Post Incarceration Syndrome (PICS) and Relapse

July 29, 2016

By Terence T. GorskiThe Post Incarceration Syndrome (PICS) is a serious problem that contributes to relapse in addicted and mentally ill offenders who are released from correctional institutions. Currently 60% of prisoners have been in prison before and there is growing evidence that the Post Incarceration Syndrome (PICS) is a contributing factor to this high rate of recidivism. [i]
The concept of a post incarceration syndrome (PICS) has emerged from clinical consultation work with criminal justice system rehabilitation programs working with currently incarcerated prisoners and with addiction treatment programs and community mental health centers working with recently released prisoners.

This article will provide an operational definition of the Post Incarceration Syndrome (PICS), describe the common symptoms, recommend approaches to diagnosis and treatment, explore the implications of this serious new syndrome for community safety, and discuss the need for political action to reduce the number of prisoners and assure more humane treatment within our prisons, jails, and correctional institutions as a means of prevention. It is my hope that this initial formulation of a PICS Syndrome will encourage researchers to develop objective testing tools and formal studies to add to our understanding of the problems encountered by released inmates that influence recovery and relapse.

Post Incarceration Syndrome (PICS) – Operational Definition

The Post Incarceration Syndrome (PICS) is a set of symptoms that are present in many currently incarcerated and recently released prisoners that are caused by being subjected to prolonged incarceration in environments of punishment with few opportunities for education, job training, or rehabilitation. The symptoms are most severe in prisoners subjected to prolonged solitary confinement and severe institutional abuse.

The severity of symptoms is related to the level of coping skills prior to incarceration, the length of incarceration, the restrictiveness of the incarceration environment, the number and severity of institutional episodes of abuse, the number and duration of episodes of solitary confinement, and the degree of involvement in educational, vocational, and rehabilitation programs.

The Post Incarceration Syndrome (PICS) is a mixed mental disorders with four clusters of symptoms:

(1) Institutionalized Personality Traits resulting from the common deprivations of incarceration, a chronic state of learned helplessness in the face of prison authorities, and antisocial defenses in dealing with a predatory inmate milieu,

(2) Post Traumatic Stress Disorder (PTSD) from both pre-incarceration trauma and trauma experienced within the institution,

(3) Antisocial Personality Traits (ASPT) developed as a coping response to institutional abuse and a predatory prisoner milieu, and

(4) Social-Sensory Deprivation Syndrome caused by prolonged exposure to solitary confinement that radically restricts social contact and sensory stimulation. 

(5) Substance Use Disorders caused by the use of alcohol and other drugs to manage or escape the PICS symptoms.

PICS often coexists with substance use disorders and a variety of affective and personality disorders.

Symptoms of the Post Incarceration Syndrome (PICS)

Below is a more detailed description of four clusters of symptoms of Post Incarceration Syndrome (PICS):

1. Institutionalized Personality Traits

Institutionalized Personality Traits are caused by living in an oppressive environment that demands: passive compliance to the demands of authority figures, passive acceptance of severely restricted acts of daily living, the repression of personal lifestyle preferences, the elimination of critical thinking and individual decision making, and internalized acceptance of severe restrictions on the honest self-expression thoughts and feelings.

2. Post Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder (PTSD) [ii] is caused by both traumatic experiences before incarceration and institutional abuse during incarceration that includes the six clusters of symptoms: (1) intrusive memories and flashbacks to episodes of severe institutional abuse; (2) intense psychological distress and physiological reactivity when exposed to cues triggering memories of the institutional abuse; (3) episodes of dissociation, emotional numbing, and restricted affect; (4) chronic problems with mental functioning that include irritability, outbursts of anger, difficulty concentrating, sleep disturbances, and an exaggerated startle response. (5) persistent avoidance of anything that would trigger memories of the traumatic events; (6) hypervigilance, generalized paranoia, and reduced capacity to trust caused by constant fear of abuse from both correctional staff and other inmates that can be generalized to others after release.,

3. Antisocial Personality Traits

Antisocial Personality Traits [iii] [iv] [v]are developed both from preexisting symptoms and symptoms developed during incarceration as an institutional coping skill and psychological defense mechanism. The primary antisocial personality traits involve the tendency to challenge authority, break rules, and victimize others. In patients with PICS these tendencies are veiled by the passive aggressive style that is part of the institutionalized personality. Patients with PICS tend to be duplicitous, acting in a compliant and passive aggressive manner with therapists and other perceived authority figures while being capable of direct threatening and aggressive behavior when alone with peers outside of the perceived control of those in authority. This is a direct result of the internalized coping behavior required to survive in a harshly punitive correctional institution that has two set of survival rules: passive aggression with the guards, and actively aggressive with predatory inmates.

4. Social-Sensory Deprivation Syndrome:

The Social-Sensory Deprivation Syndrome [vi] is caused by the effects of prolonged solitary confinement that imposes both social isolation and sensory deprivation. These symptoms include severe chronic headaches, developmental regression, impaired impulse control, dissociation, inability to concentrate, repressed rage, inability to control primitive drives and instincts, inability to plan beyond the moment, inability to anticipate logical consequences of behavior, out of control obsessive thinking, and borderline personality traits. 

5. Reactive Substance Use Disorders

Many inmates who experience PICS suffer from the symptoms of substance use disorders [vii]. Many of these inmates were addicted prior to incarceration, did not receive treatment during their imprisonment, and continued their addiction by securing drugs on the prison black market. Others developed their addiction in prison in an effort to cope with the PICS symptoms and the conditions causing them. Others relapse to substance abuse or develop substance use disorders as a result of using alcohol or other drugs in an effort to cope with PICS symptoms upon release from prison.

PICS Symptoms Severity

The syndrome is most severe in prisoners incarcerated for longer than one year in a punishment oriented environment, who have experienced multiple episodes of institutional abuse, who have had little or no access to education, vocational training, or rehabilitation, who have been subjected to 30 days or longer in solitary confinement, and who have experienced frequent and severe episodes of trauma as a result of institutional abuse. 

The syndrome is least severe in prisoners incarcerated for shorter periods of time in rehabilitation oriented programs, who have reasonable access to educational and vocational training, and who have not been subjected to solitary confinement, and who have not experienced frequent or severe episodes of institutional abuse.

Reasons To Be Concerned About PICS

There is good reason to be concerned because about 40% of the total incarcerated population (currently 700,000 prisoners and growing) are released each year. The number of prisoners being deprived of rehabilitation services, experiencing severely restrictive daily routines, being held in solitary confinement for prolonged periods of time, or being abused by other inmates or correctional staff is increasing. [viii]

The effect of releasing this number of prisoners with psychiatric damage from prolonged incarceration can have a number of devastating impacts upon American society including the further devastation of inner city communities and the destabilization of blue-collar and middle class districts unable to reabsorb returning prisoners who are less likely to get jobs, more likely to commit crimes, more likely to disrupt families. This could turn many currently struggling lower middle class areas into slums. [ix]

As more prisoners are returned to the community, behavioral health providers can expect to see increases in patients admitted with the Post Incarceration Syndrome and related substance use, mental, and personality disorders. The national network of Community Mental health and Addiction treatment Programs need to begin now to prepare their staff to identify and provide appropriate treatment for this new type of client.

The nation’s treatment providers, especially addiction treatment programs and community mental health centers, are already experiencing a growing number of clients experiencing the Post Incarceration Syndrome (PICS). This increase is due to a number of factors including: the increasing size of the prisoner population, the increasing use of restrictive and punishing institutional practices, the reduction of access to education, vocational training, and rehabilitation programs; the increasing use of solitary confinement and the growing number of maximum security and super-max type prison and jails. 

Both the number of clients suffering from PICS and the average severity of symptoms is expected to increase over the next decade. In 1995 there were 463,284 prisoners released back to the community. Based upon conservative projections in the growth of the prisoner population it is projected that in the year 2000 there will be 660,000 prisoners returned to the community, in the year 2005 there will 887,000 prisoners returned to the community, and in the year 2010 1.2 million prisoners will be released. [x] The prediction of greater symptom severity is based upon the growing trend toward longer periods of incarceration, more restrictive and punitive conditions in correctional institutions, decreasing access to education, vocational training, and rehabilitation, and the increasing use solitary confinement as a tool for reducing the cost of prisoner management.

Clients with PICS are at a high risk for developing substance dependence, relapsing to substance use if they were previously addicted, relapsing to active mental illness if they were previously mentally ill, and returning to a life of aggression, violence, and crime. They are also at high risk of chronic unemployment and homelessness.

Post Release Symptom Progression

This is because released prisoners experiencing PICS tend to experience a six stage post release symptom progression leading to recidivism and often are not qualified for social benefits needed to secure addiction, mental health, and occupation training services. 

· Stage 1 of this Post Release Syndrome is marked by Helplessness and hopelessness due to inability to develop a plan for community reentry, often complicated by the inability to secure funding for treatment or job training; 

· Stage 2 is marked by an intense immobilizing fear; 

· Stage 3 is marked by the emergence of intense free-floating anger and rage and the emergence of flashbacks and other symptoms of PTSD; 

· Stage 4 is marked by a tendency toward impulse violence upon minimal provocation; 

· Stage 5 is marked by an effort to avoid violence by severe isolation to avoid the triggers of violence; 

· Stage 6 is marked by the intensification of flashbacks, nightmares, sleep impairments, and impulse control problems caused by self-imposed isolation. This leads to acting out behaviors, aggression, violence, and crime, which in turn sets the stages for arrest and incarceration.

Currently 60% of prisoners have been in prison before and there is growing evidence that the Post Incarceration Syndrome (PICS) is a contributing factor to this high rate of recidivism.

Reducing The Incidence Of PICS

Since PICS is created by criminal justice system policy and programming in our well intentioned but misguided attempt to stop crime, the epidemic can be prevented and public safety protected by changing the public policies that call for incarcerating more people, for longer periods of time, for less severe offenses, in more punitive environments that emphasize the use of solitary confinement, that eliminate or severely restrict prisoner access to educational, vocational, and rehabilitation programs while incarcerated. 

The political antidote for PICS is to implement public policies that: 

(1) Fund the training and expansion of community based addiction and mental health programs staffed by professionals trained to meet the needs of criminal justice system clients diverted into treatment by court programs and released back to the community after incarceration; 

(2) Expand the role of drug and mental health courts that promote treatment alternatives to incarceration;

(3) Convert 80% of our federal, state, and county correctional facilities into rehabilitation programs with daily involvement in educational, vocational, and rehabilitation programs; 

(4) Eliminate required long mandated minimum sentences; 

(5) Institute universal prerelease programs for all offenders with the goal of preparing them to transition into community based addiction and mental health programs;

(6) Assuring that all released prisoners have access to publicly funded programs for addiction and mental health treatment upon release.

[i] Ditton, Paula M. Mental Health and Treatment of Inmates and Probationers, Bureau of Justice Statistics, July 11, 1999 (NCJ-174463), (http://www.ojp.usdoj.gov/bjs/)

[ii] American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM IV), Fourth Edition, 1994 (Pg 424 – 429)

[iii] American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM IV), Fourth Edition, 1994 (Pg 645 – 650)

[iv] Forrest, Gary G., Chemical Dependency and antisocial Personality Disorder – Psychotherapy and Assessment Strategies, The Hawthorn Press, New York, April 1994

[v] Hempphill, James F.; Templeman, Ron; Wong, Stephen; and Hare, Robert D. Psychopathy and Crime: Recidivism and Criminal Careers. IN: Cooke, David J.; Forth, Adelle E., and Hare, Robert D. ED: Psychopathy: Theory, Research, and implications for Society, Kluwar Academic Publishers, Boston, 1995

[vi] Grassian, Stuart, Psychopathological effects of solitary confinement, American Journal of Psychiatry, 140, 1450 – 1454 (1983)]

[vii] American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM IV), Fourth Edition, 1994 (Pg 175 – 272)

[viii] Ditton, Paula M. Mental Health and Treatment of Inmates and Probationers, Bureau of Justice Statistics, July 11, 1999 (NCJ-174463), (http://www.ojp.usdoj.gov/bjs/)

[ix] Sabol, William, Urban Institute, Washington DC

[x] Abramsky, Sasha, When They Get Out, Atlantic Monthly, June, 1999 p. 30


Spirituality In Recovery 

July 25, 2016


By Terence T. Gorski
GORSKI-CENAPS Web Publications 

(www.relapse.org)

May 6, 2001

Defining Spirituality
There is a relationship between spirituality and relapse. To understand it, we must first define spirituality. People have both physical characteristics, determined by the structure and actions of their bodies, and non-physical characteristics, determined by the structure and actions of their minds. These non-physical or spiritual characteristics include the ability to perceive, think, feel, act, and assign meaning and purpose to life. 

Human beings not only think and feel, but they are conscious of the fact that they do so. This individual consciousness creates a core personal identity that moves beyond physical existence into a complex world of ideas and images. This personal consciousness drives people to find meaning and purpose in human existence.

This desire for a sense of meaning that transcends the physical has led many recovering people to a search for the laws or organizing principles of the non-physical dimension of human existence. They believe that human existence is ruled by laws, or organizing principles. The physical world is governed by physical laws. The non-physical world is governed by mental and spiritual laws. People who live in accordance with these universal laws find peace and serenity in life. They discover a sense of meaning and purpose in their sobriety. Those who violate these universal principles, either through ignorance or intent, experience inner pain, turmoil, and frustration. They become disillusioned in recovery and many relapse to chemical use to medicate the pain.

Mystical & Non-mystical Spirituality

There are two different ways of thinking about human spirituality. Mystical spirituality is based upon the belief that there is a spiritual world inhabited by a Higher Power or God. The meaning and purpose of life, according to mystical spirituality, can only be found through a conscious relationship with this spiritual Higher Power who reveals information not available through our ordinary senses or intelligence. The ultimate goal of mystical spirituality, therefore, is to establish a personal relationship with God, and to seek knowledge of his will and the courage to carry that out.

Non-mystical spirituality recognizes that human beings exist not only in the physical world, but also in a unique world of ideas, thoughts, feelings, and fantasies that transcends physical limitations. In this sense the word spiritual can be used interchangeably with the word psychological. Non-mystical spirituality, like psychology, is directed at learning to effectively use human mental powers to find meaning and purpose in life. The spiritual life is based upon developing these mental and emotional abilities. Non-mystical spirituality, however, believes that human beings can discover basic spiritual truths thorough the use of their senses and intellect. They do not rely upon divine revelation, but look to human reason to find the answers to sobriety.

Mystical and non-mystical spirituality are not mutually exclusive. 

Many recovering people have a mixed spiritual system. In the mystical sense, they seek to develop a personal relationship with the God of their understanding and pray to discover what God’s will is for them. In a non-mystical sense, they actively work at psychological growth. They believe this mixture of the mystical and non-mystical captures the principle of “turning it over, but doing the leg work”. Mystical spirituality allows them to turn over some aspects of their human experience to the care of a Higher Power. Non-mystical spirituality allows them to “do the leg work” by taking responsibility for personal growth and change.

Relapse & The Extremes of Mystical Spirituality

Extreme and rigid views of spirituality can result in relapse. Many people relapse because they believe that the mystical god of their understanding will somehow magically save them from their problems. They abdicate personal responsibility and expect God to take care of everything. When God doesn’t, they sink into a deep existential depression and say, “Since God won’t fix my life, I might as well get drunk.”

An example of this is the man who turned $60,000 worth of debt incurred from his cocaine addiction over to his higher power. He was absolutely shocked when his higher power turned his debts over to a collection agency. 

Another man, who was divorced shortly after getting sober, looked to God to clean up his apartment. He was disappointed when God wouldn’t do it. Upon spiritual reflection the man concluded that since God wouldn’t clean his apartment, it must be God’s will for him to live in the mess. Shortly afterwards he got drunk.

Relapse & The Extremes of Non-mystical Spirituality 

Other people relapse because they cannot find a higher power to believe in. Some of these people are overwhelmed with such intense shame and guilt that they can’t believe God or any other higher power is available to them. Others are locked into grandiosity. They see themselves as bigger, strong, and smarter than anyone or anything else in the universe. When they encounter overwhelming problems they feel cut off from all sources of courage strength and hope. They often become disillusioned and relapse to chemical use.

Most people who succeed in recovery have organized their sobriety around a source of meaning and purpose that is greater than themselves. Most practice the mixed system of spirituality described in the serenity prayer. The Serenity Prayer is “God grant me the serenity to accept the things I can, God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference”.

 People who live in accordance with these spiritual principles recognize that there are things that they can and must change if they are to stay sober, and they seek the courage to make those changes. They also recognize that there are other things that are beyond their control. They turn these things over to a Higher Power. They have faith that there is someone or something bigger, stronger and more powerful than they that will take care of the things that they can’t manage. As a result, they can comfortably let go of the things that they cannot manage and invest their energies in taking care of things that are within their power.

Recovery & A Balanced Sense Of Spirituality

People who stay sober are able to transform themselves by surrendering their narrow, addictive world view and embracing a broader and more effective sobriety-based world view. This transformation is a spiritual process, though not necessarily a mystical one. It is a consciousness expanding experience that requires a belief that there is someone or something more powerful than I am. It requires a willingness to believe in a seek out that source of power, to ask for help, and ultimately to follow directions. 

Recovering people need to find a source of courage and strength that can overcome frustration, transform despair into hope, and motivate them to move ahead in the sober life. Some recovering people find this in a mystical higher power that many call God. Others find it in the mysterious power present in their group conscience. Still others find it in a higher value system that replaces addictive thinking with rationality and reason.

People who maintain sobriety learn that they are responsible for themselves. They internalize the AA principle of “easy does it, but do it.” They realize that they need to identify the next little thing they have to do to stay sober, and do it. In essence, they realize that they are responsible for whether or not they take the next drink or the next drug. They recognize that they must learn how to look within themselves and find the source of courage, strength, and hope needed to stay sober. Ultimately, they are responsible for rebuilding their lives and finding meaning and purpose in sobriety.

The Spiritual Paradox of Recovery

This is the paradox of recovery. We cannot do it alone, but yet we must do it by ourselves. We cannot expect God or a higher power to do what we are able to do for ourselves, but yet we cannot do it for ourselves without somehow touching a source of courage and strength that exceeds our own abilities. And here seems to be the ultimate spiritual principle that allows alcoholics to avoid relapse and move ahead in recovery. It is a philosophy of balance. It is the ability to recognize and affirm the quality of physical existence, to learn how the physical world operates and operate within the limits of its laws and imperatives. It is also the willingness to affirm the world of ideas, thoughts, and images. It is the ability to learn to turn within and find a creative spark of life, a creative spiritual energy that will allow us to go on and find solutions when none seem available. The balance of these two worlds, the world of physical reality, and the world of ideas where the ultimate spiritual reality exists, allow people to forge a strong and powerful sobriety.


Spin – The Art of Political Lying

July 20, 2016


By Terence T. Gorski

Here is how Wilipedia defines and describes SPIN: 

Spin is propaganda or presenting lies to the public as the truth. The term, “plausible deniability” actual means to protect politicians from the consequences of getting caught in a lie. 

In public relations, Spin is a form of propaganda, achieved through providing a biased interpretation of an event or campaigning to persuade public opinion in favor or against some organization or public figure. 

While traditional public relations may also rely on creative presentation of the facts, “spin” often implies the use of disingenuous, deceptive, and highly manipulative tactics.[1]

Politicians are often accused by their opponents of claiming to be truthful and seek the truth while using spin tactics to manipulate public opinion. Large corporations with sophisticated public relations branches also engage in “spinning” information or events in their favor. 

Because of the frequent association between spin and press conferences (especially government press conferences), the room in which these take place is sometimes described as a spin room.

Public relations advisors, pollsters and media consultants who develop spin may be referred to as “spin doctors” or “spinmeisters” who manipulate the truth and create a biased interpretation of events for the person or group that hired them.
The term has its origin in the old American expression “to spin a yarn”. 

Sailors were known for using their spare time on board making thread or string (yarn) and also for telling incredible tales when they were on shore. 

When someone fooled you, it was said that “he spun me an amazing yarn”. Yarn also became a synonym for “tall tale” – “What a yarn!”, means “what a lie”. 

A coarser and more contemporary version of this expression is “bullshit”, and, for anyone who seeks to deceive, “bullshit artist”. 
History of Spin

Edward Bernays has been called the “Father of Public Relations”. As Larry Tye describes in his book The Father of Spin: Edward L. Bernays and The Birth of Public Relations, Bernays was able to help tobacco and alcohol companies use techniques to make certain behaviors more socially acceptable in the 20th-century United States. Tye claims that Bernays was proud of his work as a propagandist. 

As information technology has increased dramatically since the end of the 20th century, commentators like Joe Trippi have advanced the theory that modern Internet activism spells the end for political spin. By providing immediate counterpoint to every point a “spin doctor” can come up with, this theory suggests, the omnipresence of the Internet in some societies will inevitably lead to a reduction in the effectiveness of spin.[4]
The techniques of spin include:
Selectively presenting facts and quotes that support one’s position (cherry picking). For example, a pharmaceutical company could pick and choose trials where their product shows a positive effect, ignoring the unsuccessful trials, or a politician’s staff could handpick speech quotations from past years which appear to show her support for a certain position)

  • Non-denial denial
  • Non-apology apology
  • Politically-correct deception
  • Making misinformation (deliberate lies) seem like the truth 

“Mistakes were made” is an expression that is commonly used as a rhetorical device, whereby a speaker acknowledges that a situation was managed by using low-quality or inappropriate handling but seeks to evade any direct admission or accusation of responsibility by not specifying the person who made the mistakes. The acknowledgement of “mistakes” is framed in an abstract sense, with no direct reference to who made the mistakes and what exactly the mistakes were. The ultimate mistake, of course, is to get caught in the lie. 

A less evasive construction might be along the lines of “I made mistakes” or “John Doe made mistakes.” The speaker neither accepts personal responsibility nor accuses anyone else. The word “mistakes” also does not imply intent.
Phrasing in a way that assumes unproven truths, or avoiding the question[5]

“Burying bad news”: announcing unpopular things at a time when it is believed that the media will focus on other news. In some cases, governments have released potentially controversial reports on summer long weekends, to avoid significant news coverage. Sometimes that other news is supplied by deliberately announcing popular items at the same time.

Spin includes the art of misdirection and diversion[6]

For years businesses have used fake or misleading customer testimonials by editing/spinning customers to reflect a much more satisfied experience than was actually the case. In 2009 the Federal Trade Commission updated their laws to include measures to prohibit this type of “spinning” and have been enforcing these laws as of late. 

Additionally, over the past 5 to 6 years several companies have arisen that verify the authenticity of the testimonials businesses present on the marketing materials in an effort to convince one to become a customer.

https://en.m.wikipedia.org/wiki/Spin_(propaganda) 

GORSKI BOOKS: www.relapse.org


What Makes Us Stronger

July 7, 2016


By Terence T. Gorski

What Makes Us Stronger? Why is that question important?
The German philosopher, Friedrich Nietzsche believed this simple principle:

“That which does not kill us, makes us stronger.”

The principle is correct on many levels. It eloquently states Nietzsche’s “superman hypothesis” which proposed that it is best for people to be determined, strong and merciless so that human empathy and compassion did not interfere with people living their lives or supporting their collective causes.

This philosophy of Nietzsche was embraced by Hitler and integrated at the core of the education and training to be a NAZIS.

I believe that ideas have powerful personal and collective consequences. Either for good or evil. The more eloquently and memorably an idea is crafted the more effective it is. Ideologies that are brief, easy to remember and repeat to others are most effective. These brief compelling descriptions of ideologies take on a life of their own as they spread from mind to mind.

I try to be careful about the ideologies I embrace and promote because I realize a well-crafted idea is more powerful than a loaded gun.

Like a virus, once an idea or ideology is released to other minds it spreads and is very difficult to stop.

GORSKI-BOOKS: www.relapse.org


The Death Bed

May 9, 2016

By Siegfried Sassoon
He drowsed and was aware of silence heaped 

Round him, unshaken as the steadfast walls; 

Aqueous like floating rays of amber light, 

Soaring and quivering in the wings of sleep.

Silence and safety; and his mortal shore 

Lipped by the inward, moonless waves of death. 

 

Someone was holding water to his mouth. 

He swallowed, unresisting; moaned and dropped 

Through crimson gloom to darkness; and forgot 

The opiate throb and ache that was his wound. 

Water—calm, sliding green above the weir; 

Water—a sky-lit alley for his boat, 

Bird-voiced, and bordered with reflected flowers 

And shaken hues of summer: drifting down, 

He dipped contented oars, and sighed, and slept. 

 

Night, with a gust of wind, was in the ward, 

Blowing the curtain to a gummering curve. 

Night. He was blind; he could not see the stars 

Glinting among the wraiths of wandering cloud; 

Queer blots of colour, purple, scarlet, green, 

Flickered and faded in his drowning eyes. 

 

Rain—he could hear it rustling through the dark; 

Fragrance and passionless music woven as one; 

Warm rain on drooping roses; pattering showers 

That soak the woods; not the harsh rain that sweeps 

Behind the thunder, but a trickling peace, 

Gently and slowly washing life away. 

He stirred, shifting his body; then the pain 

Leaped like a prowling beast, and gripped and tore 

His groping dreams with grinding claws and fangs. 

But someone was beside him; soon he lay 

Shuddering because that evil thing had passed. 

And death, who’d stepped toward him, paused and stared. 

Light many lamps and gather round his bed. 

Lend him your eyes, warm blood, and will to live. 

Speak to him; rouse him; you may save him yet. 

He’s young; he hated war; how should he die 

When cruel old campaigners win safe through? 

But death replied: “I choose him.” So he went, 

And there was silence in the summer night; 

Silence and safety; and the veils of sleep. 

Then, far away, the thudding of the guns.
Source: The Old Huntsman and Other Poems (1917)


GORSKI ADDICTION MODEL

April 26, 2016

  The Gorski Comprehensive Addiction Model is a a science-based system that incorporates both chemical and behavioral addictions in a comprehensive biopsychosocial perspective. 

THE HUMAN CONDITION: The Gorski Model builds upon a recognition that all addiction is based within the human condition. The human condition is organized and directed by the CORE HUMAN PROCESSES OF PERSONALITY

DEVELOPMENT. The human process begins with an intangible but self-evident primal life force which motivates human beings to survive and thrive in the physical world. The frustration resulting from the collision of the infinite potential of the human spirit with the finite limitation of the physical world results in ANGST, the normal pain of life and living. ANGST is managed by people in one of three ways: DENIAL, it doesn’t exist – everything is beautiful;

DEMORALIZATION, since life hurts I will just give up and stop trying; or MOTIVATION, in spite of the psi of living there is a counterbalancing joy in living that makes it worth while. Motivated people to STRIVE to find safety, security, excitement, and accomplishment in an often difficult and hostile world. They maintain their motivation because of the capacity human beings have for with PASSION. With maturity passion becomes focused into psychological and spiritual practices that help people find peace, serenity, and security without the constant need to strive, perform, and produce.

Many people find that a state of euphoria induced by the addictive use of alcohol and other drugs can give them short term relief from the angst of life. Unfortunately, people who experience this addictive brain response are at high risk of developing addiction. The addictive release leads to obsession I have intrusive thoughts about how good the euphoric response felt. I feel a COMPULSION to repeat the experience.

As the compulsion becomes stronger it turns into CRAVING which turns wanting the addictive release into the need for the addictive release. This creates a self reinforcing pattern of addictive use which is called ADDICTION, which is marked a compulsive pattern of DRUG SEEKING BEHAVIOR.

Over time, the cycle can be described as a EUPHORIC RESPONSE to addictive use, a DYSPHORIC RESPONSE to abstinence, a CRAVING or perceived need to use, DEPENDENCE or being unable to function normally without addictive use, and TOLERANCE the need to use more in order to get the same level of euphoria.

Once the ADDICTION CYCLE BEGINS, addictive THOUGHTS, FEELINGS, URGES, and ACTIONS become engrained in automatic and unconscious habits. These habits attract people who support the addictive way of life or are willing to become committed to enabling it.

These Social and Cultural Reactions to addiction create a permissive environment for early stage addiction when addictive use makes people feel good and be more productive and stigma reaction when people lose control and begin stepping outside of social, cultural and legal limits.

This is all part of the addiction, which is a health crd problem that is best dealt with using a Public health Addiction Policy:

(1) TOXIC SUBSTANCE: Identifying the toxic substances causing the illness;

(2) VULNERABLE HOST: Identifying the people who are predisposed to addiction); and

(3) PERMISSIVE ENVIRONMENT: Changing the societal and cultural norms that make ready access to and heavy regular use of the toxic substances and behaviors socially, culturally, and personally unacceptable.

Gorski Books: http://www.relapse.org

Gorski Training: http://www.cenaps.com 

Gorski On Facebook: http://www.facebook.com/gorskirecovery

LIVE SOBER – BE RESPONSIBLE – LIVE FREE

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Young In Spirit

February 4, 2016

When I was young I felt all-powerful. There was nothing that I could not do. When I walked the earth shook beneath my feet. When I ran, the world turned a little bit faster. I am still young in spirit. It’s just that my body doesn’t always cooperate.   
 


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