presence?" When someone feels this way, their face lights up and there's warmth in their eyes. If you can remember many times like this when you were a child, you are very lucky indeed. You were loved.

WHEN A CHILD IS LOVED...

When a child feels the love of parents in their very early years, they immediately know they have value in the world. As they get older they automatically assume they will "fit in" with other kids
and that they will be able to do whatever anyone else can do. (Real life will show them this isn't always true, but they'll be surprised when they learn it. Kids who weren't well loved are surprised when they discover that they do fit in and can do things well.)

As adults, someone who was loved as a child will find it easy to believe they are lovable and it will also be easy for them to love anyone who doesn't regularly mistreat them.

DO YOU KNOW YOU HAVE VALUE IN THE WORLD?

If you have always wondered if you are valuable - at work, in your relationships, at play, verywhere - then you still need to get and absorb enough love. You need to focus on finding people who are capable of loving and then learn to take their love deep into that part of your brain where you realize your own worth.

Romantic love from one person probably won't be enough, although it sure will help! Being deeply valued by people who you initially think are "better" than you will help the most.

So notice the kind of relationships you have with people who you think of as better than you. Do you always stay far away from such people? When they show that they value you, do you think they are just manipulating or that they don't really care? Psychologically, these people are some of the "new parents" the world has provided for you. Learn to believe them when they sincerely care about you and your welfare.

DO YOU KNOW THAT YOU FIT IN AND YOU CAN HANDLE LIFE?

Maybe you do have the sense that you are valuable as a human being but you still doubt whether you fit in with others socially - and whether you can handle life's demands. This happens to people who were loved enough as infants and toddlers but who stopped feeling loved later in their young lives when things got more complicated. Their parents' love seemed to go away when they made mistakes (which, of course, happened many times every day).

If this sounds like you, what you need is to do a lot of exploring with people who accept you as you are. While you and your friend explore new activities and strange places together you will notice that your friend likes you and enjoys your company regardless of whether you handle things well, poorly, or in between. You will know you are acceptable, good enough, and valued in your friend's eyes - regardless.

A lover or a very close friend can be excellent as your "partner in exploration." Friends in a therapy group or a good support group can also be excellent in this role.

IS IT EASY FOR YOU TO FEEL LOVE AND TO GIVE LOVE?

Once you have absorbed enough love from people who you initially thought were "superior" to you, and have felt loved and accepted while exploring the world with your friends, you are emotionally ready to fully absorb the love other people have for you. And you are almost ready to begin spreading your love to others.

You might say: "But I've always loved other people, even when I didn't love myself." And, in a sense, you are right. You probably did love other people as well as you possibly could considering the amount of love you had to spare. But once you feel plenty of self-love - and no longer fear that it will go away - you will have much more to share and you will have much stronger impulses to share it.

NO LIMITS

Love isn't some limited commodity you need to guard carefully. It's abundant in the world if it's abundant in you.

I wish all our parents knew this when we were born, but I'm very glad we can learn about unlimited love at any age.

Enjoy Your Changes!

Everything here is designed to help you do just that!

next: What Terror Does To Us

Self-Therapy For People Who ENJOY Learning About Themselves

A STORY OF FAILURE

A 28 year old man came to therapy because his wife insisted, under threat of divorce. He talked only of his business, saying nothing at all about his wife, his children, or his friends.

He had built a successful business which he recently sold at a very high profit. Now he wanted to do this again in a new industry.

He was extremely worried that he would fail, sweating and even shaking as he talked about it.

He said he had vowed: "I won't be happy until I make my first million."

When I mentioned that he could be happy much sooner if he would change his decision, he became enraged, stomped out of my office, and said: "I won't change it! Ever!"

I never saw him again.

If he doesn't change, he won't be wealthy or happy. He will be a failure.

WHAT IS SUCCESS?

Success is accomplishing what you set out to accomplish.

SUCCESSFUL AT WHAT?

We don't want success for its own sake. We want it so we can ENJOY it!

To be able to enjoy it, we must first be successful at personal goals such as:

Taking care of our bodies.

Enjoying our family and friends.

Controlling our thoughts.

(See all other topics in this series!)

THE PATH TO SUCCESS

Success does not occur in a straight line.

It's a journey with many curves and dead-ends.

Success requires you to be ready to reevaluate your decisions at any time.

HOW TO BE SUCCESSFUL

1. Set a very general goal that you know will make you happy in your work.
2. Don't decide on a specific "straight-line" path you will follow to get there.
3. Take advantage of every opportunity you find that is even slightly related to accomplishing your goal.

Your task is only to get there!

Your path will change every day.

You must be ready for the changes.

SETTING THE GOAL

Set the most general goal you can possibly set.

Good Example: "I will run my own business someday."

Too Specific: "I will open a restaurant" or "I will make at least $100,000 within five years."

DON'T DECIDE ON A SPECIFIC PATH

Simply Choose To Get There!

Here's the kind of path most people select:
"First I will take business courses in college, then I will borrow some money from my parents, then I will open a small restaurant and serve excellent food, and then I will use the proceeds from this to open a larger restaurant which will make me rich."

Discussion:
Of course, these specific ideas (such as going to school) may be good for you. But don't confuse the steps along your path with the goal itself. You may fail at school, or your parents might refuse you the loan, but you can still succeed by expecting that there will be changes and by being ready to make changes in your path as they are needed.

TAKE ADVANTAGE OF ALL THE OPPORTUNITIES THAT COME BY

Examples:
When you meet someone who likes to discuss problems associated with running their own business, pick their brain. Do this even if you don't respect the person's thinking! (They might serve as a good "bad example.")

When you hear of a seminar on franchise operations, go to it even if you know that you'd never want to own a franchise. They are certain to discuss many things which relate to your goal.

When you receive a service of any kind, always pick the independent entrepreneurs. Who knows what might come from meeting them?

If you follow some "straight-line" path toward success, you won't even notice all of these smaller, almost daily opportunities for pursuing your goal. Successful people will tell you that it was these smaller opportunities, which seemed almost lucky to them at the time, that made them succeed.

Being "lucky" comes from choosing a goal and a path which are general enough to allow you to seize life's regularly occurring opportunities!

REMEMBER WHO WILL BE DOING THE SUCCEEDING!

Don't spend all of your time and energy working toward success.

Spend it on the person who will be achieving the goal: YOU!

Enjoy Your Changes!

Everything here is designed to help you do just that!

next: My Wishes For Real People

COMPARISONS. Your mind makes them all the time. And whether you are content or dissatisfied depends entirely on what you are comparing your life to.

The problem is, we live in a culture where advertisers are constantly giving us perfect images to compare ourselves with: people with perfect homes and cars and spouses and children, and they give us the illusion that this perfection is somehow possible.

The advertisers are taking advantage of the way our minds work naturally. You automatically and naturally compare yourself and your life to others and with your own ideals and aspirations.

Although the process of comparison happens without your active effort, it is a process you can assume control of. Like your own own breathing, it happens on its own, but you can make it do what you want at any time. All you have to do is pay attention to it.

Here's what to do: When you feel discontented, ask yourself What could be worse? And really try to think of something.

If you feel unhappy because you haven't advanced in your job as fast as you'd hoped, imagine how you'd feel if you lived in a country or a time when advancement wasn't possible. Imagine being an "untouchable" in India, sentenced to generation after generation of poverty with no chance of escape.

Try this technique and you'll recognize that in many ways you're lucky to be where you are and who you are. It's a good feeling. It's relaxing and peaceful. It won't last very long, but you can always do it again. The technique works every time.

If you think this is a technique for starry-eyed dreamers with their heads in the clouds, try reading some books that give you an idea of realities you can compare your own life with. My choices would be: Free the Children, Man's Search For Meaning, and Endurance.

If you have any questions about how to use this technique or you'd like to share with me what happened when you did, write to me at adamkhan@aol.com. I would love to hear from you. I will not put your name on a mailing list of any kind.

Find out why failing at losing weight may be a good thing.
Click here.

How can negative thinking actually make you feel better?
Click here.

How can you make people like you for five cents?
Click here.

How can it improve your life to take less responsibility?
Click here.

The ancient Hindus used the same technique as modern cognitive therapy to lessen human suffering. Curious?
Click here.

The secret of success is persistence. But how can you become more persistent? There's a hard way and an easy way.
Click here.

Enhance the quality of your life using a technique developed in one of Hitler's concentration camps.
Click here.

How is it possible that pessimistic thoughts in your head could shut down your immune system? The evidence is in.
Click here.

Abraham Lincoln was probably the greatest, most profoundly moral president ever to be elected to office. Do you know what he thought about religion?
Click here.

next: What Was Abraham Lincoln's Religion?

Chapter 61 of the book Self-Help Stuff That Works

by Adam Khan:

MIHALY CSIKSZENTMIHALYI has been doing some fascinating research into creativity and enjoyment at the University of Chicago for over thirty years now. He invented a new way to study enjoyment. It's called the Experience Sampling Method.

Basically, subjects are given a pager and a booklet, and then they go about their normal lives. At random intervals eight times each day, the pager goes off. The subjects immediately stop what they're doing and fill out the questionnaire in the booklet.

Each questionnaire is identical. It asks what they're doing, where they are, and who they're with. Then it asks them to mark where they are on several scales of experience, such as one to seven to indicate where they are from "happy" to "very sad."

After collecting over a hundred thousand of these samples, Csikszentmihalyi had a huge fund of raw information. He began to wonder, "Are people happier when they use more material resources in their leisure activities? Or are they happier when they invest more of themselves?" In other words his question was, "If I spend my day off going to a movie and out to dinner (or using resources and electricity in some way), will I have a more enjoyable day off than I would if I spent the day gardening or reading or talking or doing something requiring just my own effort?"

Which is ultimately more enjoyable? Using energy outside yourself, or using your own energy?

What would you guess? To answer the question, Csikszentmihalyi and his colleagues went back through the data and sorted each experience sample by the amount of energy being used. They measured the material resources in units of energy called BTUs (British Thermal Units, the energy it takes to raise one pound of water one degree Fahrenheit) and sifted the data in search of an answer.

What they found surprised everyone. The fewer BTUs a person used in his leisure, the more he enjoyed it. Those time-off activities like watching TV, driving, boating, or anything that used electricity or expensive equipment were less enjoyable than self-powered activities like conversing with a friend, working on a hobby, training a dog, or gardening. This goes against the prevailing notions of what's enjoyable. "Everybody knows" it would be more fun cruising on a yacht drinking margaritas than building a bookshelf in your basement. "Everybody knows" it would be more fun to go to the movies than it would to sit home and read a book. But according to the research, that's not the case. Certainly those high-BTU activities are easier and more immediately appealing. But not more enjoyable.

When the pager went off and the participants stopped and checked how much they were enjoying what they were doing, they discovered something truly illuminating: The most fun things don't cost much.

Is this true for you? Test it. On your next two days off, do something that uses up material resources the first day, and the next day, have a friend over and converse or do something powered by your own energy. You'll see a difference. The activity might not be as titillating at the moment, but when your day is done, you'll be more satisfied with the self-powered day.

Do you want some first-class leisure? Find an interest and pursue it. Turn off the TV and use your own energy. You may be surprised to find it doesn't wear you out but fully refreshes you.

This is extremely good news. It's good for your pocketbook, it's good for the planet, and it's good for your own enjoyment. Use more of your own BTUs on your time off and the world will be a better place.

Use your own energy during your leisure time.

Achieving goals is sometimes difficult. When you feel discouraged, check this chapter out. There are three things you can do to make the achievement of your goals more likely.
Do You Want to Give Up?

Some tasks are just plain boring and yet they have
to be done. Washing the dishes, for example.
Learn how to make the tasks more fun.
A Terrible Thing to Waste

Scientists have found out some interesting facts about happiness. And much of your happiness is under your influence.
Science of Happiness

Find peace of mind, tranquility in body, and clarity of purpose with this simple method.
Constitutional Right

The questions you ask direct your mind. Asking the right kind of questions makes a big difference.
Why Ask Why?

next: How to Earn More Money

Bathing a patient with Alzheimer's or dementia is often a difficult task for the caregiver. Here are some suggestions.

For most adults, washing is a personal and private activity. When you are helping someone with Alzheimer's to wash, it's important to be sensitive and tactful, and to respect their dignity. A few simple considerations can help to ensure that washing and bathing remains a relaxing experience for both of you.

Personal care, including washing and bathing, is a common source of anxiety for people with Alzheimer's and their caregivers. It's not hard to understand why - most of us have been carrying out these activities on our own since we were small children.

There are some particularly common reasons for anxiety among people with Alzheimer's, including:

• Deep bath water
  Deep water can make some people feel worried. You can reassure them by making sure the bath water is shallow, or by setting up a bath seat for them to use.
• Overhead showers
  Some people find the rush of water from an overhead shower frightening or disorienting. A hand-held shower may work better.
• Incontinence
  This may be a sensitive issue for both of you. If the person has an accident, they may feel ashamed. They may refuse to admit that it has happened, or to wash afterwards. Try to be reassuring. A matter-of-fact approach, or humor, may work well. Adopt an approach that fits with the nature of your relationship with the person.
• Self-consciousness
  The person with Alzheimer's may find it embarrassing to be undressed in your presence. One way to overcome this is to uncover only the part of their body that you are washing at the time, leaving the rest covered.
• Isolation
  Some people may become anxious if they are left on their own and may want you to stay with them while they are washing

Talk to the person about how you feel about bathing them. Ask how they feel and how they would prefer you to do things. Try to find ways to help them remain independent in as many ways as possible, and offer support as unobtrusively as you can. Here are some practical tips.

continue story below

Encouraging independence

We all have our own routines for personal care - particularly when we get up in the morning. Try to encourage the person with Alzheimer's to continue with these routines for as long as possible. Take the time to think about which routines work best, as well as the person's preferences, so that you can help them carry on with their normal routine. Where do they like to get undressed? Do they prefer a bath or a shower? What toiletries are they used to? What dental care do they need?

If the person seems confused, it can help if you break the process down into small stages. When someone's nerve pathways are damaged, it becomes harder for them to process a lot of information at once.

• Offer tactful reminders about which step comes next in their process of personal hygiene.
• Offer practical help - for example, by handing the person the soap at the point when they would normally wash, or holding out a towel when it's time for them to dry themselves.

Safety precautions

There are some very practical considerations when someone with Alzheimer's is using the bathroom:

• Check that the floor is not slippery.
• Make sure that the room is warm before the person undresses. Older people are more sensitive to heat and cold than younger people.
• Check that the water temperature is not too hot or too cold. You can buy a heat sensor that sticks to the side of the bath and changes color if the bath water is too hot, to prevent scalding.
• You may need to remove locks from the bathroom door, or replace them with locks that can be opened from outside. Someone with Alzheimer's may lock themselves in and panic, or they may go into the bathroom and then forget why they went in.
• Don't forget your own safety. If you have to help the person get into the bath, make sure you don't strain your back. If this is becoming a problem, talk to an occupational therapist about equipment to help you (see Aids and equipment, below).

Aids and Equipment

If washing is becoming difficult, you might find it useful to install some equipment such as bars and handrails. This equipment can help the person feel more independent and more in control of their situation, and can make washing and bathing easier. Information about this sort of equipment is available from an occupational therapist, who you can contact through your GP or district nurse. The service is free of charge. An occupational therapist may suggest some of the following pieces of equipment:

• Grab rails to help with getting in and out of the bath
• Handrails, attached to the wall near the shower, washbasin or toilet
• Non-slip mats in the bath or shower
• Seats to go in the bath or shower
• Raised toilet seats.

Washing hair and Alzheimer's

Most people like having their hair washed regularly. Many people enjoy the feeling of having their hair washed, and feel better when it is done. However, some people don't enjoy it at all. If this is the case, you need to balance the advantages of clean hair against the disadvantages of creating tension between you and the person you are caring for.

• If you are washing the person's hair yourself, a hand-held shower may work best.
• If the person prefers to have their hair washed by a hairdresser, either arrange regular trips to the hairdresser, or you may be able to find a hairdresser who will come to the house.

Using the toilet and Alzheimer's

Try to make sure that the person wipes themselves properly after using the toilet, or help them to do so if this feels appropriate. This will depend on your relationship.

• Wiping from front to back, rather than back to front, helps to prevent infection.
• Moist toilet tissues, obtainable from any chemist, are useful if the person has had an accident.

When someone is reluctant to wash and Alzheimer's

If the person with Alzheimer's doesn't want to wash, try to remain calm and find a way to cope that does not involve confrontation. It's not the end of the world if they don't shower every day. Everyone has different standards of hygiene; you may prefer to bathe every day, but they might have different ideas about cleanliness. Think about what their routine was like before they had Alzheimer's, and encourage them to maintain that level of cleanliness.

• Try giving gentle reminders about using the toilet or washing.
• Think about the timing of your request, or the way you phrase it. A person may adamantly refuse to wash when you suggest they should, but may decide to wash themselves later in the day. This doesn't necessarily mean that they are being difficult - it may relate to the damage that has been caused to the nerve pathways in the brain.
• You may find it easier to reason with the person that they should wash if they are going out, or if they are expecting visitors.
• If bathing or showering causes distress, a strip wash may be sufficient.
• If the person is reluctant to change their clothing, try removing dirty clothes and substituting clean ones at bedtime, or after a bath. This can help prevent arguments.

continue story below

The bottom line

Washing is a matter of personal choice. However, washing is not just about smelling fresh and looking well-kempt. It also helps prevent ill health. Not washing enough can lead to infections and skin complaints. If the person you are caring for doesn't choose to wash as often as you would wash yourself, that's not necessarily something to worry about. But there are some minimum requirements where you will need to put your foot down.

• Make sure the person washes their hands before eating or handling food and after using the toilet.
• Bottoms and genitals should be washed every day to prevent infection.
• Faces should be washed every day to keep the skin clear.
• The person should bathe or shower at least twice a week.
• Teeth need to be cleaned twice a day to prevent cavities

Helping someone wash: useful tips

• Try to make the experience as pleasant and relaxed as possible. Nice-smelling bubble bath or relaxing music can make wash time feel like a treat rather than a chore.
• Be sensitive to the person's preferences, and try to work out which approaches are most likely to be effective.
• Use the time to have a chat, as well as to explain what you are doing.
• If the person finds the experience difficult, try to imagine how you would feel in their situation.
• Making a joke about any muddles may help you both feel better.
• Try to be flexible. You may find that different approaches work at different times, depending on the person's mood and the severity of their Alzheimer's.
• Being organized can help reduce stress. Try to make sure you have everything you need ready to hand before you start.
• While the person is undressed, check for any red or sore areas. If you notice anything you're concerned about, mention it to your district nurse or GP.
• Make sure the person is thoroughly dried, especially in the skin folds. This will prevent the skin from becoming chafed.

Source:

• Alzheimer's Society - UK, Carers' Advice Sheet 504, Nov. 2005.

next: Dressing the Alzheimer's Patien

What is Aromatherapy and how does it work? And is aromotherapy effective for treatment of anxiety, depression and other mental health conditions?

Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.

• Background
• Theory
• Evidence
• Unproven Uses
• Potential Dangers
• Summary
• Resources

Background

For thousands of years, oils from plants have been used to lubricate the skin, purify air and repel insects. Essential oils were used in ancient Egypt for bathing and massage and in ancient Greece and Rome for treating infections. The origin of modern aromatherapy is often traced to the French chemist Rene-Maurice Gattefosse, who is said to have poured lavender oil onto his hand after accidentally burning himself. He believed that the pain, redness and skin damage healed more quickly than expected, and he began to study the effects of oils on the body.

Essential oils are extracted from a plant's flowers, leaves, needles, branches, bark, berries, seeds, fruits, rind or roots. These oils are often mixed with a milder "carrier" oil (usually a vegetable oil) or are weakened (diluted) in alcohol. Essential oils are used in many different ways, including directly on the skin, as a part of massage, in bathwater, via steam inhalation or in mouthwashes.

Aromatherapy sessions often begin with an interview, after which the therapist selects a blend of oils that he or she feels is appropriate for the client. Appointments may last up to 90 minutes. Clients may be asked not to shower for several hours afterwards, to allow more time for oils to sink into the skin. Manmade compounds are usually not used. Commonly sold products such as scented candles, pomanders or potpourri are usually not as strong as the oils typically used by aromatherapists.

There is no required training or licensing for aromatherapists in the United States. Many types of practitioners, including massage therapists, chiropractors and nurses, offer aromatherapy.

Theory

Different theories have been proposed to explain the reported effects of aromatherapy, although none has been proven scientifically. Some explanations include:

• Stimulation of pleasure centers of the brain by nerves in the nose that sense smell
• Direct effects on hormones or enzymes in the blood
• Stimulation of the adrenal glands

Evidence

Scientists have studied aromatherapy for the following health problems:

Anxiety
Lavender aromatherapy is traditionally believed to be relaxing. Several small studies report that it helps relieve anxiety. Overall, the scientific evidence suggests a small benefit. It is possible that aromatherapy may have effects on mood, cognitive performance and relaxation in adults. Larger, well-designed studies are needed to confirm the available data.

Agitation in patients with dementia
There is preliminary evidence that aromatherapy using essential oil of lemon balm (Melissa officinalis) can effectively reduce agitation in people with severe dementia when applied to the face and arms twice daily. Other research reports that steam inhalation of lavender aromatherapy may have similar effects. However, other research reports no benefits of aromatherapy using lemon balm, Lavender officinalis, sweet orange (Citrus aurantium), or tea tree oil (Malaleuca alternifolia). Overall, the evidence does suggest potential benefits. There is also preliminary research suggesting that aromatherapy used with massage may help to calm people with dementia who are agitated. However, it is not clear if this approach is any better than massage used alone. Additional research is necessary before strong recommendations can be made.

Poor sleep, sedation
Lavender and chamomile are popularly regarded as effective sleep aids. Research is too early to form a clear conclusion.

Quality of life in patients with cancer or life-threatening illnesses
Aromatherapy and aromatherapy massage are often used in people with severe illnesses to improve quality of life. In one randomized controlled trial, sleep scores improved, but pain control and anxiety scores did not. There is not enough scientific evidence at this time to form a firm conclusion about effectiveness.

Alopecia areata
Alopecia areata is a condition in which the body's immune system attacks hair follicles, causing hair loss. A well-designed study using a mixture of oils (cedarwood, lavender, rosemary and thyme in carrier oils of grapeseed and jojoba) reported improvements in patients compared with patients using carrier oils alone. More research is needed before a clear conclusion can be reached.

Congestion, respiratory tract infection
Eucalyptus oil and a component of eucalyptus called eucalyptol are included in many over-the-counter vapors and other treatments. One small study showed a positive effect of aromatics on mucous clearance in patients with chronic airway obstruction. However, there is not enough scientific information to form a clear conclusion.

Itching in dialysis patients
It is not clear if aromatherapy reduces itchiness in patients with kidney disease on dialysis.

Anxiety or stress in intensive care unit patients
It is not clear if aromatherapy reduces stress levels in patients in intensive care units. Early research suggests that it may not be helpful.

Labor pain
A small trial of aromatherapy for pain management in women during labor gave unclear results. More research is needed to make a conclusion.

Nausea
Aromatherapy may play a role in reducing postoperative nausea. However, the evidence is not clear, and more research is needed before a clear recommendation can be made.

Obesity
It has been suggested that aromatherapy massage may reduce abdominal obesity or appetite. Additional evidence is necessary before a clear conclusion can be reached.

Constipation
Preliminary research in this area is inconclusive.

Unproven Uses

Aromatherapy has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using aromatherapy for any use.

Potential Dangers

Essential oils may be toxic if taken by mouth and should not be swallowed.

Many types of essential oils can cause skin rash or irritation on direct contact, and they should be diluted with a base oil before use. Some oils, such as peppermint and eucalyptus oils, may burn the skin if applied at full strength. Skin sensitivity to light may occur, particularly with oil of bergamot (extracted from the rind of the bergamot orange) or a chemical in oil of bergamot called 5-methoxypsoralen. Vapors released during aromatherapy can irritate the eyes. Use near children's faces is discouraged.

Allergy may occur with use of essential oils; it may be caused by contamination or by constituents of the herbs from which the oil is derived. Individuals who have difficulty breathing with the use of aromatherapy should seek medical attention before attempting aromatherapy again.

There are published reports of agitation, drowsiness, nausea and headache with the use of aromatherapy. Some oils are thought to have toxic effects on the brain, liver and kidney or to increase the risk of cancer with long-term use. Aromatherapies that may increase sedation or drowsiness, such as lavender or chamomile, may enhance the effects of drugs, herbs or supplements that also cause fatigue or sedation. Use caution if you are driving or operating heavy machinery.

Sage, rosemary and juniper oils may cause the uterus to contract when taken in large amounts, and their use is discouraged during pregnancy.

Infants and young children may be especially sensitive to the effects and side effects of essential oils. Peppermint oil is not recommended in children younger than 30 months. Consult a health care provider before using aromatherapy in children.

Summary

Aromatherapy has been suggested for many health conditions. Several small studies suggest that lavender aromatherapy may help relieve anxiety. There is no conclusive scientific evidence for the effectiveness of any other use or type of aromatherapy. Essential oils may be toxic if taken by mouth and should not be swallowed. Several other adverse effects have been reported, most commonly skin allergy or irritation after direct contact. Some types of aromatherapy may be dangerous in children and in pregnant women. Do not rely on aromatherapy alone to treat potentially dangerous medical conditions. Speak with your health care provider if you are considering the use of aromatherapy.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

Resources

1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Aromatherapy

Natural Standard reviewed more than 640 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

1. Anderson LA, Gross JB. Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea. J Perianesth Nurs 2004;19(1):29-35.
2. Anderson C, Lis-Balchin M, Kirk-Smith M. Evaluation of massage with essential oils on childhood atopic eczema. Phytother Res 2000;14(6):452-456.

1. Ballard CG, O'Brien JT, Reichelt K, et al. Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: the results of a double-blind, placebo-controlled trial with Melissa. J Clin Psych 2002;63(7):553-558.
2. Buckle J. Aromatherapy for health professionals. Beginnings 2003;Jan-Feb, 23(1):40-41.
3. Bureau JP, Ginouves P, Guilbaud J, et al. Essential oils and low-intensity electromagnetic pulses in the treatment of androgen-dependent alopecia. Adv Ther 2003;20(4):220-229.
4. Burnett KM, Solterbeck LA, Strapp CM. Scent and mood state following an anxiety-provoking task. Psychol Rep 2004;95(2):707-722.
5. Burns A, Byrne J, Ballard C. Sensory stimulation in dementia (editorial). Br Med J 2002;325:1312-1313.
6. Calvert I. Ginger: an essential oil for shortening labour? Pract Midwife 2005;8(1):30-34.
7. Christen L, Christen S, Waldmeier V, et al. [Nursing without and with essential oils: a controlled study of patients in an acute rheumatologic department]. Pflege 2003;16(4):193-201.
8. Connell FEA, Tan G, Gupta I, et al. Can aromatherapy promote sleep in elderly hospitalized patients? J Canadian Ger Soc 2001;4(4):191-195.
9. Cooke B, Ernst E. Aromatherapy: a systematic review. Br J Gen Pract 2000;50(455):493-496.
10. Edge J. A pilot study addressing the effect of aromatherapy massage on mood, anxiety and relaxation in adult mental health. Complement Ther Nurs Midwifery 2003;May, 9(2):90-97.
11. Fellowes D, Barnes K, Wilkinson S. Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database Syst Rev 2004;CD002287.
12. Gedney JJ, Glover TL, Fillingim RB. Sensory and affective pain discrimination after inhalation of essential oils. Psychosom Med 2004;66(4):599-606.
13. Graham PH, Browne L, Cox H, Graham J. Inhalation aromatherapy during radiotherapy: results of a placebo-controlled double-blind randomized trial. J Clin Oncol 2003;Jun 12, 21(12):2372-2376.
14. Gray SG, Clair AA. Influence of aromatherapy on medication administration to residential-care residents with dementia and behavioral challenges. Amer J Alzheimer's Disease Dementias 2002;17(3):169-174.
15. Han SH, Yang BS, Kim HJ. [Effectiveness of aromatherapy massage on abdominal obesity among middle aged women]. Taehan Kanho Hakhoe Chi 2003;33(6):839-846.
16. Hasani A, Pavia D, Toms N, et al. Effect of aromatics on lung mucociliary clearance in patients with chronic airways obstruction. J Altern Complement Med 2003;Apr, 9(2):243-249.
17. Holmes C, Hopkins V, Hensford C, et al. Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study. Int J Geriatr Psychiatry 2002;17(4):305-308.
18. Itai T, Amayasu H, Kuribayashi M, et al. Psychological effects of aromatherapy on chronic hemodialysis patients. Psychiatry Clin Neurosci 2000;54(4):393-397.
19. Kaddu S, Kerl H, Wolf P. Accidental bullous phototoxic reactions to bergamot aromatherapy oil. J Am Acad Dermatol 2001;45(3):458-461.
20. Kim MA, Sakong JK, Kim EJ, et al. [Effect of aromatherapy massage for the relief of constipation in the elderly]. Taehan Kanho Hakhoe Chi 2005;35(1):56-64.
21. Lengacher CA, Bennett MP, Kipp KE, et al. Design and testing of the use of a complementary and alternative therapies survey in women with breast cancer. Oncol Nurs Forum 2003;Sep-Oct, 30(5):811-821.
22. Moss M, Cook J, Wesnes K, Duckett P. Aromas of rosemary and lavender essential oils differentially affect cognition and mood in healthy adults. Int J Neurosci 2003;Jan, 113(1):15-38.
23. Orton-Jay L, Formation of the International Federation of Professional Aromatherapists (IFPA). An interview with Linda Orton-Jay. Complement Ther Nurs Midwifery 2003;Feb, 9(1):35-37.
24. Resnick B. Putting research into practice: behaviorial and pharmacologic management of dementia. Geriatr Nurs 2003;Jan-Feb, 24(1):58-59.
25. Richards K, Nagel C, Markie M, et al. Use of complementary and alternative therapies to promote sleep in critically ill patients. Crit Care Nurs Clin North Am 2003;Sep, 15(3):329-340.
26. Ro YJ, Ha HC, Kim CG, et al. The effects of aromatherapy on pruritis in patients undergoing hemodialysis. Derm Nursing 2002;14(4):231-234, 237-239.
27. Sgoutas-Emch S, Fox T, Preston M, et al. Stress management: aromatherapy as an alternative. Sci Rev Alternative Med 2001;5(2):90-95.
28. Smallwood J, Brown R, Coulter F, et al. Aromatherapy and behaviour disturbances in dementia: a randomized controlled trial. Int J Geriatr Psychiatry 2001;16(10):1010-1013.
29. Smith CA, Collins CT, Cyna AM, Crowther CA. Complimentary and alternative therapies for pain management in labor. Cochran Database Syst Rev 2003;(2):CD003521.
30. Soden K, Vincent K, Craske S, et al. A randomized controlled trial of aromatherapy massage in a hospice setting. Palliat Med 2004;18(2):87-92.
31. Taylor J. Sweet smell of success. Nurs Times 2003;Jan 7-13, 99(1):40-41.
32. Thorgrimsen L, Spector A, Wiles A, et al. Aroma therapy for dementia. Cochrane Database Syst Rev 2003;(3):CD003150.
33. Westcombe AM, Gambles MA, Wilkinson SM, et al. Learning the hard way! Setting up an RCT of aromatherapy massage for patients with advanced cancer. Palliat Med 2003;Jun, 17(4):300-307.
34. Wilkinson JM, Hipwell M, Ryan T, Cavanagh HM. Bioactivity of Backhousia citriodora: antibacterial and antifungal activity. J Agric Food Chem 2003;Jan 1, 51(1):76-81.
35. Wiebe E. A randomized trial of aromatherapy to reduce anxiety before abortion. Effective Clin Pract 2000;3(4):166-169.

back to: Alternative Medicine Home ~ Alternative Medicine Treatments

The symptoms of depression in children can be very different than in adults. Learn about depression in children and how parents can help.

It was long believed that the tumultuous moods of the teenage years were "normal", but we now understand that excessive irritability, moodiness, sleep and appetite change may signal vulnerability to depression. (Pine et al. 1999) Common symptoms of adolescent depression are irritability, hopelessness, an inability to experience pleasure from normally pleasurable life events, changes in sleep and appetite, academic decline, reduced energy, reduced social interactions, somatic symptoms, and suicidal ideation.

And unlike adults, most children deny rather than admit depression. Symptoms of depression vary with the developmental stage of the child.

Sadness and depression in children may be expressed through temper tantrums, boredom, low self-esteem, lack of motivation, and deterioration in school work. Sleep and eating problems may be expressed either way, too much or too little sleep and poor appetite or overeating.

Depressive symptoms may be acute (major depressive disorder), chronic (dysthymic disorder), or in response to a triggering life event (adjustment disorder with depressed mood). Also, normal grief symptoms that continue past two months and lead to impairment at school or home require intervention.

Treatment of Childhood Depression

• Don't ignore the symptoms of childhood depression. It's very important to seek professional treatment (a child psychologist, child psychiatrist) if you think your child is depressed. The earlier, the better to prevent deterioration in the child's functioning and recurring depressive episodes.
• For mild depression, psychological therapy alone should do. More serious depression may require antidepressant medication in combination with psychological therapy. While antidepressants have proven effective in children, the FDA has warned parents to be aware of suicidal thoughts and behaviors during antidepressant treatment; especially during the start of antidepressant medication. Parents should work with the mental health professional to observe symptoms and behavior when the child is taking antidepressant medication.

Suggestions for Helping Your Depressed Child

• Keep a resource folder to organize your child's assessment and treatment records. Include practical information such as appointments, names and numbers, and insurance records. Be proactive in your child's treatment by utilizing simple behavior, mood, and symptom logs (mood charts) to record your child's progress. When you see a helpful article or handout related to your child's disorder, print or cut it out and keep it in your folder.
• Look for environmental factors that may be related to the child's depression. Address issues of grief and loss, marital discord, alcohol or drug abuse in your family, or your own mental health problems. Other environmental conditions that are related to childhood depression are physical or sexual abuse, changes in primary caregiver, ongoing problems with learning or peer interaction, and disruption of family housing or employment. Seek counseling for yourself and your child when these environmental issues are present in your family life.
• Build social support systems for your child and your family. Find ways to spend more time with your child; she/he needs your steady presence and support. Encourage their participation in group activities that are led by a caring adult. Some examples might be church groups, child support groups, Scouts, after-school sports and recreation groups. Talk to your child's teacher or school counselor about their condition, and enlist their support to encourage and motivate your child.
• Help your child understand that depression is not forever. Talk about her/his feelings, and counteract hopeless thoughts and negative beliefs with encouragement and reality-testing. Find ways to build self-esteem and sense of competence to lead the way out of a depressive episode or chronic dysthymic disorder.

Parents should keep in mind though that relapses are common and almost one-half of the children diagnosed with depression are likely to suffer a relapse over a five-year follow-up period. Young people who suffer from depression are also likely to suffer from depression during their adult lives. Therefore, depression could continue or reappear between childhood and adulthood.

Sources:

• University of Michigan, "Facts about Depression in Children and Adolescents", Oct. 2007.
• NIMH
• About.com Parenting of K-6 Children

Question:

You mention three different types of victims of the narcissist. What things would cause a narcissist to victimise a significant other sadistically versus just discarding them when no longer useful?

Answer:

The narcissist simply discards people when he becomes convinced that they can no longer provide him with Narcissistic Supply. This conviction, subjective and emotionally charged, does not have to be grounded in reality. Suddenly - because of boredom, disagreement, disillusion, a fight, an act, inaction, or a mood - the narcissist wildly swings from idealisation to devaluation.

The narcissist then detaches immediately. He needs all the energy he can muster to obtain new Sources of Narcissistic Supply and would rather not spend these scarce resources over what he regards as human refuse, the waste left after the extraction of Narcissistic Supply.

A narcissist would tend to display the sadistic aspect of his personality in one of two cases:

1. That the very acts of sadism generate Narcissistic Supply to be consumed by the narcissist ("I inflict pain, therefore I am superior"), or
2. That the victims of his sadism are still his only or major Sources of Narcissistic Supply but are perceived by him to be intentionally frustrating and withholding. Sadistic acts are his way of punishing them for not being docile, obedient, admiring and adoring as he expects them to be in view of his uniqueness, cosmic significance, and special entitlement.

The narcissist is not a full-fledged sadist, masochist, or paranoiac. He does not enjoy hurting his victims. He does not believe firmly that he is the focal point of persecution and the target of conspiracies.

But, he does enjoy punishing himself when it provides him with a sense of relief, exoneration and validation. This is his masochistic streak.

Because of his lack of empathy and his rigid personality, he often inflicts great (physical or mental) pain on meaningful others in his life - and he enjoys their writhing and suffering. In this restricted sense he is a sadist.

To support his sense of uniqueness, greatness and (cosmic) significance, he is often hypervigilant. If he falls from grace - he attributes it to dark forces out to destroy him. If his sense of entitlement is not satisfied and he is ignored by others - he attributes it to the fear and inferiority that he provokes in them. So, to some extent, he is a paranoid.

The narcissist is as much an artist of pain as any sadist. The difference between them lies in their motivation. The narcissist tortures and abuses as means to punish and to reassert superiority, omnipotence, and grandiosity. The sadist does it for pure (usually, sexually-tinged) pleasure. But both are adept at finding the chinks in people's armours. Both are ruthless and venomous in the pursuit of their prey. Both are unable to empathise with their victims, self-centred, and rigid.

The narcissist abuses his victim verbally, mentally, or physically (often, in all three ways). He infiltrates her defences, shatters her self-confidence, confuses and confounds her, demeans and debases her. He invades her territory, abuses her confidence, exhausts her resources, hurts her loved ones, threatens her stability and security, enmeshes her in his paranoid state of mind, frightens her out of her wits, withholds love and sex from her, prevents satisfaction and causes frustration, humiliates and insults her privately and in public, points out her shortcomings, criticises her profusely and in a "scientific and objective" manner - and this is a partial list.

Very often, the narcissist sadistic acts are disguised as an enlightened interest in the welfare of his victim. He plays the psychiatrist to her psychopathology (totally dreamt up by him). He acts the guru, the avuncular or father figure, the teacher, the only true friend, the old and the experienced. All this in order to weaken her defences and to lay siege to her disintegrating nerves. So subtle and poisonous is the narcissistic variant of sadism that it might well be regarded as the most dangerous of all.

Luckily, the narcissist's attention span is short and his resources and energy limited. In constant, effort consuming and attention diverting pursuit of Narcissistic Supply, the narcissist lets his victim go, usually before it had suffered irreversible damage. The victim is then free to rebuild her life from ruins. Not an easy undertaking, this - but far better than the total obliteration which awaits the victims of the "true" sadist.

If one had to distil the quotidian existence of the narcissist in two pithy sentences, one would say:

The narcissist loves to be hated and hates to be loved.

Hate is the complement of fear and narcissists like being feared. It imbues them with an intoxicating sensation of omnipotence.

Many of them are veritably inebriated by the looks of horror or repulsion on people's faces: "They know that I am capable of anything."

The sadistic narcissist perceives himself as Godlike, ruthless and unscrupulous, capricious and unfathomable, devoid of emotions and asexual, omniscient, omnipotent and omnipresent, a plague, a devastation, an inescapable verdict.

He nurtures his ill-repute, stoking it and fanning the flames of gossip. It is an enduring asset. Hate and fear are surefire generators of attention. It is all about Narcissistic Supply, of course - the drug which narcissists consume and which consumes them in return.

Deep inside, it is the horrid future and inescapable punishment that await the narcissist that are irresistibly appealing. Sadists are often also masochists. In sadistic narcissists, there is, actually, a burning desire - nay, need - to be punished. In the grotesque mind of the narcissist, his punishment is equally his vindication.

By being permanently on trial, the narcissist defiantly claims the high moral ground and the position of the martyr: misunderstood, discriminated against, unjustly roughed, outcast due to his very towering genius or other outstanding qualities.

To conform to the cultural stereotype of the "tormented artist", the narcissist provokes his own suffering. He is thus validated. His grandiose fantasies acquire a modicum of substance. "If I were not so special, they surely wouldn't have persecuted me so." The persecution of the narcissist proves his uniqueness. To "deserve" or provoke it, he must be different, for better or for worse.

The narcissist's aforementioned streak of paranoia makes his persecution inevitable. The narcissist is in constant conflict with "lesser beings": his spouse, his shrink, his boss, his colleagues, the police, the courts, his neighbours. Forced to stoop to their intellectual level, the narcissist feels like Gulliver: a giant shackled by Lilliputians. His life is a constant struggle against the self-contented mediocrity of his milieu. This is his fate which he accepts, though never stoically. It is his calling and the mission of his stormy life.

Deeper still, the narcissist has an image of himself as a worthless, bad and dysfunctional extension of others. In constant need of Narcissistic Supply, he feels humiliated by his dependency. The contrast between his grandiose fantasies and the reality of his habit, neediness and, often, failure (the Grandiosity Gap) is an emotionally corroding experience. It is a perpetual background noise of devilish, demeaning scorn. His inner voices "say" to him: "You are a fraud", "You are a zero", "You deserve nothing", "If only they knew how worthless you are".

The narcissist attempts to silence these tormenting voices not by fighting them but by agreeing with them. Unconsciously - sometimes consciously - he "responds" to them: "I do agree with you. I am bad and worthless and deserving of the most severe punishment for my rotten character, bad habits, addiction and the constant fakery that is my life. I will go out and seek my doom. Now that I have complied - will you leave me alone? Will you let me be?"

Of course, they never do.

next: Crime and Punishment: The Never Repenting Narcissist

More about these issues in "Metaphors of the Mind - Part II" and "Metaphors of the Mind - Part III".

Background

This dream was related to me by a male, 46 years old, who believes that he is in the throes of a major personal transformation. Whether he is a narcissist (as he believes himself to be) or not is quite irrelevant. Narcissism is a language. A person can choose to express himself in it, even if he is not possessed by the disorder. The dreamer made this choice.

Henceforth, I will treat him as a narcissist, though insufficient information renders a "real" diagnosis impossible. Moreover, the subject feels that he is confronting his disorder and that this could be a significant turning point on his way to being healed. It is in this context that this dream should be interpreted. Evidently, if he chose to write to me, he is very preoccupied with his internal processes. There is every reason to believe that such conscious content invaded his dream.

The Dream

"I was in a run-down restaurant/bar with two friends sitting at a table in a large open area with a few other tables and a bar. I did not like the music or the smoky atmosphere or other customers or greasy food, but we were travelling and were hungry and it was open and the only place we could find.

There was a woman with other people at a table about 10 feet in front of me that I found attractive, and noticed she was noticing me as well. There was also another woman with other people at a table about 30 feet to my right, old with heavy make-up and poorly dyed hair, loud, obnoxious, drunk who noticed me. She started saying negative things to me, and I tried to ignore her. She just got louder and more derogatory, with horrible rude and jabbing comments. I tried to ignore her, but my other friends looked at me with raised eyebrows, as if to ask: 'How much more are you going to take before you stand up for yourself?' I felt sick to my stomach, and did not want to confront her, but everyone in the place was now noticing her confrontation of me, and she was almost screaming at me. I couldn't believe no one was telling her to stop it, to be civil, to be nice.

I finally looked over at her and raised my voice and told her to shut up. She looked at me and seemed to get even angrier, and then looked at her plate and picked up a piece of food and threw it at me! I couldn't believe it. I told her I wasn't going to take one more thing, and to stop it now or I would call the police. She got up, walked towards me, picking up a plate of popcorn from another table, and upended it flat upon the top of my head. I stood up and said: 'That's it! That's assault! You're going to jail!' and went to the cash register area by the door and called the police.

The police instantly appeared and took her away, with her resisting arrest the whole time. I sat down and someone at the table next to me said: 'Now you can open up the dam gate.' I said: 'What?', and he explained how the woman was actually pretty powerful and owned a dam and had shut the gate down years ago, but that now she was locked up we could go open it up.

We piled into a truck and I was led into a cavernous room and shown a small room with a glass wall in it and a big wheel, a control valve. I was told that I could turn it whenever I wanted. So I started to turn it and the water started flowing. I could easily see it through the glass, and the level on the glass rose higher the more I turned the wheel. Soon there was a torrent, and it was thrilling. I had never seen such an incredible roar of water. It was like the Niagara Falls flowing through the huge room. I got frightened along with being thrilled, but discovered I could lessen the water with the valve if it got to be too much. It went on for a long time, and we whooped and laughed and felt so excited. Finally, the water grew less no matter how wide I opened the valve, and it reached a steady flow.

I noticed the pretty woman from the grill way across the huge area, and she seemed to be looking for someone. I hoped it was me. I opened the door, and went out to go meet her. On the way out, I got grease on my hand, and picked up a rag on the table to wipe it off. The rag had even more grease on it, and so now my hands were completely covered in grease. I picked up another rag on top of a box, and there were wet spark plugs stuck with globs of grease to the underside of the rag, lined up in order as if they used to be in an engine and someone stuck them in this order on purpose, and some of it got on my clothes. The guys with me laughed and I laughed with them, but I left without going to meet the woman, and we went back to the grill.

I found myself in a tiny room with a table in it and a picture window looking out into the area where everyone was sitting and eating. The door was open into a back hallway. I started to go out, but a man was coming into the room. For some reason he frightened me, and I backed up. However, he was robot-like, and walked to the window and looked out to the dining area, making no indication that he even noticed me, and stared blandly at the people having fun. I left and went out into the dining area. I noticed everyone staring at me in an unfriendly way. I started for the exit, but one of the policemen who had arrested the woman from the night before was off-duty in plain clothes and grabbed my arm and twisted me around and shoved me face down on a table. He told me that what I did to the woman was wrong, and that no one liked me because of it. He said that just because I had the law on my side and was in the right didn't mean anyone would like me. He said if I was smart I would leave town. Others were around me and spit on me.

He let me go, and I left. I was driving in a car alone out of town. I didn't know what became of the friends I was with. I felt both elated and ashamed at the same time, crying and laughing at the same time, and had no idea where to go and what I was doing."

The Interpretation

As the dream unfolds, the subject is with two friends. These friends vanish towards the end of the dream and he doesn't seem to find this worrisome. "I didn't know what became of the friends I was with." This is a strange way to treat one's friends. It seems that we are dealing not with three dimensional, full-blown, flesh and blood friends but with FRIENDLY MENTAL FUNCTIONS. Indeed, they are the ones who encourage the subject to react to the old woman's antics. "How much more are you going to take before you stand up for yourself?" - they ask him, cunningly. All the other people present at the bar-restaurant do not even bother to tell the woman "to stop, to be civil, to be nice". This eerie silence contributes to the subject's reaction of disbelief that mushrooms throughout this nightmare. At first, he tries to emulate their behaviour and to ignore the woman himself. She says negative things about him, goes louder and more derogatory, horribly rude and jabbing and he still tries to ignore her. When his friends push him to react: "I felt sick to my stomach and did not want to confront her." He finally does confront her because "everyone was noticing" as she was almost screaming at him.

The subject emerges as the plaything of others. A woman screams at him and debases him, friends prod him to react, and motivated by "everyone" he does react. His actions and reactions are determined by input from the outside. He expects others to do for him the things that he finds unpleasant to do by himself (to tell the woman to stop, for instance). His feeling of entitlement ("I deserve this special treatment, others should take care of my affairs.") and his magical thinking ("If I want something to happen, it surely will.") are so strong - that he is stunned when people do not do his (silent) bidding. This dependence on others is multi-faceted. They mirror the subject to himself. He modifies his behaviour, forms expectations, gets disbelievingly disappointed, punishes and rewards himself and takes behavioural cues from them ("The guys with me laughed and I laughed with them."). When confronted with someone who does not notice him, he describes him as robot-like and is frightened by him. The word "look" disproportionately recurs throughout the text. In one of the main scenes, his confrontation with the rude, ugly woman, both parties do not do anything without first "looking" at each other. He looks at her before he raises his voice and tells her to shut up. She looks at him and gets angrier.

The dream opens in a "run down" restaurant/bar with the wrong kind of music and of customers, a smoky atmosphere and greasy food. The subject and his friends were travelling and hungry and the restaurant was the only open place. The subject takes great pains to justify his (lack of) choice. He does not want us to believe that he is the type of person to willingly patronise such a restaurant. What we think about him is very important to him. Our look still tends to define him. Throughout the text, he goes on to explain, justify, excuse, reason and persuade us. Then, he suddenly stops. This is a crucial turning point.

It is reasonable to assume that the subject is relating to his personal Odyssey. At the end of his dream, he continues his travels, continues his life "ashamed and elated at the same time". We are ashamed when our sense of propriety is offended and we are elated when it is reaffirmed. How can these contradictory feelings coexist? This is what the dream is about: the battle between what the subject has been taught to regard as true and proper, the "shoulds" and the "oughts" of his life, usually the result of overly strict upbringing - and what he feels is good for him. These two do not overlap and they foster in the subject a sense of escalating conflict, enacted before us. The first domain is embedded in his Superego (to borrow Freud's quasi-literary metaphor). Critical voices constantly resound in his mind, an uproarious opprobrium, sadistic criticism, destructive chastising, uneven and unfair comparisons to unattainable ideals and goals. On the other hand, the powers of life are reawakening in him with the ripening and maturation of his personality. He vaguely realises what he missed and misses, he regrets it, and he wants out of his virtual prison. In response, his disorder feels threatened and flexes its tormenting muscles, a giant awakened, Atlas shrugged. The subject wants to be less rigid, more spontaneous, more vivacious, less sad, less defined by the gaze of others, and more hopeful. His disorder dictates rigidity, emotional absence, automatism, fear and loathing, self-flagellation, dependence on Narcissistic Supply, a False Self. The subject does not like his current locus in life: it is dingy, it is downtrodden, it is shabby, and inhabited by vulgar, ugly people, the music is wrong, it is fogged by smoke, polluted. Yet, even while there, he knows that there are alternatives, that there is hope: a young, attractive lady, mutual signalling. And she is closer to him (10 feet) than the old, ugly woman of his past (30 feet). His dream will not bring them together, but he feels no sorrow. He leaves, laughing with the guys, to revisit his previous haunt. He owes this to himself. Then he continues his life.

He finds himself, in the middle of the road of life, in the ugly place that is his soul. The young woman is only a promise. There is another woman "old, with heavy make-up, poorly dyed hair, loud, obnoxious, drunk". This is his mental disorder. It can scarcely sustain the deception. Its make-up is heavy, its hair dyed poorly, its mood a result of intoxication. It could well be the False Self or the Superego, but I rather think it is the whole sick personality. She notices him, she berates him with derogatory remarks, she screams at him. The subject realises that his disorder is not friendly, that it seeks to humiliate him, it is out to degrade and destroy him. It gets violent, it hurls food at him, it buries him under a dish of popcorn (a cinema theatre metaphor?). The war is out in the open. The fake coalition, which glued the shaky structures of the fragile personality together, exists no longer. Notice that the subject does not recall what insults and pejorative remarks were directed at him. He deletes all the expletives because they really do not matter. The enemy is vile and ignoble and will make use and excuse of any weakness, mistake and doubt to crack the defence set up by the subject's budding healthier mental structures (the young woman). The end justifies all means and it is the subject's end that is sought. There is no self-hate more insidious and pernicious than the narcissist's.

But, to fight his illness, the subject still resorts to old solutions, to old habits and to old behaviour patterns. He calls the police because they represent the Law and What Is Right. It is through the rigid, unflinching, framework of a legal system that he hopes to suppress what he regards as the unruly behaviour of his disorder. Only at the end of his dream he comes to realise his mistake: "He said that just because I had the law on my side and I was in the right didn't mean that anyone would like me." The Police (who appear instantly because they were always present) arrest the woman, but their sympathy is with her. His true aides can be found only among the customers of the restaurant/bar, whom he found not to his liking ("I did not like... the other customers..."). It is someone in the next table who tells him about the dam. The way to health is through enemy territory, information about healing can be gotten only from the sickness itself. The subject must leverage his own disorder to disown it.

The dam is a potent symbol in this dream. It represents all the repressed emotions, the now forgotten traumas, the suppressed drives and wishes, fears and hopes. It is a natural element, primordial and powerful. And it is dammed by the disorder (the vulgar, now-imprisoned, lady). It is up to him to open the dam. No one will do it for him: "Now YOU can open the dam gate." The powerful woman is no more, she owned the dam and guarded its gates for many years ago. This is a sad passage about the subject's inability to communicate with himself, to experience his feelings unmediated, to let go. When he does finally encounter the water (his emotions), they are safely contained behind glass, visible but described in a kind of scientific manner ("the level on the glass rose higher the more I turned the wheel") and absolutely controlled by the subject (using a valve). The language chosen is detached and cold, protective. The subject must have been emotionally overwhelmed but his sentences are borrowed from the texts of laboratory reports and travel guides ("Niagara Falls"). The very existence of the dam comes as a surprise to him. "I said: What?, and he explained."

Still, this is nothing short of a revolution. It is the first time that the subject acknowledges that there is something hidden behind a dam in his brain ("cavernous room") and that it is entirely up to him to release it ("I was told that I could turn it whenever I wanted."). Instead of turning around and running in panic, the subject turns the wheel (it is a control valve, he hurries to explain to us, the dream must be seen to obey the rules of logic and of nature). He describes the result of his first encounter with his long repressed emotions as "thrilling", "incredible" "roar(ing)", "torrent(ial)". It did frighten him but he wisely learned to make use of the valve and to regulate the flow of his emotions to accord with his emotional capacity. And what were his reactions? "Whooped", "laughed", "excited". Finally, the flow became steady and independent of the valve. There was no need to regulate the water anymore. There was no threat. The subject learned to live with his emotions. He even diverted his attention to the attractive, young woman, who reappeared and seemed to be looking for someone (he hoped it was for him).

But, the woman belonged to another time, to another place and there was no turning back. The subject had yet to learn this final lesson. His past was dead, the old defence mechanisms unable to provide him with the comfort and illusory protection that he hitherto enjoyed. He had to move on, to another plane of existence. But it is hard to bid farewell to part of you, to metamorphesise, to disappear in one sense and reappear in another. A break in one's consciousness and existence is traumatic no matter how well controlled, well intentioned and beneficial.

So, our hero goes back to visit his former self. He is warned: it is not with clean hands that he proceeds. They get greasier the more he tries to clean them. Even his clothes are affected. Rags, wet (useless) spark plugs, the ephemeral images of a former engine all star in this episode. Those are passages worth quoting (in parentheses my comments):

"I noticed the pretty woman from the grill (from my past) way across the huge area (my brain), and she seemed to be looking for someone. I hoped it was me. I opened the door, and went out to go meet her (back to my past). On the way out, I got grease on my hand (dirt, warning), and picked up a rag on the table to wipe it off. The rag had even more grease on it (no way to disguise the wrong move, the potentially disastrous decision), and so now my hands were completely covered in grease (dire warning). I picked up another rag on top of a box, and there were wet (dead) spark plugs stuck with globs of grease to the underside of the rag, lined up in order as if they used to be in an engine (an image of something long gone) and someone stuck them in this order on purpose, and some of it got on my clothes. The guys with me laughed and I laughed with them (he laughed because of peer pressure, not because he really felt like it), but I left without going to meet the woman, and we went back to the grill (to the scene of his battle with his mental disorder)."

But, he goes on to the grill, where it all started, this undefined and untitled chain of events that changed his life. This time, he is not allowed to enter, only to observe from a tiny room. Actually, he does not exist there anymore. The man that enters his observation post, does not even see him or notice him. There are grounds to believe that the man who thus entered was the previous, sick version of the subject himself. The subject was frightened and backed up. The "robot-like" person (?) "looked through the window, stared blandly at people having fun." The subject then proceeded to commit the error of revisiting his past, the restaurant. Inevitably, the very people that he debunked and deserted (the elements of his mental disorder, the diseased occupants of his mind) were hostile. The policeman, this time "off duty" (not representing the Law) assaults him and advises him to leave. Others spit on him. This is reminiscent of a religious ritual of ex-communication. Spinoza was spat on in a synagogue, judged to have committed in heresy. This reveals the religious (or ideological) dimension of mental disorders. Not unlike religion, they have their own catechism, compulsive rituals, set of rigid beliefs and "adherents" (mental constructs) motivated by fear and prejudice. Mental disorders are churches. They employ institutions of inquisition and punish heretical views with a severity befitting the darkest ages.

But these people, this setting, exert no more power over him. He is free to go. There is no turning back now, all bridges burnt, all doors shut firmly, he is a persona non grata in his former disordered psyche. The traveller resumes his travels, not knowing where to go and what he is doing. But he is"crying and laughing" and "elated and ashamed". In other words, he, finally, after many years, experiences emotions. On his way to the horizon, the dream leaves the subject with a promise, veiled as a threat "If you were smart you would leave town." If you know what is good for you, you will get healthy. And the subject seems to be doing just that.

next:   Persecutory Anxiety