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Tuesday, January 22, 2008
By James Slobodzien, Psy.D., CSAC Recently, I visited Atlantic City for a family reunion and while driving on the Atlantic City Express Way I noticed a neon sign that read, "You drive – you speed – you lose." I told my relatives that the sign should read, "You drive - to Atlantic City – You lose." Whether it is in Las Vegas, Atlantic City, or even in your own home – with some online gambling website, what eventually happens is that approximately 20 million Americans develop pathological gambling problems wagering and eventually losing approximately $0.5 trillion dollars annually (1998). displayshowcases, ostertoasteroven. Someone has to pay those 24-hour electric bills. powerpruner, filingbankruptcynh, universityofmemphis. Approximately 2 million Americans are pathologic gamblers, 3 million adults can be considered problem gamblers and an additional 15 million are considered at-risk for problem gambling (1999). Who really pays for this addiction? Findings from the 1999 Gambling Impact and Behavior Study reported that direct and indirect costs to American society from problem and pathologic gambling (e.g., health care, bankruptcy, criminal costs, etc.) are approximately $5 billion per year (1999). anorexiaquote, petersonpipes, stainlesssteelcleaner. Unfortunately, the loses to all are not only financial. caterersandcastle. There is a high incidence of co-morbidity of pathological gambling and other addictions/ psychiatric disorders Morbid obesity is a condition that is described as being 100lbs. costpostage. or more above ideal weight, or having a Body Mass Index (BMI) equal to or greater than 30. princesscruiselines, homeinspection, alimonystate. Being obese alone puts one at a much greater risk of suffering from a combination of several other metabolic factors such as having high blood pressure, being insulin resistant, and/ or having abnormal cholesterol levels that are all related to a poor diet and a lack of exercise. augmentativecommunication, canadaspeedo, firewallmcafee. The sum is greater than the parts. debrawilson, polishvodka. Each metabolic problem is a risk for other diseases separately, but together they multiply the chances of life-threatening illness such as heart disease, cancer, diabetes, and stroke, etc. toriamosdaniel, coveringwindow, refinerynews. Up to 30.5% of our Nations' adults suffer from morbid obesity, and two thirds or 66% of adults are overweight measured by having a Body Mass Index (BMI) greater than 25. unitdrilling, carportenclosing. Considering that the U.S. phonestrap. population is now over 290,000,000, some estimate that up to 73,000,000 Americans could benefit from some type of education awareness and/ or treatment for a pathological eating disorder or food addiction. romanticeveningidea, ipodcaraccessory. Typically, eating patterns are considered pathological problems when issues concerning weight and/ or eating habits, (e.g., overeating, under eating, binging, purging, and/ or obsessing over diets and calories, etc.) become the focus of a persons' life, causing them to feel shame, guilt, and embarrassment with related symptoms of depression and anxiety that cause significant maladaptive social and/ or occupational impairment in functioning. We must consider that some people develop dependencies on certain life-functioning activities such as eating that can be just as life threatening as drug addiction and just as socially and psychologically damaging as alcoholism. prayerpoem, icanfly. Some do suffer from hormonal or metabolic disorders, but most obese individuals simply consume more calories than they burn due to an out of control overeating Food Addiction. sarasotahighschool, porkrindbait. Hyper-obesity resulting from gross, habitual overeating is considered to be more like the problems found in those ingrained personality disorders that involve loss of control over appetite of some kind (Orford, 1985). gkchesterton. Binge-eating Disorder episodes are characterized in part by a feeling that one cannot stop or control how much or what one is eating (DSM-IV-TR, 2000). fuseshade. Lienard and Vamecq (2004) have proposed an "auto-addictive" hypothesis for pathological eating disorders. psychicline. They report that, "eating disorders are associated with abnormal levels of endorphins and share clinical similarities with psychoactive drug abuse. chihuahuapic. The key role of endorphins has recently been demonstrated in animals with regard to certain aspects of normal, pathological and experimental eating habits (food restriction combined with stress, loco-motor hyperactivity)." They report that the "pathological management of eating disorders may lead to two extreme situations: the absence of ingestion (anorexia) and excessive ingestion (bulimia)." Co-morbidity & Pathological Gambling Addictions and other mental disorders as a rule do not develop in isolation. redwoodlodge, adidaspredatorabsolute. The National Co-morbidity Survey (NCS) that sampled the entire U.S. chaterafm. population in 1994, found that among non-institutionalized American male and female adolescents and adults (ages 15-54), roughly 50% had a diagnosable Axis I mental disorder at some time in their lives. conflictdiamonds, floridabartendingschools, gayinsult. This survey's results indicated that 35% of males will at some time in their lives have abused substances to the point of qualifying for a mental disorder diagnosis, and nearly 25% of women will have qualified for a serious mood disorder (mostly major depression). toxicmold. A significant finding of note from the NCS study was the widespread occurrence of co-morbidity among diagnosed disorders. evdorouter, dadsfriend, austintexasrelocation. It specifically found that 56% of the respondents with a history of at least one disorder also had two or more additional disorders. pontiacgtp. These persons with a history of three or more co-morbid disorders were estimated to be one-sixth of the U.S. softballtrophies, guatemalaadoptions, otterpops. population, or some 43 million people (Kessler, 1994). thairestaurant, personalizedsiliconebracelets, chicagoforeclosedhome. McGinnis and Foege, (1994) report that, "the most prominent contributors to mortality in the United States in 1990 were tobacco (an estimated 400,000 deaths), diet and activity patterns (300,000), alcohol (100,000), microbial agents (90,000), toxic agents (60,000), firearms (35,000), sexual behavior (30,000), motor vehicles (25,000), and illicit use of drugs (20,000). singlemoms, headachetreatment. Acknowledging that the leading cause of preventable morbidity and mortality was risky behavior lifestyles, the U.S. fishpendant, quiltingsite. Prevention Services Task Force set out to research behavioral counseling interventions in health care settings (Williams & Wilkins, 1996). bluevervain, veterinariangrandrapid, scrapcars. Poor Prognosis We have come to realize today more than any other time in history that the treatment of lifestyle diseases and addictions are often a difficult and frustrating task for all concerned. reeboklogo, rusticsofa, uniquebabyname. Repeated failures abound with all of the addictions, even with utilizing the most effective treatment strategies. reverselookups, topiaryform, milleniumhilton. But why do 47% of patients treated in private treatment programs (for example) relapse within the first year following treatment (Gorski,T., 2001)? Have addiction specialists become conditioned to accept failure as the norm? There are many reasons for this poor prognosis. canoncolorcopier. Some would proclaim that addictions are psychosomatically- induced and maintained in a semi-balanced force field of driving and restraining multidimensional forces. spaweekend, floridamurder. Others would say that failures are due simply to a lack of self-motivation or will power. academicsuperstore, diadeenero, nauticaldecoration. Most would agree that lifestyle behavioral addictions are serious health risks that deserve our attention, but could it possibly be that patients with multiple addictions are being under diagnosed (with a single dependence) simply due to a lack of diagnostic tools and resources that are incapable of resolving the complexity of assessing and treating a patient with multiple addictions? Diagnostic Delineation Thus far, the DSM-IV-TR has not delineated a diagnosis for the complexity of multiple behavioral and substance addictions. breakfastmachine. It has reserved the Poly-substance Dependence diagnosis for a person who is repeatedly using at least three groups of substances during the same 12-month period, but the criteria for this diagnosis do not involve any behavioral addiction symptoms. makeupinfomercial, groundwire, waterproofdecking. In the Psychological Factors Affecting Medical Condition's section (DSM-IV-TR, 2000); maladaptive health behaviors (e.g., overeating, unsafe sexual practices, excessive alcohol and drug use, etc.) may be listed on Axis I only if they are significantly affecting the course of treatment of a medical or mental condition. tundralodge, inuyashakagomelemon, nikeirons. Since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning, it is no wonder that repeated rehabilitation failures and low success rates are the norm instead of the exception in the addictions field, when the latest DSM-IV-TR does not even include a diagnosis for multiple addictive behavioral disorders. watercraftinsurance, showercurtainrings, pipetobacco. Treatment clinics need to have a treatment planning system and referral network that is equipped to thoroughly assess multiple addictive and mental health disorders and related treatment needs and comprehensively provide education/ awareness, prevention strategy groups, and/ or specific addictions treatment services for individuals diagnosed with multiple addictions. rvpartsonline, sexyeveningdresses. Written treatment goals and objectives should be specified for each separate addiction and dimension of an individuals' life, and the desired performance outcome or completion criteria should be specifically stated, behaviorally based (a visible activity), and measurable. quickquote. New Proposed Diagnosis To assist in resolving the limited DSM-IV-TRs' diagnostic capability, a multidimensional diagnosis of "Poly-behavioral Addiction," is proposed for more accurate diagnosis leading to more effective treatment planning. flatwareholder. This diagnosis encompasses the broadest category of addictive disorders that would include an individual manifesting a combination of substance abuse addictions, and other obsessively-compulsive behavioral addictive behavioral patterns to pathological gambling, religion, and/ or sex / pornography, etc.). websafecolors. Behavioral addictions are just as damaging - psychologically and socially as alcohol and drug abuse. cardesigning. They are comparative to other life-style diseases such as diabetes, hypertension, and heart disease in their behavioral manifestations, their etiologies, and their resistance to treatments. phoneentrysystem, startupbusinessideas, autoleasedeals. They are progressive disorders that involve obsessive thinking and compulsive behaviors. postcardpaper, humancastration. They are also characterized by a preoccupation with a continuous or periodic loss of control, and continuous irrational behavior in spite of adverse consequences. cornerbench, rockymountainsunscreen. Poly-behavioral addiction would be described as a state of periodic or chronic physical, mental, emotional, cultural, sexual and/ or spiritual/ religious intoxication. eyewearframe, healthnutrients. These various types of intoxication are produced by repeated obsessive thoughts and compulsive practices involved in pathological relationships to any mood-altering substance, person, organization, belief system, and/ or activity. quiltstencils, halfpipeblueprint. The individual has an overpowering desire, need or compulsion with the presence of a tendency to intensify their adherence to these practices, and evidence of phenomena of tolerance, abstinence and withdrawal, in which there is always physical and/ or psychic dependence on the effects of this pathological relationship. woodenwindmill, ladiesclothes, youknowwhat. In addition, there is a 12 - month period in which an individual is pathologically involved with three or more behavioral and/ or substance use addictions simultaneously, but the criteria are not met for dependence for any one addiction in particular (Slobodzien, J., 2005). electricityderegulation, leosbluebook, benefitcosmetic. In essence, Poly-behavioral addiction is the synergistically integrated chronic dependence on multiple physiologically addictive substances and behaviors (e.g., using/ abusing substances - nicotine, alcohol, & drugs, and/or acting impulsively or obsessively compulsive in regards to gambling, food binging, sex, and/ or religion, etc.) simultaneously. New Proposed Theory The Addictions Recovery Measurement System's (ARMS) theory is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between multiple risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. onmulticulturaleducation, discountedcashflow. Multiple influences trigger and operate within high-risk situations and influence the global multidimensional functioning of an individual. photocake, beadtable, unbeldi. The process of relapse incorporates the interaction between background factors (e.g., family history, social support, years of possible dependence, and co-morbid psychopathology), physiological states (e.g., physical withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). freegallerieslingerie. To put it simply, small changes in an individual's behavior can result in large qualitative changes at the global level and patterns at the global level of a system emerge solely from numerous little interactions. The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individual's develop to any one form of treatment to a single dimension of their lives, because the effects of an individual's addiction have dynamically interacted multi-dimensionally. heartwormsymptom. Having the primary focus on one dimension is insufficient. scrapgoldprices, fusionesyadquisiciones, groomingpubichair. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. onlinehondacatalog. nicotine, alcohol, and obesity, etc.). spencerforhire, stmartinslane. Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. coralprincess, toshibanotebookcomputers, joebudden. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. breastwoman, negotiationarticle. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual's primary addiction. rebeccastaab. The ARMS' theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual's life dimensions in addition to developing specific goals and objectives for each dimension. The ARMS acknowledges the complexity and unpredictable nature of lifestyle addictions following the commitment of an individual to accept assistance with changing their lifestyles. easwheyprotein. The Stages of Change model (Prochaska & DiClemente, 1984) is supported as a model of motivation, incorporating five stages of readiness to change: pre-contemplation, contemplation, preparation, action, and maintenance. organicvitamins, torchierelampshades. The ARMS theory supports the constructs of self-efficacy and social networking as outcome predictors of future behavior across a wide variety of lifestyle risk factors (Bandura, 1977). certsupplies, quickcashadvance. The Relapse Prevention cognitive-behavioral approach (Marlatt, 1985) with the goal of identifying and preventing high-risk situations for relapse is also supported within the ARMS theory. acnecyst, jobsalary, caribbeancruiseprincess. The ARMS continues to promote Twelve Step Recovery Groups such as Food Addicts and Alcoholics Anonymous along with spiritual and religious recovery activities as a necessary means to maintain outcome effectiveness. devonshireproductions, certifiedappraisersmassachusetts, knittingsupplies. The beneficial effects of AA may be attributable in part to the replacement of the participant's social network of drinking friends with a fellowship of AA members who can provide motivation and support for maintaining abstinence (Humphreys, K.; Mankowski, E.S, 1999) and (Morgenstern, J.; Labouvie, E.; McCrady, B.S.; Kahler, C.W.; and Frey, R.M., 1997). misfitclothing, freightcom. In addition, AA's approach often results in the development of coping skills, many of which are similar to those taught in more structured psychosocial treatment settings, thereby leading to reductions in alcohol consumption (NIAAA, June 2005). removinggarter, selectphone, underagestories. Treatment Progress Dimensions The American Society of Addiction Medicine's (2003), "Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition", has set the standard in the field of addiction treatment for recognizing the totality of the individual in his or her life situation. mississippiroofers, teamassociated, flowersvan. This includes the internal interconnection of multiple dimensions from biomedical to spiritual, as well as external relationships of the individual to the family and larger social groups. phoeneticalphabet, dracaenafragrans, softwaredevelop. Life-style addictions may affect many domains of an individual's functioning and frequently require multi-modal treatment. jamesarthurvineyard. Real progress however, requires appropriate interventions and motivating strategies for every dimension of an individual's life. playahotels. The Addictions Recovery Measurement System (ARMS) has identified the following seven treatment progress areas (dimensions) in an effort to: (1) assist clinicians with identifying additional motivational techniques that can increase an individual's awareness to make progress: (2) measure within treatment progress, and (3) measure after treatment outcome effectiveness: PD- 1. Abstinence/ Relapse: Progress Dimension PD- 2. Bio-medical/ Physical: Progress Dimension PD- 3. Mental/ Emotional: Progress Dimension PD- 4. Social/ Cultural: Progress Dimension PD- 5. Educational/ Occupational: Progress Dimension PD- 6. Attitude/ Behavioral: Progress Dimension PD- 7. torontoluxuryhotel. Spirituality/ Religious: Progress Dimension Considering that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the ARMS philosophy promotes that positive treatment effectiveness and successful outcomes are the result of a synergistic relationship with "The Higher Power," that spiritually elevates and connects an individuals' multiple life functioning dimensions by reducing chaos and increasing resilience to bring an individual harmony, wellness, and productivity. adjustableshelving, splashmagazine, caribbeanholidays. Addictions Recovery Measurement - Subsystems Since chronic lifestyle diseases and disorders such as diabetes, hypertension, alcoholism, drug and behavioral addictions cannot be cured, but only managed - how should we effectively manage poly-behavioral addiction? The Addiction Recovery Measurement System (ARMS) is proposed utilizing a multidimensional integrative assessment, treatment planning, treatment progress, and treatment outcome measurement tracking system that facilitates rapid and accurate recognition and evaluation of an individual's comprehensive life-functioning progress dimensions. milliecaseres, asiantigermosquito, youngcirclejerk. The "ARMS"- systematically, methodically, interactively, & spiritually combines the following five versatile subsystems that may be utilized individually or incorporated together: 1) The Prognostication System – composed of twelve screening instruments developed to evaluate an individual's total life-functioning dimensions for a comprehensive bio-psychosocial assessment for an objective 5-Axis diagnosis with a point-based Global Assessment of Functioning score; 2) The Target Intervention System - that includes the Target Intervention Measure (TIM) and Target Progress Reports (A) & (B), for individualized goal-specific treatment planning; 3) The Progress Point System - a standardized performance-based motivational recovery point system utilized to produce in-treatment progress reports on six life-functioning individual dimensions; 4) The Multidimensional Tracking System – with its Tracking Team Surveys (A) & (B), along with the ARMS Discharge criteria guidelines utilizes a multidisciplinary tracking team to assist with discharge planning; and 5) The Treatment Outcome Measurement System – that utilizes the following two measurement instruments: (a) The Treatment Outcome Measure (TOM); and (b) the Global Assessment of Progress (GAP), to assist with aftercare treatment planning. National Movement With the end of the Cold War, the threat of a world nuclear war has diminished considerably. homeparty. It may be hard to imagine that in the end, comedians may be exploiting the humor in the fact that it wasn't nuclear warheads, but "French fries" that annihilated the human race. gableshonda, rebuiltgmtransmissions. On a more serious note, lifestyle diseases and addictions are the leading cause of preventable morbidity and mortality, yet brief preventive behavioral assessments and counseling interventions are under-utilized in health care settings (Whitlock, 2002). craftsmangenerator, strawberrydaiquiri. The U.S. sentrystorage. Preventive Services Task Force concluded that effective behavioral counseling interventions that address personal health practices hold greater promise for improving overall health than many secondary preventive measures, such as routine screening for early disease (USPSTF, 1996). intuittrackit. Common health-promoting behaviors include healthy diet, regular physical exercise, smoking cessation, appropriate alcohol/ medication use, and responsible sexual practices to include use of condoms and contraceptives. 350 national organizations and 250 State public health, mental health, substance abuse, and environmental agencies support the U.S. lakecharlescasino, denverhealth, organizationalpsychology. Department of Health and Human Services, "Healthy People 2010" program. curediabetes, sexslavery, sanddrag. This national initiative recommends that primary care clinicians utilize clinical preventive assessments and brief behavioral counseling for early detection, prevention, and treatment of lifestyle disease and addiction indicators for all patients' upon every healthcare visit. mylarballoonwholesale, toddcollins. Partnerships and coordination among service providers, government departments, and community organizations in providing treatment programs are a necessity in addressing the multi-task solution to poly-behavioral addiction. contemporarychristian. I encourage you to support the mental health and addiction programs in America, and hope that the (ARMS) resources can assist you to personally fight the War on pathological eating disorders within poly-behavioral addiction. For more info see: Poly-Behavioral Addiction and the Addictions Recovery Measurement System, By James Slobodzien, Psy.D., CSAC at: http://www.booklocker.com/books/1966.html http://www.geocities.com/drslbdzn/Behavioral-Addictions.html Food Addicts Anonymous: http://www.foodaddictsanonymous.org/ Alcoholics Anonymous: http://www.alcoholics-anonymous.org/ James Slobodzien, Psy.D., CSAC, is a Hawaii licensed psychologist and certified substance abuse counselor who earned his doctorate in Clinical Psychology. harpjaw, firewallfreepersonal, machineautomation. The National Registry of Health Service Providers in Psychology credentials Dr. squareshape, allergicrhinitis, flapjackrecipe. Slobodzien. coraljeannesmith. He has over 20-years of mental health experience primarily working in the fields of alcohol/ substance abuse and behavioral addictions in medical, correctional, and judicial settings. ashleyharrison, handdrill. He is an adjunct professor of Psychology and also maintains a private practice as a mental health consultant. References American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. scubacompressor. Washington, DC, American Psychiatric Association, 2000, p. oxygengas, bankofganja. 787 & p. soilphtester, headporting. 731. American Society of Addiction Medicine's (2003), "Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition,. pubicshaver, onlinepharmacyvicodin, piscestattoos. Retrieved, June 18, 2005, from: http://www.asam.org/ Bandura, A. fortlewiswashington, expressionistart. (1977), Self-efficacy: Toward a unifying theory of behavioral change. hiphopclothing. Psychological Review, 84, 191-215. Brownell, K. playgroundmisting. D., Marlatt, G. iowacanoerentals, dinosaursound, trikeclub. A., Lichtenstein, E., & Wilson, G. girlsspitting. T. rudefun. (1986). exchangerate, bingobonus, watertownnynews. Understanding and preventing relapse. dutyheavystapler, thuggames. American Psychologist, 41, 765-782. Centers for Disease Control and Prevention (CDC). Retrieved June 18, 2005, from: http://www.cdc.gov/nccdphp/dnpa/obesity/ Gorski, T. (2001), Relapse Prevention In The Managed Care Environment. GORSKI-CENAPS Web Healthy People 2010. Retrieved June 20, 2005, from: http://www.healthypeople.gov/ Publications. Retrieved June 20, 2005, from: www.tgorski.com Lienard, J. & Vamecq, J. (2004), Presse Med, Oct 23;33(18 Suppl):33-40. Marlatt, G. A. (1985). Relapse prevention: Theoretical rationale and overview of the model. In G. A. Marlatt & J. R. Gordon (Eds.), Relapse prevention (pp. 250-280). New York: Guilford Press. McGinnis JM, Foege WH (1994). Actual causes of death in the United States. US Department of Health and Human Services, Washington, DC 20201 Humphreys, K.; Mankowski, E.S.; Moos, R.H.; and Finney, J.W (1999). Do enhanced friendship networks and active coping mediate the effect of self-help groups on substance abuse? Ann Behav Med 21(1):54-60. Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H. H,-U, & Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the national co morbidity survey. Arch. Gen. Psychiat., 51, 8-19. Morgenstern, J.; Labouvie, E.; McCrady, B.S.; Kahler, C.W.; and Frey, R.M (1997). Affiliation with Alcoholics Anonymous after treatment: A study of its therapeutic effects and mechanisms of action. J Consult Clin Psychol 65(5):768-777. Orford, J. (1985). Excessive appetites: A psychological view of addiction. New York: Wiley. Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing the boundaries of therapy. Malabar, FL: Krieger. Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS), Booklocker.com, Inc., p. 5. Whitlock, E.P. (1996). Evaluating Primary Care Behavioral Counseling Interventions: An Evidence-based Approach. Am J Prev Med 2002;22(4): 267-84.Williams & Wilkins. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd ed. Alexandria, VA. U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition). Washington, DC: U.S. Government Printing Office; 2000. World Health Organization, (WHO). Retrieved June 18, 2005, from: http://www.who.int/topics/obesity/en/ According to the World Health Organization (June, 2005), "obesity has reached epidemic proportions globally, with more than 1 billion adults overweight - at least 300 million of them clinically obese - and is a major contributor to the global burden of chronic disease and disability. This article purports that the poor prognosis in treating patients with obesity may possibly be due to not diagnosing and treating thier other poly-behavioral addictions simultaneously. This systematic underdiagnostic standard in the field of addictions could be due to a lack of diagnostic tools and resources that are presently incapable of resolving the complexity of assessing and treating a patient with multiple behavioral and substance abuse addictions. The Addictions Recovery Measurement System (ARMS) is proposed as a first step in fighting this global War on Poly-behavioral Addictions. 7 Steps to Connect with your Angels 7 Steps to Connect with your Angels by Christopher Dilts of www.AskAnAngel.org The room you are in is filled with Angels! The next room you go to will be filled with Angels and Angels will be at your side with every step you take today. The Angels are with us and are eager to help us. How do I know that? That's my specialty - I am an author, workshop leader and Ordained Minister whose specialty is Angels. For the past 10 years I have been helping people in private sessions and in workshops to connect more deeply with their Angels for help and assistance. Angels are truly universal. The Pew Foundation reported that 72% of Americans believe in Angels. This is a much higher percentage than Americans who believe in any world religion, because Angels are fundamental to most of the world's major religions. We find them in Christianity, Islam, Hinduism, Buddhism, Judaism, Mormonism and many other spiritual traditions. St. Augustine, an authority on Angels, said, "Make friends with Angels." He recommended that we make personal relationships with Angels and that we let our relationships with them deepen - much as we would with any important, intimate relationship. Asking an Angel for help is one of our most powerful spiritual practices. We can ask the Angels for immediate help at any time and in any place. Here are some techniques that will help you: 1) Ask for help - Angels offer us help 24/7. The more receptive we are, the more help they can give us. If you diminish your receptivity you limit the Angels ability to help you. Create your own invocations, or prayers, that specifically call for the help you need. Realize that when you call upon an Angel, what really happens is that you open yourself into greater receptivity to their assistance. (See the Angel Messages at www.AskAnAngel.org for examples of invocations.) When asking for help, it's important to realize yourself as fully worthy of Angelic assistance. Angels work with everyone regardless of personal histories and beliefs. Angels are infinite and omnipresent - your request does not diminish them in anyway nor does it affect their ability to help the rest of us at the same time. They exist beyond our experience of time and space and respond to everyone with complete unconditional love. 2) Connect with your inner divine child as you call upon the Angels and ask for help. Your inner divine child is whole, innocent and true and recognizes Angels as trustworthy gifts of Creator. This will help create openness, receptivity, excitement, eagerness and wonder as you prepare to receive the gift your Angels have prepared for you. 3) Hand everything over to the Angels when you ask for their help: every issue, problem, worry and fear as well as every good intention and positive outcome you imagine as the result of your request. Release all expectations of how your request will be answered. 4) Express Appreciation and Gratitude - Find and express genuine appreciation and gratitude for things exactly as they are. If you are struggling with this, ask the Angels to help you to find the love that is present in whatever difficulty you are facing. Have patience with this and let go of any expectation of how this love may be revealed to you. 5) Know that it is done - Every request is answered and help is always given. If you fear that your request will not be answered, then also ask for help in understanding. Trust that you will see the love in every answered prayer. You are known completely and loved unconditionally by the Angels and nothing that will serve you is ever withheld from you. 6) Act quickly on the guidance you receive. Accept the opportunity and act upon it immediately. Angelic help is infinite and unlimited - you can not use it up or run out of it. You cannot ask for "too much" and the Angels are joyously happy to give to you without limit. The faster you act, the faster you receive more assistance! 7) Celebrate yourself exactly as you are in the moment. Leave any critical judgments or negative feelings about yourself, your life, or others in the hands of the Angels for healing. Even if it is just for a few moments, let go of everything that is not of love for yourself and everything around you. In this moment of surrender much more can done for you by the Angels than you can accomplish on your own. Thank yourself and the Angels for deepening the relationship between you. Christopher Dilts has helped people come into greater partnership with their Guiding Angels for over ten years. For sessions or workshops, FREE Angel Messages, and our FREE Monthly Teleseminar, contact www.askanangel.org or newinfo@askanangel.org. Dichotomy of Preference Copyright 2006 Marshall House This is a wonderful world of duality. The physical world as we know it could not exist and grow, nor could our consciousness expand, without duality. I think this is extraordinary. Each of us selects the side of the duality that comes into our life by how/where we focus of our attention. We also get to choose the duality itself; that is, we choose the scale or dichotomy or opposites that define the duality. Always, on one end of a scale of duality is one thing/idea and at the other end is either the opposite or the lack of that thing/idea. The naming of the duality can be empowering or disempowering. In most cultures, we're taught at a very young age to distinguish between "right and wrong" and "good and bad." I have found that these dichotomies are not necessarily paths to happiness. In fact, I often view them as paths to much unhappiness. As I see it, the reason is that such filters often lead to judging others or ourselves when falling into the "wrong" or "bad" side of the scale. Another dichotomy that is particularly popular these days is "positive and negative." This is a little more helpful in some situations, but leads to some of the same dynamics as described with "right and wrong" and "good and bad." Any of these scales would be greatly enhanced by adding "for me" or the equivalent at the end, so that we say or think, "this is good for me" or "this is right for my life" or "this feels positive to me." In fact, that addition really does convert all these dichotomies into a similar approach to the the dichotomy of preference that I describe next. "The dichotomy of preference" is a way of looking at a subject to decide whether or not you prefer it, like it, want it, etc. Is it something you prefer in your life or not? To use this dichotomy in the most empowering way: * you notice what you prefer, and expand that preference by giving more and more attention to it; and * you notice what you do not prefer, and minimize that non-preference by giving less and less attention to it. An Example I have a friend (I will call her Penelope). She's an acquaintance, really, someone I know in a social setting, and only by her story-telling to the group. I think by nearly everyone's standards she's considered a "positive person." She's upbeat, smart, friendly. She's also beautiful, successful, and interesting. She wants very much to be married. She's been looking for a partner for more than six years. Many people will have their opinions about why this is so, and they may or may not be correct. Here is my view of her situation: Penelope gives far more attention to what she does not prefer, does not like, and does not want than to what she prefers or likes or wants. About a specific man, she often says, "I like (this attribute), but I do not like (that attribute)." She's even warm and friendly when she's talking about what she does not like, often joking to provide entertainment value. Actually, some of her stories are so funny and engaging that even I laugh, although I recognize that this is keeping from her what she most wants in her life. I rarely laugh when people are disempowering themselves, so I can see that she is truly engaging. Because of Penelope's nature, it's difficult to think of her as being "negative" or "wrong" or "bad," but it's easy to see that she's giving her attention to the opposite of what she prefers (or wants or likes). And when any of us give the Focus of our Attention to what we don't want, we get more of what we don't want. Whatever we give our attention to expands. Another example of how Penelope makes it more difficult for her partner to come to her is the fact that she counts the days and months and years that she's been experiencing what she does not want. Every holiday is a marker to tell her that yet another (birthday, New Year's Thanksgiving, etc.) is approaching or happening or ending, and still she is not in a relationship. Now, consider some of your preferences... Are you giving your attention to what you want, like, prefer, and want more of? ------ Jeanie Marshall, Empowerment Consultant and Coach with Marshall House, produces Guided Meditations on CD albums and MP3 downloads and writes extensively on subjects related to personal development and empowerment. Voice of Jeanie Marshall, http://www.jmvoice.com |
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