Tuesday, April 26, 2011
Obsessive-compulsive disorder (OCD) is an anxiety disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel driven to do something (compulsions).Often the person carries out the behaviors to get rid of the obsessive thoughts, but this only provides temporary relief. Not performing the obsessive rituals can cause great anxiety. A person's level of OCD can be anywhere from mild to severe, but if severe and left untreated, it can destroy a person's capacity to function at work, at school or even to lead a comfortable existence in the home.
OCD affects about 2.2 million American adults, and the problem can be accompanied by eating disorders, other anxiety disorders, or depression. It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families.
Although OCD symptoms typically begin during the teen years or early adulthood, research shows that some children may even develop the illness during preschool. Studies indicate that at least one-third of cases of adult OCD began in childhood. Suffering from OCD during early stages of a child's development can cause severe problems for the child. It is important that the child receive evaluation and treatment as soon as possible to prevent the child from missing important opportunities because of this disorder.
People with OCD:
• Have repeated thoughts or images about many different things, such as fear of germs, dirt, or intruders; violence; hurting loved ones; sexual acts; conflicts with religious beliefs; or being overly neat.
• Do the same rituals over and over such as washing hands, locking and unlocking doors, counting, keeping unneeded items, or repeating the same steps again and again.
• Have unwanted thoughts and behaviors they can't control.
• Don't get pleasure from the behaviors or rituals, but get brief relief from the anxiety the thoughts cause.
• Spend at least an hour a day on the thoughts and rituals, which cause distress and get in the way of daily life.
Unwanted repetitive ideas or impulses frequently well up in the mind of the person with OCD. Persistent paranoid fears, an unreasonable concern with becoming contaminated or an excessive need to do things perfectly, are common. Again and again, the individual experiences a disturbing thought, such as, "This bowl is not clean enough. I must keep washing it." "I may have left the door unlocked." Or "I know I forgot to put a stamp on that letter." These thoughts are intrusive, unpleasant and produce a high degree of anxiety. Other examples of obsessions are fear of germs, of being hurt or of hurting others, and troubling religious or sexual thoughts.
In response to their obsessions, most people with OCD resort to repetitive behaviors called compulsions. The most common of these are checking and washing. Other compulsive behaviors include repeating, hoarding, rearranging, counting (often while performing another compulsive action such as lock-checking). Mentally repeating phrases, checking or list making are also common. These behaviors generally are intended to ward off harm to the person with OCD or others. Some people with OCD have regimented rituals: Performing things the same way each time may give the person with OCD some relief from anxiety, but it is only temporary.
People with OCD show a range of insight into the uselessness of their obsessions. They can sometimes recognize that their obsessions and compulsions are unrealistic. At other times they may be unsure about their fears or even believe strongly in their validity.
Most people with OCD struggle to banish their unwanted thoughts and compulsive behaviors. Many are able to keep their obsessive-compulsive symptoms under control during the hours when they are engaged at school or work. But over time, resistance may weaken, and when this happens, OCD may become so severe that time-consuming rituals take over the sufferers' lives and make it impossible for them to have lives outside the home.
The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. If OCD becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves.
The old belief that OCD was the result of life experiences has become less valid with the growing focus on biological factors. The fact that OCD patients respond well to specific medications that affect the neurotransmitter serotonin suggests the disorder has a neurobiological basis. For that reason, OCD is no longer attributed only to attitudes a patient learned in childhood -- inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. The search for causes now focuses on the interaction of neurobiological factors and environmental influences, as well as cognitive processes.
OCD is sometimes accompanied by depression, eating disorders, substance abuse, a personality disorder, attention deficit disorder or another of the anxiety disorders. Coexisting disorders can make OCD more difficult both to diagnose and to treat. Symptoms of OCD are seen in association with some other neurological disorders. There is an increased rate of OCD in people with Tourette's syndrome, an illness characterized by involuntary movements and vocalizations. Investigators are currently studying the hypothesis that a genetic relationship exists between OCD and the tic disorders.
Other illnesses that may be linked to OCD are trichotillomania (the repeated urge to pull out scalp hair, eyelashes, eyebrows or other body hair), body dysmorphic disorder (excessive preoccupation with imaginary or exaggerated defects in appearance) and hypochondriasis (the fear of having -- despite medical evaluation and reassurance -- a serious disease). Researchers are investigating the place of OCD within a spectrum of disorders that may share certain biological or psychological bases. It is currently unknown how closely related OCD is to other disorders such as trichotillomainia, body dysmorphic disorder and hypochondriasis.
There are also theories about OCD linking it to the interaction between behavior and the environment, which are not incompatible with biological explanations.
A person with OCD has obsessive and compulsive behaviors that are extreme enough to interfere with everyday life. People with OCD should not be confused with a much larger group of people sometimes called "compulsive" for being perfectionists and highly organized. This type of "compulsiveness" often serves a valuable purpose, contributing to a person's self-esteem and success on the job. In that respect, it differs from the life-wrecking obsessions and rituals of the person with OCD.
Clinical and animal research sponsored by NIMH and other scientific organizations has provided information leading to both pharmacological and behavioral treatments that can benefit the person with OCD. One patient may benefit significantly from behavior therapy, yet another will benefit from pharmacotherapy. And others may benefit best from both. Others may begin with medication to gain control over their symptoms and then continue with behavior therapy. Which therapy to use should be decided by the individual patient in consultation with his or her therapist.
Clinical trials in recent years have shown that drugs that affect the neurotransmitter serotonin can significantly decrease the symptoms of OCD. The first of these serotonin re-uptake inhibitors (SRIs) specifically approved for the use in the treatment of OCD was the tricyclic anti-depressant clomipramine (Anafranil). It was followed by other SRIs that are called "selective serotonin re-uptake inhibitors" (SSRIs). Those that have been approved by the Food and Drug Administration for the treatment of OCD are citalopram (Celexa), flouxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil) and sertraline (Zoloft).
Large studies have shown that more than three-quarters of patients are helped by these medications at least a little. And in more than half of patients, medications relieve symptoms of OCD by diminishing the frequency and intensity of the obsessions and compulsions. Improvement usually takes at least three weeks or longer. If a patient does not respond well to one of these medications, or has unacceptable side effects, another SRI may give a better response. For patients who are only partially responsive to these medications, research is being conducted on the use of an SRI as the primary medication and one of a variety of medications as an additional drug (an augmenter). Medications are of help in controlling the symptoms of OCD, but often, if the medication is discontinued, relapse will follow.
Cognitive behavioral therapy (CBT) has been shown to be the most effective type of psychotherapy for this disorder. The patient is exposed many times to a situation that triggers the obsessive thoughts, and learns gradually to tolerate the anxiety and resist the urge to perform the compulsion. Medication and CBT together are considered to be better than either treatment alone at reducing symptoms.
A specific behavior therapy approach called "exposure and response prevention" is effective for many people with OCD. In this approach, the patient deliberately and voluntarily confronts the feared object or idea, either directly or by imagination. At the same time the patient is strongly encouraged to refrain from ritualizing, with support and structure provided by the therapist, and possibly by others whom the patient recruits for assistance. For example, a compulsive hand washer may be encouraged to touch an object believed to be contaminated, and then urged to avoid washing for several hours until the anxiety provoked has greatly decreased. Treatment then proceeds on a step-by-step basis, guided by the patient's ability to tolerate the anxiety and control the rituals. As treatment progresses, most patients gradually experience less anxiety from the obsessive thoughts and are able to resist the compulsive urges.
Psychotherapy can also be used to provide effective ways of reducing stress, anxiety and resolving inner conflicts.
Ways to Make Treatment More Effective
Many people with anxiety disorders benefit from joining a self-help or support group and sharing their problems and achievements with others. Internet chat rooms can also be useful in this regard, but any advice received over the Internet should be used with caution, as Internet acquaintances have usually never seen each other and false identities are common. Talking with a trusted friend or member of the clergy can also provide support, but it is not a substitute for care from a mental health professional.
Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy. There is preliminary evidence that aerobic exercise may have a calming effect. Since caffeine, certain illicit drugs, and even some over-the-counter cold medications can aggravate the symptoms of anxiety disorders, they should be avoided. Check with your physician or pharmacist before taking any additional medications.
The family is very important in the recovery of a person with an anxiety disorder. Ideally, the family should be supportive but not help perpetuate their loved one's symptoms. Family members should not trivialize the disorder or demand improvement without treatment. When a family member suffers from obsessive-compulsive disorder it's helpful to be patient about their progress and acknowledge any successes, no matter how small.
Obsessive-Compulsive Disorder. Last reviewed 06/01/2010
Archives of General Psychiatry
British Journal of Psychiatry Supplement
Diagnostic and Statistical Manual, Fourth Edition
National Institutes of Mental Health
National Library of Medicine
Psychiatric disorders in America: the Epidemiologic Catchment Area Study
Posted by Johana Johari at 10:32 AM
It's one of the most missed diagnoses in psychiatry. Bipolar disorder, involving moods that swing between the highs of mania and the lows of depression, is typically confused with everything from unipolar depression to schizophrenia to substance abuse, to borderline personality disorder, with just about all stops in between. Patients themselves often resist diagnosis, because they may not see as pathologic the surge in energy that accompanies the mania or hypomania that distinguishes the condition.
But on a few points consensus is emerging. Bipolar disorder is a chronically recurring illness. And the age of onset is dropping—in less than one generation it has gone from age 32 to 19. Whether there is a genuine increase in prevalence of the disorder is a matter of some debate, but there does seem to be a genuine increase among the young.
What's more, the depression of manic-depression is emerging as a particularly thorny problem for both patients and their doctors.
"Depression is the bane of treatment of bipolar disorder," says Robert M.A. Hirschfeld, M.D., head of psychiatry at the University of Texas Medical Branch in Galveston.
It's what is most likely to motivate patients to accept care. People spend more time in the depression phase of the disorder. And unlike unipolar depression, the depression of bipolar illness tends to be treatment-resistant.
"Antidepressants don't work very well in bipolar depression," says Dr. Hirschfeld. "They are underwhelming in their ability to treat the depression." In fact, a shift away from antidepressants is formally recognized in new treatment guidelines for bipolar disorder just released by the American Psychiatric Association.
As physicians gain experience in treating the disorder, they are discovering that antidepressants have two negative effects on the course of the disorder. Used by themselves, antidepressants can induce manic episodes. And over time they can accelerate mood cycling, increasing the frequency of episodes of depression or of mania followed by depression.
Instead, research points to the value of drugs that work as mood stabilizers for the depression of bipolar disorder, either alone or in combination with antidepressants. If antidepressants have any use at all in bipolar disorder, it may be as acute treatment for bouts of severe depression before mood stabilizers are added or substituted.
Even in cases of severe depression, the new guidelines favor increasing the dosage of mood stabilizers over other strategies.
Not so long ago, mood stabilizers could be summed up in a single word—lithium, in use since the 1960s to tame mania. But research has additionally demonstrated the effectiveness of divalproex sodium (Depakote) and lamotrigine (Lamictal), drugs that were initially developed for use as anticonvulsants in seizure disorders. Divalproex sodium has been approved for use as a mood stabilizer in bipolar disorder for several years, while lamotrigine is undergoing clinical trials for such an application.
"Optimizing the dose of lithium or divalproex has good antidepressant effects," reports Dr. Hirschfeld. "We also now know that divalproex and lamotrigine are very good for preventing recurrence in bipolar patients." A study showed that lamotrigine not only delays the time to any mood events but is notably effective against the depressive lows of bipolar illness.
No one knows for sure exactly how anticonvulsants work in bipolar disorder. For that matter, the condition has been described since the time of Hippocrates, but it is still not clear what goes awry in manic-depression.
Despite the unknowns, medications for treating the disorder are proliferating. In contrast to downplaying antidepressants in the depressive phase of the disorder, clinical research is ramping up the value of antipsychotic drugs for combating the manic phase, albeit a new generation of such drugs, collectively called atypical antipsychotics. Chief among them are olanzapine (Zyprexa) and risperidone (Risperdal). They are now considered a first-line approach to acute mania, and adjuncts for long-term therapy along with mood stabilizers.
In the long term, however, observes Nassir Ghaemi, M.D., assistant professor of psychiatry at Harvard and head of bipolar research at Cambridge Hospital, medication goes only so far. "Drugs are not effective enough. It may have to do with the overuse of antidepressants; they interfere with the benefits of mood stabilizers.
"Medications don't take you to the finish line." There seem to be residual symptoms of depression that don't clear. Even when patients stabilize into a normal, or euthymic, mood state, he says, some troubling signs can appear.
"Sometimes we see in euthymic patients cognitive dysfunction that we didn't expect in the past—word-finding difficulties, trouble maintaining concentration," Dr. Ghaemi explains. "Cumulative cognitive impairment seems to emerge with time. It may be related to findings of decreased size of the hippocampus, a brain structure that serves memory. We are on the verge of recognizing long-term cognitive impairment as a result of bipolar disorder."
He believes there is a role for aggressive psychotherapy for keeping patients well, for keeping everyday ups and downs from becoming full-blown episodes. At the very least, he finds, psychotherapy can help patients resolve the work and relationship problems that often outlast symptoms.
In addition, psychotherapy can help patients learn new coping styles and interpersonal habits. "Many of the ways patients deal with their illness are not relevant when they are well," explains Dr. Ghaemi.
For example, he says, many people develop the habit of staying up late as a way of coping with the manic symptoms. "What they couldn't change before because of the illness needs to be changed after treatment if, for example, it bothers a spouse. People have to learn to change. But the longer one is ill, the harder it is to become completely well, because the harder it is to change the habits of one's life."
And for young people diagnosed with bipolar illness, he considers psychotherapy essential. "The younger patients are, the less convinced they are that they have bipolar disorder," he says. "They have impaired insight. They're especially concerned about the need to take medications. They should be in psychotherapy to get educated about the illness and medication."
He also stresses the value of support groups, especially for young people. "It's another, important layer of validation."
By Hara Estroff Marano, published on May 01, 2002 - last reviewed on July 24, 2007
Posted by Johana Johari at 10:19 AM
Thursday, April 14, 2011
Although I have received a fair amount of letters and feedbacks from past clients over the many years of practice, I have never considered organizing a more orderly method of collecting these much needed information.
As a start, I'd like to share a short note I received from a client; with her personal consent, of course. I've also deleted her name to protect her identity for privacy reasons. Below is the note she sent me:
salam. kak johana,
thanks for the friend approval.
also, i have to say that i'm very glad you took up psychology and having your own practice because you're really good at it.
its a big relief to have someone to not only understand but to be able to offer solutions.
i'm happy that the chronic fatigue syndrome was pointed out and really happy that the multivitamins/exercises/deep breathing are working out. i also love working at the assignments given.
looking forward to combat the post trauma stress disorder and driving phobia. truthfully still nervous thinking about driving but i hope to get over it.
here's wishing you all the best and May Allah bless you!
Any of my past and current clients are most welcomed to write comments here using pseudonyms. Given time, I will create a link specifically designed for feedback purposes only. Meanwhile, to all my clients, past and present; thank you for providing me the opportunity to be useful in your lives. Stay blessed, sweet ones.
Posted by Johana Johari at 10:03 AM
Friday, April 1, 2011
Saturday, January 15, 2011
The wedding of the 20th century, in 1981, celebrated a marriage that turned out to be a huge bust. It ended as badly as a relationship can: scandal, divorce and, ultimately, death and worldwide weeping.
So when the firstborn son of that union, Britain's Prince William, set in motion the wedding of this century by getting engaged to Catherine Middleton, he did things a little differently. He picked someone older than he is (by six months), who went to the same university he did and whom he'd dated for a long time. Although she is not of royal blood, she stands to become the first English Queen with a university degree, so in one fundamental way, theirs is a union of equals. In that regard, the new couple reflect the changes in the shape and nature of marriage that have been rippling throughout the Western world for the past few decades.
In fact, statistically speaking, a young man of William's age — if not his royal English heritage — might be just as likely not to get married, yet. In 1960, the year before Princess Diana, William's mother, was born, nearly 70% of American adults were married; now only about half are. Eight times as many children are born out of wedlock. Back then, two-thirds of 20-somethings were married; in 2008 just 26% were. And college graduates are now far more likely to marry (64%) than those with no higher education (48%).
When an institution so central to human experience suddenly changes shape in the space of a generation or two, it's worth trying to figure out why. This fall the Pew Research Center, in association with TIME, conducted a nationwide poll exploring the contours of modern marriage and the new American family, posing questions about what people want and expect out of marriage and family life, why they enter into committed relationships and what they gain from them. What we found is that marriage, whatever its social, spiritual or symbolic appeal, is in purely practical terms just not as necessary as it used to be. Neither men nor women need to be married to have sex or companionship or professional success or respect or even children — yet marriage remains revered and desired.
And of all the transformations our family structures have undergone in the past 50 years, perhaps the most profound is the marriage differential that has opened between the rich and the poor. In 1960 the median household income of married adults was 12% higher than that of single adults, after adjusting for household size. By 2008 this gap had grown to 41%. In other words, the richer and more educated you are, the more likely you are to marry, or to be married — or, conversely, if you're married, you're more likely to be well off.
The question of why the wealth disparity between the married and the unmarried has grown so much is related to other, broader issues about marriage: whom it best serves, how it relates to parenting and family life and how its voluntary nature changes social structures.
The Marrying Kind
In 1978, when the divorce rate was much higher than it is today, a TIME poll asked Americans if they thought marriage was becoming obsolete. Twenty-eight percent did.
In 1978, when the divorce rate was much higher than it is today, a TIME poll asked Americans if they thought marriage was becoming obsolete. Twenty-eight percent did.
Since then, we've watched that famous royal marriage and the arrival of Divorce Court. We've tuned in to Family Ties (nuclear family with three kids) and Modern Family (nuclear family with three kids, plus gay uncles with an adopted Vietnamese baby and a grandfather with a Colombian second wife and dorky stepchild). We've spent time with Will and Grace, who bickered like spouses but weren't, and with the stars of Newlyweds: Nick & Jessica, who were spouses, bickered and then weren't anymore. We've seen some political marriages survive unexpectedly (Bill and Hillary Clinton) and others unpredictably falter (Al and Tipper Gore).
Read more: http://www.time.com/time/nation/article/0,8599,2031962,00.html#ixzz1B6UngrZ0
Posted by Johana Johari at 3:50 AM
Published: December 31, 2010
A lasting marriage does not always signal a happy marriage. Plenty of miserable couples have stayed together for children, religion or other practical reasons.
But for many couples, it’s just not enough to stay together. They want a relationship that is meaningful and satisfying. In short, they want a sustainable marriage.
“The things that make a marriage last have more to do with communication skills, mental health, social support, stress — those are the things that allow it to last or not,” says Arthur Aron, apsychology professor who directs the Interpersonal Relationships Laboratory at the State University of New York at Stony Brook. “But those things don’t necessarily make it meaningful or enjoyable or sustaining to the individual.”
The notion that the best marriages are those that bring satisfaction to the individual may seem counterintuitive. After all, isn’t marriage supposed to be about putting the relationship first?
Not anymore. For centuries, marriage was viewed as an economic and social institution, and the emotional and intellectual needs of the spouses were secondary to the survival of the marriage itself. But in modern relationships, people are looking for a partnership, and they want partners who make their lives more interesting.
Caryl Rusbult, a researcher at Vrije University in Amsterdam who died last January, called it the “Michelangelo effect,” referring to the manner in which close partners “sculpt” each other in ways that help each of them attain valued goals.
Dr. Aron and Gary W. Lewandowski Jr., a professor at Monmouth University in New Jersey, have studied how individuals use a relationship to accumulate knowledge and experiences, a process called “self-expansion.” Research shows that the more self-expansion people experience from their partner, the more committed and satisfied they are in the relationship.
To measure this, Dr. Lewandowski developed a series of questions for couples: How much has being with your partner resulted in your learning new things? How much has knowing your partner made you a better person? (Take the full quiz measuring self-expansion.)
While the notion of self-expansion may sound inherently self-serving, it can lead to stronger, more sustainable relationships, Dr. Lewandowski says.
“If you’re seeking self-growth and obtain it from your partner, then that puts your partner in a pretty important position,” he explains. “And being able to help your partner’s self-expansion would be pretty pleasing to yourself.”
The concept explains why people are delighted when dates treat them to new experiences, like a weekend away. But self-expansion isn’t just about exotic experiences. Individuals experience personal growth through their partners in big and small ways. It happens when they introduce new friends, or casually talk about a new restaurant or a fascinating story in the news.
The effect of self-expansion is particularly pronounced when people first fall in love. Inresearch at the University of California at Santa Cruz, 325 undergraduate students were given questionnaires five times over 10 weeks. They were asked, “Who are you today?” and given three minutes to describe themselves. They were also asked about recent experiences, including whether they had fallen in love.
After students reported falling in love, they used more varied words in their self-descriptions. The new relationships had literally broadened the way they looked at themselves.
“You go from being a stranger to including this person in the self, so you suddenly have all of these social roles and identities you didn’t have before,” explains Dr. Aron, who co-authored the research. “When people fall in love that happens rapidly, and it’s very exhilarating.”
Over time, the personal gains from lasting relationships are often subtle. Having a partner who is funny or creative adds something new to someone who isn’t. A partner who is an active community volunteer creates new social opportunities for a spouse who spends long hours at work.
Additional research suggests that spouses eventually adopt the traits of the other — and become slower to distinguish differences between them, or slower to remember which skills belong to which spouse.
In experiments by Dr. Aron, participants rated themselves and their partners on a variety of traits, like “ambitious” or “artistic.” A week later, the subjects returned to the lab and were shown the list of traits and asked to indicate which ones described them.
People responded the quickest to traits that were true of both them and their partner. When the trait described only one person, the answer came more slowly. The delay was measured in milliseconds, but nonetheless suggested that when individuals were particularly close to someone, their brains were slower to distinguish between their traits and those of their spouses.
“It’s easy to answer those questions if you’re both the same,” Dr. Lewandowski explains. “But if it’s just true of you and not of me, then I have to sort it out. It happens very quickly, but I have to ask myself, ‘Is that me or is that you?’ ”
It’s not that these couples lost themselves in the marriage; instead, they grew in it. Activities, traits and behaviors that had not been part of their identity before the relationship were now an essential part of how they experienced life.
All of this can be highly predictive for a couple’s long-term happiness. One scale designed by Dr. Aron and colleagues depicts seven pairs of circles. The first set is side by side. With each new set, the circles begin to overlap until they are nearly on top of one another. Couples choose the set of circles that best represents their relationship. In a 2009 report in the journal Psychological Science, people bored in their marriages were more likely to choose the more separate circles. Partners involved in novel and interesting experiences together were more likely to pick one of the overlapping circles and less likely to report boredom. “People have a fundamental motivation to improve the self and add to who they are as a person,” Dr. Lewandowski says. “If your partner is helping you become a better person, you become happier and more satisfied in the relationship.”
Source: New York Times - Week In Review.
Posted by Johana Johari at 3:42 AM
The art of good parenting begins with the fundamental skill of seeing through the eyes of the child, of sharing the child's view or reality, feelings and hopes. It is this awareness of the world that permits a parent, grandparent or teacher to hold the child when threatened, to love the child when lonely, to teach the child when inquisitive, and to discipline the child who knows he is wrong.
The success of the entire parent-child relationship depends on this perceptive skill. How often do teenagers complain, "My parents don't understand me"? They are pronouncing judgment on their parents' inability to "mind read" their life. This ability is acquired by developing an understanding of the meaning of behavior.
Behavior, in turn, is closely related to those mysterious factors of individuality and temperament. Every parent of more than one child has wondered how two children raised in the same home with the same genetic makeup can be so different from one another. How can one child be so reverently quiet and withdrawn, while another is so noisy and self-assertive?
Extending that question to adulthood, we might wonder why one person is kind and gentle, while another is mean and hateful. Certainly, part of the story of human temperament is told by genetics, but I believe the real heavyweight in shaping the personality is that same old companion--inferiority.
You see, damage to the ego (loss of self-worth) actually equals or exceeds the pain of physical discomfort in intensity. In fact, I have seen people experience extreme physical pain, and I have witnessed others whose self-esteem had completely crumbled. I believe the latter is worse! It gnaws on the soul through the conscious mind by day and in the dreams by night. So painful is its effect that our entire emotional apparatus is designed to protect us from its oppression.
A sizable portion of all human activity is devoted to the task of shielding us from the inner pain of inferiority. I believe this to be the most dominant force in life, even exceeding the power of sex in its influence. Therefore, if we are to understand the meaning of behavior in our boys and girls, husband or wife, friends and neighbors--and even our enemies--then we must begin by investigating the ways in which human beings typically cope with self-doubts and personal inadequacies.
Six personality patterns, I believe, offer the most direct and accurate explanation of human behavior that I have seen. Most children adopt one or more of these avenues of defense. Each parent is encouraged to look through this article for the footprints of his own child, and while doing so, he might even find the sand-filled remnants of his own tracks. The six patterns are:
1 "I'll withdraw";
2. "I'll fight";
3. "I'll be a clown";
4. "I'll deny reality";
5. "I'll conform"; and
6. "I'll compensate." (By James Dobson, Ph.D.)
2. "I'll fight";
3. "I'll be a clown";
4. "I'll deny reality";
5. "I'll conform"; and
6. "I'll compensate." (By James Dobson, Ph.D.)
This material is excerpted from Dr. Dobson's book The New Hide or Seek (copyright © 1974, 1979, 1999 by James Dobson), published by Revell, a division of Baker Publishing Group, and is used by permission.
Posted by Johana Johari at 3:34 AM