Dealing with Addiction

11 03 2015

Recently I saw a couple of encouraging articles in the news which inspired me to write a brief post about dealing with addiction. I will link to the two articles at the end of this post.

Addiction is an issue that comes up all the time in therapy. Sometimes it appears in very overt and obvious forms – such as substance misuse, gambling, or sex addiction – but often in more covert and subtle ways as well, such as compulsive exercise, workaholism, or obsessive thoughts and habits. In many ways all humans are addicts, as we are creatures of habit; we thrive on things that are familiar and comforting, and carve out repetitive patterns for ourselves. This is no bad thing, as it means that we can create healthy routines, or stick to a structured approach when making changes or adjustments; but it can also be dangerous and become an unhealthy, destructive force where a reliance on a certain way of thinking or behaving can start to interfere with the rest our lives.

addictionhelp

So, why is it that some people can keep their habits under control and choose healthy routines for themselves, whereas others find themselves losing control to harmful urges? What decides whether we will find a healthy or an unhealthy outlet for our need for comfort? This is a complex issue, with numerous answers (see Gabor Mate’s talk on The Power Of Addiction for some great points), but I think these three are the most important:

1. Psychobiology. Some people inherit genetic traits or learned behaviours from their ancestors, where they may be predisposed to certain ways of thinking or doing things, or have a particular physiological ‘weakness’ for a certain substance.
2. Environment. We are hugely influenced by our surroundings, and by our social networks (see Nicholas Christakis’ wonderful talk on The Hidden Influence Of Social Networks for more information). The people around us shape our ideas of accepted norms and influence the behaviours that we establish; we often look to see how others are coping with their lives, and then we copy them.
3. Early attachment experiences. Our early experiences shape our identities and also, crucially, our emotion regulation strategies. If we have positive attachment experiences then we learn that we can rely on others, and turn to them during times of need; and this also teaches us that we are ‘worthy’ of other people’s care and attention. However, if we have negative attachment experiences then we learn that we cannot rely on others, and instead have to develop our own methods of self-soothing; and this also teaches that we are ‘unworthy’ of other people’s care and attention. It’s this latter group of people who often seek external sources of affirmation and validation, which can slip into addictive cycles: if it doesn’t feel emotionally safe to turn to other people for reassurance, then they will seek that comfort from the escapism and rush of sex, drugs, or gambling instead.

Amazingly, many addiction treatment programs continue to focus on only the first of those three issues. They see addiction simply as a psychobiological disease, and they dissect the cognitive, behavioural, and physiological components of this disease, and then set out to replace previous bad habits with healthy new ones. However, they often overlook the crucial factors of social networks and attachment experiences; factors which will be massively influential on a person’s chances of maintaining their recovery over time. I believe a crucial element in treating addiction is to process and repair negative attachment experiences from the past, and then to create new, healing attachment experiences in therapy; so that a client can feel a sense of attunement, and learn that it’s safe to turn to others for soothing and reassurance, rather than having to self-soothe or seek out alternative sources of validation. This process also empowers the client to develop a new sense of worthiness, overcoming internalished shame from past rejection, and recognising that they are indeed deserving of the attention, care, and love of others.

hugging

I spent several years as the Clinical Lead of a substance misuse treatment agency within the NHS in North London, and always made sure that we were taking a holistic approach to our clients’ recovery; addressing all three of the factors I list above. I continue to use this approach in therapy with my clients.

Now, here are the two articles I referred to earlier:

1. A Huffington Post article, titled “The Likely Cause Of Addiction Has Been Discovered, And It Is Not What You Think”.
2. An NPR article, titled “What Heroin Addiction Tells Us About Changing Bad Habits”.

Hopefully you will find them as informative as I did. And if you are seeking information or therapy for issues related to addiction, then please do feel free to contact me.

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Lost Highway

4 03 2012

I’ve been a fan of Lost Highway, by David Lynch for many years. I remember seeing it in the cinema when it first came out and being mesmerised by what I had just seen, although not fully understanding it.

Since then I have watched the film many more times, and last month’s David Lynch retrospective at the BFI recently inspired me to revisit it again.

I’d like to think that I have a pretty good grasp of what the film is about, now, and I get frustrated by all the reviews saying that it is ‘meaningless’ or ‘pure surrealism’, so I thought I’d share my interpretation here. Before I start, I should point out that you should not read ahead if you haven’t seen the film yet – I discuss the full plot of the film here, and my review contains many spoilers.

Right, now that’s out of the way…

In summary, I think it is a film about infidelity and unrequited love, and how they can lead to literal madness. I think it’s a wonderful study of mental anguish, and of dissociation, and personality disorders.

When watching the film, it’s also important to remember that David Lynch is primarily an artist, not a film-maker. He often mixes fantasy and reality, and uses a lot of surreal imagery in his films. Many of his films are wonderful studies of consciousness, dreams, identity, and mindfulness (in fact Lynch runs his own center for transcendental meditation), as well as the primary emotions, including desire, shame, fear, and anger.

Here’s my summary of Lost Highway:

Lost Highway film poster

[At the start of the film a buzzer goes off. A man answers it, and he hears a voice say “Dick Laurent is dead”. Then we hear police sirens in the distance, and the scene fades out.]

We meet our two main characters: Fred Madison and his wife, Renee. They live in a minimalistic, modern house in the Hollywood Hills. Fred is a professional musician and Renee (as we later discover) used to be an actress in the sex industry. Right from the outset, we see that there is a lot of tension in their relationship. They barely speak to each other, and most of the scenes are silent and awkward. One night Fred is preparing to go and play a gig, and Renee says that she’s not going to attend. Fred seems suspicious and asks what she’ll do instead, and the following dialogue occurs:

Renee: “You don’t mind that I’m not coming tonight?”
Fred: “What are you going to do?”
Renee: “Stay home, read.”
Fred: “Read? Read what, Renee?”
Renee laughs.
Fred: “It’s nice to know I can still make you laugh.”
Renee: “I like to laugh, Fred.”
Fred: “That’s why I married you.”

The tension is palpable, and the distrust between them is obvious. Fred is clearly suspicious of Renee. After he comes off stage, Fred calls the house, but nobody answers. We see the phones ringing throughout the house, but nobody is there to pick them up. When Fred gets home later that night, he finds Renee asleep in bed, and seems relieved; momentarily, at least.

It becomes clear that Fred suspects that Renee is cheating on him, and that this is literally driving him crazy. His fear of losing her is so great that it begins to cause him to ‘dissociate’; to split off different aspects of his identity as a means of coping with the trauma, as is common in cases of dissociative identity disorder (DID). During these dissociative episodes he imagines that he is ‘outside of himself’ and is completely unaware of his own actions; almost as if he has blacked out. It is only afterwards that he can remember what happened, by imagining that someone else had videotaped him during that time. Lynch brings these videotapes into the movie as if it they were real objects, but they are metaphorical, and they represent those dissociated parts of Fred’s consciousness; the parts that contain his deepest fears, and which are starting to enter into his daily life as he can no longer push them aside any more.

One night Fred and Renee have sex. It is a frenzied scene, and we see the conflicting emotions in Fred’s eyes as he orgasms, and the emptiness in Renee’s. Fred comes quickly, and as Renee attempts to reassure him, he recounts a dream where he couldn’t find her in the house – he says he saw someone that looked like her, lying in bed, but it wasn’t her. At that moment, the image of a spooky white face suddenly flashes across Renee’s face. This terrifying image represents Fred’s inner demon. The dream suggests that, for Fred, Renee is slowly beginning to represent his inner demon; the source of his deepest fear and rage.

The videotapes start to appear more and more regularly, as Fred is no longer able to prevent these dissociated parts of his consciousness from coming to the surface and entering his daily life. Renee is spooked by them, and they call the police.

Two detectives visit the house, and the following conversation occurs:

Detective: “Do you own a video camera?”
Renee: “Fred hates them.”
Fred: “I like to remember things my own way.”
Detective: “What do you mean by that?”
Fred: “How I remember them… Not necessarily the way they happened.”

This explains why videotapes are such a dangerous metaphor for Fred’s darkest thoughts (and video cameras will later appear as incredibly threatening objects); and why he is struggling so hard to create a coherent narrative for himself. He wants to construct a story that makes sense to him; but which may not necessarily be true.

In one scene we see Fred remembering the night he was on stage at a gig. We see him noticing Renee at the back of the room, and then he sees her leaving through the exit, with a sleazy looking man. He suspects that they might be having an affair.

A couple of scenes later, we see Fred and Renee at a showbiz party at someone else’s house. The camera pans back and suddenly we see the sleazy looking man from the club scene. We learn that his name is Andy, and that he is a ‘friend’ of Renee’s. Renee is drunk and very flirtatious with Andy. They are all over each other. Renee asks Fred to go and get them some drinks. This seems to be the snapping point, which pushes Fred over the edge. He cannot stand it any more. He goes to the bar, and drinks two drinks himself, and then suddenly his inner demon (the spooky white face we saw earlier) appears at the door; his nemesis. The demon approaches, and they talk. This is the first time Fred’s inner demon has ever entered into his waking life. The demon knowingly says “We’ve met before, haven’t we?” and when Fred asks where, he says “At your house” (in a sense, he is saying “I am inside you”). The demon proves his existence via a trick on Fred’s phone, and then leaves.

Fred is understandably distressed by this encounter, and asks Andy who the demon was. Andy says he is a “friend of Dick Laurent’”, which reminds Fred of the very first scene in the film. He looks confused, and the following dialogue takes place:

Fred: “But Dick Laurent is dead, isn’t he?”
Andy, looking angry and threatened: “He is? I didn’t think you knew Dick. How do you know he’s dead?” (The use of the name ‘Dick’ here, and the reminder that ‘Dick is dead’ may also be a reference to Fred’s sexual performance, and his shame from the other night).

Fred is confused and upset and angry, and pulls Renee away from the party. On the way home, he asks her how she met Andy. She says “We met at a place called Moke’s. We became friends. He told me about a job.”. When Fred asks what job it was, Renee simply says she can’t remember; but by this point it’s already too late. Fred is filled with jealousy and rage, and he is convinced that Renee is cheating on him. He can no longer dissociate, or keep it under control. As they approach the house, we see shadows moving indoors. Fred enters the house, and asks Renee to wait outside. He goes into the house and we see him moving amongst the shadows; starting to merge with his dissociative alter-ego.

Renee enters the house, and we later see her calling for him in the darkness. This is the last time we will see her. Later that night (as we will discover through footage from Fred’s ‘videotape memories’) Fred murders her in their bed.

Once out of his dissociative state, Fred has no memory of this afterwards; in fact when the police accuse him of being a murderer, he begs for them to “Tell me I didn’t kill her”. He is sentenced to jail, and execution in the electric chair. In his cell, Fred struggles to make sense of what has happened. He can’t sleep, and suffers from constant headaches. He has short glimpses of memory where he sees what he did to Renee, but still cannot resolve everything in his mind. He needs closure somehow; he needs another chance to make his relationship work, or to understand what went wrong. He has to figure out what happened, and why. He has to know who caused it, and he has to get revenge on those people that corrupted Renee and helped her cheat on him. There is only one way he can do this: by creating an ‘alternate reality’ for himself and entering into a fugue state.

So this is exactly what he does, and from here on everything we see is taking place within Fred’s consciousness, as he attempts to battle his inner demons and make sense of what has happened. Fred imagines himself to be a young man named Pete, and from this point on, we see the movie from this alter-ego’s perspective.

Pete is a young, attractive ladies’ man, who works as a mechanic, and dates a girl named Sheila. Pete ‘appears’ in Fred’s cell, and is set free; with detectives following his movements from a distance. Pete decides to go to work, and here we meet a terrifying character named ‘Mr Eddy’. ‘Mr Eddy’ takes Pete for a ride to fix his car, but whilst they’re out driving someone overtakes them, and ‘Mr Eddy’ rams his car off the road, beats him up, and threatens to kill him. Clearly, ‘Mr Eddy’ is not somebody you should mess with. As they get back to the workshop, the detectives spot them, and identify ‘Mr Eddy’ as Dick Laurent; the man we heard about earlier. Clearly, this man represents the corrupt, dangerous, nasty side of life.

Mr Eddy

The next day, ‘Mr Eddy’ returns with a different car, but this time there’s a woman in it: it’s Renee. Except she has blonde hair, and her name is now ‘Alice’. This is Fred’s way of bringing her back to life; to incorporate her into his fantasy world as some kind of identical twin.

Alice

Pete instantly falls in lust with her, and she seems to feels the same way. Time slows down, and they glance at each other as music plays. Later that night she returns, and asks Pete to accompany her to dinner. Pete hesitates, as he recognises the danger of getting involved with ‘Mr Eddy’s’ girl, but he cannot resist. They go to a motel and have sex. They swap numbers, and start a sexual relationship. They regularly meet in motels and sleep together, and seem to be developing feelings for each other.

Notably, as Pete starts to develop feelings for Alice, reminders of reality start to creep into the fantasy word Fred has constructed in his mind: Pete starts to have headaches, and to become confused about ‘what happened to him’, and there is an occasion where we hear Fred’s sax solo on the radio at the workshop, and Pete quickly has to change it.

One day, Alice tells Pete that they are in danger, and that ‘Mr Eddy’ knows about them. Pete asks what they should do, and she comes up with a plan. She says that she knows a man who “pays girls to party with him” and has a lot of cash. They could kill him and steal the money and run away together. Fred asks Alice how she met this man, and she explains that he works with ‘Mr Eddy’. She reluctantly confesses that she made adult films for them in the past, and explains that their very first meeting was “at a place called Moke’s”. Suddenly it becomes clear that she is talking about Andy. Finally, through Pete, Fred is able to understand the full story of what happened. Pete agrees to Alice’s plan; to kill Andy and run away with her.

But when Pete gets home that night, Sheila is there. She is distraught, and says she knows he is cheating on her. She urges Pete’s parents to tell him something, but they refuse. Finally, she bids him farewell, and says she will never see him again. It’s clear Pete’s time is running short and that his fantasy can’t last forever. Fred needs resolution.

Pete goes into the house and his parents pass him the phone. It’s ‘Mr Eddy’, and he is with Fred’s inner demon; working in cahoots. At this point, the demon still represents Fred’s nemesis, and the source of his darkest fears and deepest anger. Pete talks to the demon, and has the same conversation that Fred has with him at the party. Finally the demon tells him a story:

Demon: “In the East, the far East, when a person is sentenced to death, they’re sent to a place where they can’t escape, never knowing when an executioner may step up behind them and fire a bullet into the back of their head.”

This is of course a thinly-veiled threat against Fred; who already has been sentenced to death, but still awaits the execution itself.

The next day, Pete goes to the address Alice told him about, and murders Andy, as planned. However, what he didn’t expect was to actually have to witness seeing Alice in her adult films. They’re projected onto a wall in the living room, and he cannot avoid them. This is too much for Fred’s psyche to handle, and Pete starts to convulse and bleed. Fred’s fragile alternate reality is falling apart, and suddenly we see a picture, of both Alice and Renee, standing with Andy and ‘Mr Eddy’. Pete asks Alice if they are both her, and she points only at Alice and says “That’s me”; temporarily keeping the narrative of the alternate reality alive. Pete goes upstairs to clean himself up, and when he comes back down there is a short exchange with Alice where she points the gun at him and we once again question whether or not she can be trusted. Finally she hands it to him and suggestively tells him to stick it in his pants.

Alice tells Pete that they must drive out to the desert, to a cabin, so they do. The cabin represents the very heart of Fred’s consciousness.

When they get there, there’s nobody there yet, so they have to wait. Alice seduces Pete, saying: “You still want me, don’t you, Pete”.
“More than ever,” Pete replies, “I want you, I want you.”
Time slows down and they have sex one last time and roll around in the sand. As they finish, Alice towers above Pete, and leans down to whisper into his ear: “You’ll never have me.” Then she gets up and leaves.

Fred’s alternate reality has fallen apart. Even in this fantasy, he couldn’t convince himself that his wife loved him.

There is no need for the alter-ego any more, so Pete has turned back into Fred, and this is who we see stand up, in the middle of the desert. Pete is gone.

Fred walks to the cabin and his inner demon is there, waiting with a video camera; the window into his soul. Fred asks where Alice went and the demon makes it brutally clear: “Alice who? Her name is Renee. If she told you her name is Alice, she’s lying.”

Demon with video camera

Everything is lost. All that is left is for Fred to be executed; but he can still commit one final act of revenge, by joining forces with his inner demon and killing ‘Mr Eddy’. So this is what he decides to do.

He finds ‘Mr Eddy’ in bed with his wife, at the Lost Highway Motel (the ‘Lost Highway’ of the desert represents the journey down deep into his consciousness). He kidnaps ‘Mr Eddy’ and bundles him into the car boot. He drives him out to the desert, and then opens the boot. Suddenly ‘Mr Eddy’ leaps out, and for a moment it seems like Fred will lose the battle, but suddenly someone hands him a knife, and he cuts ‘Mr Eddy’s throat. The camera pans out, and we see that his accomplice is now his inner demon. They have joined forces, and Fred has embraced his innermost fears and rage. ‘Mr Eddy’ dies; one final token act of revenge, and closure for Fred.

We cut to a scene back at Andy’s house, and the detectives are cleaning up the mess. They notice the picture we saw earlier, but this time only Renee is in it. “That’s Fred Madison’s wife with Dick Laurent.” The fantasy world has collapsed.

Finally, all that is left for Fred to do is to run. But he has one last idea; perhaps if he can somehow go back in time, and reassure himself that the evil Dick Laurent has already been dealt with, then maybe he can find happiness with his wife after all? So this is what he does – he flees from the police, and goes right back to the start of the movie; setting a Möbius strip into motion, like a black hole in time.

In the fantasy world, Fred is suddenly submerged by flashing blue lights, and his body starts to shake violently. He screams out. In reality, he is in the electric chair, being electrocuted. These are his final moments.

And that’s the end of the film.

Film stills

Of course, I’m aware that I could be wrong, and that it could all mean something completely different, or even a million different things. But, to me, that’s what makes it such a brilliant piece of art.





Assessing Adult Attachment: A Dynamic-Maturational Approach to Discourse Analysis

10 09 2011

My review of “Assessing Adult Attachment: A Dynamic-Maturational Approach to Discourse Analysis”.

Assessing Adult Attachment front cover

Attachment theory has come a long way since John Bowlby’s paper “Forty-four Juvenile Thieves” was published in 1944. In the paper Bowlby wrote about his work with disturbed youth in London. He theorized for the first time that the nature and security of an individual’s relationships to their primary caregivers during infancy and early childhood equips them with the methods they will use to express their feelings and needs in later life. Those relationships also predict how people will form relationships with significant others during adulthood.

Through further research into Bowlby’s initial ideas – and the invention of the Strange Situation experiment – Mary Ainsworth was able to develop a clear system of classification for this theory, which could be used to identify three unique patterns of attachment: Type A (Avoidant), Type B (Secure), and Type C (Ambivalent).

This rudimentary ABC system has been at the heart of attachment theory since its inception, and has paved the way for a host of psychological texts and theories. Titles such as “Attached” by Dr. Amir Levine and the “Attachment-Focused Family Workbook” by Daniel A. Hughes join countless other attachment-specific books currently on sale, and Dr. Sue Johnson’s research into relationships and subsequent development of her Emotionally Focused Therapy (EFT) program have brought about a revolution in the field of couples therapy. Indeed, a recent issue of the American Association of Marriage and Family Therapy’s ‘Family Therapy Magazine’ was entirely devoted to The Science Of Love, reporting the recent findings of groundbreaking research focused on the understanding of romantic love and adult attachment.

It is clear, therefore, that the ABC classification system of attachment theory has a lot to offer those in the therapeutic field, but it is not without its problems, either. First, it often seems overly simplistic: the classifications can be vague and unreliable, everyone is forced to classify themselves with one of just three basic attachment styles, and there is no option of further classification within each division. Second, it is too limiting: people frequently feel typecast and stuck within one specific attachment style, with no option for change or progress. Third, it is outdated and culturally biased: the system was derived from work in the cognitive sciences in the late 1970s, and based largely on findings from observations of middle-income, low-risk American families. And fourth, it offers very little in terms of a solution: once someone has identified their attachment style, then what?

The main cause of these problems has been the source of the classification data itself: the Adult Attachment Interview (AAI), an interview and coding method developed by Mary Main and Ruth Goldwyn in the 1980s which has been the primary method of collecting and interpreting attachment information ever since. Now, at last, with this book, Crittenden and Landini have provided us with a more up-to-date, efficient and multicultural alternative, which continues to be compatible with the AAI data collection method, but works equally well with other forms of interview, too: their own Dynamic-Maturational Model (DMM) of attachment.

Various theoretical perspectives on attachment can be applied to the interpretation of the AAI. Main and her colleagues developed the AAI based on a version of attachment theory that assumed that (1) by adulthood most adults had a single representation of attachment relationships, (2) this relationship reflected one of the Ainsworth patterns of infant attachment, (3) these patterns were transmitted from mother to child across generations, and (4) frightening circumstances disrupted the organizational process, leading to a state of disorganization in infancy or lack of resolution of the frightening circumstances in adulthood.

In the Dynamic-Maturational Model of attachment and adaptation, none of these four assumptions are made. To the contrary, the DMM approach to attachment theory presumes that adults have multiple dispositional representations, each unique to the information processes underlying it. Second, the array of strategies is developmentally expanded from its roots in infancy, with endangered individuals most often using the later developing and more complex strategies. Third, it is understood that each individual constructs his or her own dispositional representation from his or her own experience. Sometimes this will reflect similarities to the parent’s dispositional representation, but, especially in cases of parental disturbance or inadequacy, children will often organize the opposite strategy from the parent… Finally, exposure to danger is assumed to be the essential condition that elicits attachment behavior, and, across repeated experiences, leads to organized self-protective strategies.

Clearly, the introduction of this model represents a major leap forward in our understanding of attachment and attachment theory, offering a far more detailed and multicultural system of classification than the old ABC model. Over the course of this book, Crittenden and Landini fastidiously lay out a new classification system, with many numeric subdivisions within each individual attachment strategy. In fact, the research is so exhaustive and delivered in such great detail that it seems almost impossible that any clinicians reading this would not recognize each of their clients at least somewhere within the text. The downside to this is that this is not an easy book to read; it is certainly not something you will want to flick through to help you relax at the end of the day. But those who do make their way through the sometimes dense and challenging text will come out feeling incredibly rewarded for their perseverance, armed with a new treatment model for working with their clients and a new understanding of the complexities of adult attachment.

Essentially, what the field of attachment theory has been sorely lacking is its own Diagnostic and Statistical Manual — a modern, flexible, and multicultural tool which will provide practitioners with the common language and standard criteria for the classification of specific attachment styles, and their best-practice solutions. Now, with Crittenden and Landini’s long-awaited book, it finally has it.

Critically, though, this book aims to do much more than serve as just a DSM for attachment theory. As well as a basis for gathering empirical data, the authors provide us with a compassionate new guide for treatment formulation, and there is a chapter – titled ‘But What Shall I Do?’ – dedicated specifically to this cause:

Researchers are happy with a reliable classification, but not so psychotherapists and others who must guide troubled individuals and their families. They need an action plan. In this chapter we describe how one uses an AAI classification, combined with information about the history and current functioning of the speaker and his or her family, to derive a functional formulation. The functional formulation is the professional’s dispositional representation (DR) of the relation between the service structure and the individual and his or her relationships. Like all DRs, a functional formulation is dynamic; it is always changing as new information is integrated into the existing set of information… We describe how to derive functional formulations that can guide treatment both at its onset and, with feedback and updating, across the course of treatment.

Crittenden and Landini then go on to demonstrate exactly how their model can be used as a therapeutic tool, using the initial classification as starting point to guide both the therapist and client toward the resolution of past issues and the reorganization of the thoughts and language that shape both our ideas of self and attachment strategy. Furthermore, this model aims to shift the focus on attachment styles from one of disorder to one of function; from the old deficit-based model to one that is dynamic and optimistic. Rather than an emphasis on diagnosis simply for the sake of identification or labels, the authors stress their hopes that this model might open the doors to new ways of thinking in not just the mental health field, but others as well, concluding that:

When functioning is understood as attempts to protect rather than to damage or harm, alliances between mental health professionals and people in need of care become more likely.

Many say that DMM theory and methods are complex, too complex for working clinicians. After a century of trying to understand and ameliorate mental illness, it seems unlikely that simple theory, simple assessment, and quick manualized treatment will be more successful than our past efforts. It is more likely that theory needs to be sufficiently complex to represent the crucial aspects of the life experiences of people with mental illness. The assessments need to be sensitively attuned to the encrypted communications of very distressed adults, and to be coded by skilled professionals trained to a high level of reliability.

Possibly, the greatest potential of the DMM-AAI is its capacity to focus observation precisely while retaining the openness to expand and change understanding of observations. We hope this book will be used to promote accuracy of observation, clarity of interpretation, and – most important – discovery of new ideas about human adaptation. Psychological tools that yield useful data without restricting thinking are very valuable. The DMM-AAI does more: It opens the door to groundbreaking basic and applied research of as much relevance for the social sciences as for the healing professions.

This is a groundbreaking piece of work, containing a life-span view of adaptation that is both intuitively succinct and simple in structure, yet also completely nuanced in execution. Researchers and clinicians alike will undoubtedly benefit from the wealth of information shared here, and it is a must-have for anyone with an interest in attachment theory, representing a major evolutionary step forward in the field.

5 out of 5 stars.





Saying No To Naked Women

28 05 2011

I thought I would share some of my book reviews on this blog, as they do contain some interesting themes.

I’ll start with my review of “Saying No To Naked Women” by David R. Yale:

Saying No To Naked Women

In the summer of 1974, Jack Derritt leaves the city and all of his material possessions behind and heads out to the Arkansas countryside, to live in a shack and take stock of his life. Tired of meaningless flings and constant feelings of misery and self-doubt, Jack wants to figure out why he’s never been able to find a stable, loving relationship, and why he never feels good enough for anyone. He asks himself: “Why is there a throbbing hurt inside me that never leaves?”

This is the opening to David R. Yale’s “Saying No To Naked Women; the story of one man’s struggle to free himself from porn values and sexual addiction”. With Jack’s story as an example, Yale’s novel shows us how our childhood fears can continue to haunt us as adults, manifesting themselves as self-doubt or insecurity, and preventing us from living fulfilling lives or maintaining loving relationships.

As Jack attempts to settle in his new home, he comes to realize that there is no escape from his inner monologue, which is often delivered in his father’s voice, constantly reminding him what a failure and a disappointment he is.

“I’ll never produce anything worthwhile. No woman will ever want me – once she sees my terrible faults. I’ve managed to fool people, but they’ll see: I don’t know what I’m doing. My father is right. I’m a parasite.”

We learn that Jack’s parents were Orthodox Jews and Marxists, and that Jack was raised in a climate of fear and secrecy, and taught to hide his identity. His parents never told him they loved him; instead they made him feel inadequate, and different from the rest of the world. The legacy of the Rosenbergs hung over his head, as a reminder of what might happen to his family if their religious and political beliefs were discovered. It’s these feelings of fear which continue to haunt Jack as an adult, as he remains convinced that he’ll never meet anyone who could possibly understand or value him for the man he is, and that he must always conceal his true self if he wants to be accepted.

Jack seems trapped in a spiral of loneliness, depression and paranoia, and at times this can be frustrating to read. Yale’s story takes a while to get going, and his pace is slow to start with. He focuses closely on setting the scene and building up the characters, but it is not always clear where this is leading, or to what end. Readers who find themselves struggling through the first half of this book should be encouraged to persevere, as the second half rewards us with plenty of valuable lessons and the denouement contains a powerful and important message. Yale’s prose is engaging and easy to read, and I found myself deeply involved in the story, once I had decided to stick with it, past the uncertain beginning. After around 200 pages, the story finally takes an interesting twist, as the solution to Jack’s torment begins to unfold.

One day, divine intervention strikes: he gets stung by a bee in the woods, and the resulting adrenaline shot sends him into a feverish dream world. In this dream world, Jack is visited by a mystical mentor, in the form of a Chassid, who begins to lead Jack through a number of conversations and sessions of immersion therapy which transform his way of thinking about himself and others.

This exposition is somewhat reminiscent of “A Christmas Carol” by Charles Dickens; just as Scrooge meets the Ghosts of Christmas Past, Present, and Yet To Come, so too must Jack accompany the Chassid on a journey through his childhood, a summary of his present life, and an enactment of what the future might be like if he continues along his current path. Yale’s novel is a Dickensian fairytale for the modern age, demonstrating the ways in which childhood fears and insecurities can leave many men struggling with the porn values and sexual addictions that are so prevalent in society today.

Jack comes to realize that he views sex as a form of validation. He tells the Chassid, “I feel like there’s something wrong with me if I’m not having sex on a regular basis.” The Chassid then helps him see how this is connected to his childhood, and he how can end this cycle:

“Some of your anger was at your Dad for not teaching you how to be a man?”
“Yes.”
“And you turned that anger against women – the more frustrated you got the angrier your fantasies got?”
“Damn! What do I do now?”
“Learn how to communicate your feelings to women.”

The Chassid requests that Jack repeat a mantra: “I define myself. I do not let others define me. I do not let my parents define me.” Through this mantra, Jack begins to understand that his parents do not control him any more, and that he is able to live his own life. He begins to let go of the fear and secrecy he learned as a little boy, and to set himself free of the doubt and anger that have controlled him for so long.

“You must affirm yourself… Every time you think a negative thought about yourself, you have to confront it, and contradict it… You can’t deal with yourself the way your parents treated you. I forbid you! When you find you’re making harsh, critical judgments about yourself, stop! And then affirm yourself.”

Through these teachings, Jack is finally able to forgive his parents for their shortcomings, and to uncover the happiness and confidence he has always longed for. He begins to feel accepted by others, and understands what it takes to have a healthy and fulfilling relationship; knowing that the sexual fantasies and flings of his past were just a repeat of the anger and confusion he felt as a child. Finally, by the time he awakes from the dream world of the fever, Jack has learned to integrate the Chassid’s teachings into himself, as an alternative to the voice of his father, which once ruled his thoughts:

“I’m sure not used to thinking strategically like this. It’s a new experience.”
“Do you like it?”
“It makes me finally feel like I have power over my own life.”
“Even without the Chassid?”
“Yes. But maybe the Chassid has become part of me.”

Yale’s novel teaches us that we must understand, forgive, and honor both ourselves and other people in order to find happiness, and that, instead of holding on to our anger, living well is often the best revenge of all. Jack’s story is one that many men will be able to relate to, and the teachings of the Chassid will no doubt resonate with them, too.

One criticism I have, though, is that the book seems unsure of its audience. As a fictional novel about a man setting off into the wilderness to reflect on his life, the book might initially seem to fit alongside classics such as Thoreau’s “Walden”, Kerouac’s “Lonesome Traveler”, Pirsig’s “Zen and the Art Of Motorcycle Maintenance”, and Krakauer’s “Into The Wild”. However, what separates this book from those (including its misleading title) is the suggestion that it is some kind of self-help manual. The back cover suggests that this book “unlocks invisible behavior patterns you must understand to solve personal troubles and identify problem people”, and this certainly seems a little far-fetched.

As a systemic marriage and family therapist, I enjoyed reading about the Chassid’s immersion therapy techniques, and recognized the narrative therapy methods employed to help Jack re-write his own story and take control of his life. I’m sure many readers will benefit from Yale’s suggestions of how to find happiness and overcome the demons of the past. But, while these techniques may work well for some, suggesting that this book could serve as a universal guide to love and happiness seems a little extreme. Those who are simply looking for an engaging fairytale about a man in the wild, on a journey to self-fulfillment, will find that this is a story worth reading. It won’t appeal to everyone, but this is a worthy book, and one that should be recommended to anyone struggling to find love as a consequence of painful childhood experiences.

3 out of 5 stars.

In addition to my review, I’d like to add that I agree with Dr Thaddeus Birchard, an expert in sexual compulsivity and addiction, who states that “sexual addiction, like any addictive substance or process, is a response to the pain and distress of narcissistic damage. All addictions have a common underlying psychobiological process. I think of narcissistic damage as the outcome of a disturbance in attachment. The function of an addiction is therefore to anaesthetize the subjective distress created by the narcissistic damage.”

In other words, sexual addiction often forms as a means by which to avoid dealing with the pain that is caused by attachment injuries from the past. And it is only by identifying and resolving these injuries -through successful therapy sessions – that the addiction can be truly cured.

If you currently suffer from sexual addiction – or are in a relationship with someone who you suspect may be a sex addict – I can help you with these issues. Don’t wait for that change – make it happen now!