Monday, July 21, 2014

Books: The Bipolar II Disorder Workbook

A mixture of very good and passable
By Not Moses (Loma Linda, CA USA)
This review is from: The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety (Paperback)

For mental health professionals:

Strengths: Differentiates Bipolar I from Bipolar II in more depth and more effectively than the other workbooks I have reviewed on this topic. Has a somewhat more effective than usual chapter on acceptance of the situation in vaguely Motivational Enhancement / Motivational Interview style. Has an excellent list of cognitive distortions / logical fallacies for REBT- / CBT-type exercises. Is written in a very patient style that should be accessible to modern-day high-school graduates, at least. Is generally an excellent psychoeducation device.

Weaknesses: Despite alluding to six, somewhat-to-well-researched, evidence-based therapies (CBT, DBT, MBCT, FFT, IPSRT and psychoeducation), the offerings are very unevenly distributed. CBT, psychoeducation and IPSRT seem featured; DBT, MBCT and FFT much less so. This seems unfortunate since the HMO-favored one-on-one set-ups are going increasingly toward DBT and MBCT at this time (CBT is still "big," of course). The exercises seem a bit scattershot and "eclectic" rather than programmatically collected and arranged to produce a defined therapeutic target. Oh, well.

Considering the lack of quality workbooks for Bipolar at this time, I'm forced to recommend this one as a carefully considered adjunct or therapeutic organizer for both one-on-one and group study utilization, but I'd also point straight at Bauer's Overcoming Bipolar Disorder (also from New Harbinger), Abramowitz's Stress Less Workbook, and Stahl and Goldstein's Mindfulness-Based Stress Reduction Workbook as germane in all three cases. One could pretty likely accomplish a lot with a BD-II patient with these four workbooks.

(c) 2014 by Rodger Garrett; all right reserved. Links are permitted. Please inquire or comment to Thank you.

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Friday, July 04, 2014

Sensation Trumps Observation (at a Price) for the Average Person

It's official: The average Jack & Jill would rather do anything than think or observe their thinking. Are we a society of escape-addicted self-distractors? This bunch of researchers at the University of Virginia and Harvard seen to be suggesting exactly that. They are well-supported by legions of authors since Immanuel Kant and Jean-Jacques Rousseau.   

T. D. Wilson, D. A. Reinhard, E. C. Westgate, D. T. Gilbert, N. Ellerbeck, C. Hahn, C. L. Brown, A. Shaked. Just think: The challenges of the disengaged mind, in Science, 2014; 345 (6192): 75 DOI: 10.1126/science.1250830

Abstract: In 11 studies, we found that participants typically did not enjoy spending 6 to 15 minutes in a room by themselves with nothing to do but think, that they enjoyed doing mundane external activities much more, and that many preferred to administer electric shocks to themselves instead of being left alone with their thoughts. Most people seem to prefer to be doing something rather than nothing, even if that something is negative.

Editor's Summary: Nowadays, we enjoy any number of inexpensive and readily accessible stimuli, be they books, videos, or social media. We need never be alone, with no one to talk to and nothing to do. Wilson et al. explored the state of being alone with one's thoughts and found that it appears to be an unpleasant experience. In fact, many of the people studied, particularly the men, chose to give themselves a mild electric shock rather than be deprived of external sensory stimuli.

Article in Science Daily, Mind & Brain:

Most people are just not comfortable in their own heads, according to a new psychological investigation led by the University of Virginia.

The investigation found that most would rather be doing something -- possibly even hurting themselves -- than doing nothing or sitting alone with their thoughts, said the researchers, whose findings will be published July 4 in the journal Science.

In a series of 11 studies, University of Virginia psychologist Timothy Wilson and colleagues at U.V. and Harvard University found that study participants from a range of ages generally did not enjoy spending even brief periods of time alone in a room with nothing to do but think, ponder or daydream. The participants, by and large, enjoyed much more doing external activities such as listening to music or using a smart phone. Some even preferred to give themselves mild electric shocks than to think.

"Those of us who enjoy some down time to just think likely find the results of this study surprising -- I certainly do -- but our study participants consistently demonstrated that they would rather have something to do than to have nothing other than their thoughts for even a fairly brief period of time," Wilson said.

The period of time that Wilson and his colleagues asked participants to be alone with their thoughts ranged from six to 15 minutes. Many of the first studies involved college student participants, most of whom reported that this "thinking period" wasn't very enjoyable and that it was hard to concentrate. So Wilson conducted another study with participants from a broad selection of backgrounds, ranging in age from 18 to 77, and found essentially the same results.

"That was surprising -- that even older people did not show any particular fondness for being alone thinking," Wilson said.

He does not necessarily attribute this to the fast pace of modern society, or the prevalence of readily available electronic devices, such as smart phones. Instead, he thinks the devices might be a response to people's desire to always have something to do.

RG: From the perspective one may gain from looking into the literature available on cultural influence, power elite imperatives, cults and thought control, one might even come to the conclusion that hand-held mind occupiers like smart phones and tablets are far more effective as mental distraction systems than the transistor radios, magazines and pocket books that preceded them, beginning about 125 years ago (see Author List No. 1  below). One wonders if unwillingness to just allow the contents of one's mind to be observed to the point of being willing to experience physical pain was anywhere near as prevalent then. The published literature of the 19th century does anything but suggest so. Descriptions and/or references to being discontent about being physically and mentally idle are very hard to find in published material much before the "jazz age" that followed the First World War (see Author List No. 2 below). 

In his paper, Wilson notes that broad surveys have shown that people generally prefer not to disengage from the world, and, when they do, they do not particularly enjoy it. Based on these surveys, Americans spent their time watching television, socializing or reading, and actually spent little or no time "relaxing or thinking."

RG: Let alone observing to notice to recognize to acknowledge to accept to own to appreciate to understand (as in 10 StEP processing; see Garrett) both internal and external phenomena a la Buddhist practice. Most people appear to be conditioned, influenced, socialized and normalized to do anything but observe the flow of their inherently temporary thoughts, evaluations, appraisals, interpretations, considerations, judgments, analyses, opinions or attributions of meaning, much less link them up to their more permanent -- but more subconsciously stored -- core beliefs, ideas, ideals, assumptions, presumptions, convictions, prejudices, rules, requirements and general dogma (see Author List No. 3 below). Nor are they disposed in this culture (and most others, including the ostensibly "older, wiser, and more thoughtful" of the Asian east) to observe their feelings, bodily sensations or emotions. "Boring, boring, boring" at best. Plain "intolerable" at worst, especially as queasy-makers like guilt, shame, remorse, regret, sorrow, grief and the like are the principle players on stage. We pay a price for ignoring all this stuff in terms of lost consciousness, creativity and problem-solving capacities (see Author List No. 4 below), but most of us don't realize that. Or if we do, try our best to distract ourselves from such awareness with a smart phone or whatever.

During several of Wilson's experiments, participants were asked to sit alone in an unadorned room at a laboratory with no cell phone, reading materials or writing implements, and to spend six to 15 minutes -- depending on the study -- entertaining themselves with their thoughts. Afterward, they answered questions about how much they enjoyed the experience and if they had difficulty concentrating, among other questions. Most reported they found it difficult to concentrate and that their minds wandered, though nothing was competing for their attention. On average the participants did not enjoy the experience. A similar result was found in further studies when the participants were allowed to spend time alone with their thoughts in their homes.

"We found that about a third admitted that they had 'cheated' at home by engaging in some activity, such as listening to music or using a cell phone, or leaving their chair," Wilson said. "And they didn't enjoy this experience any more at home than at the lab."

An additional experiment randomly assigned participants to spend time with their thoughts or the same amount of time doing an external activity, such as reading or listening to music, but not to communicate with others. Those who did the external activities reported that they enjoyed themselves much more than those asked to just think, that they found it easier to concentrate and that their minds wandered less.

The researchers took their studies further. Because most people prefer having something to do rather than just thinking, they then asked, "Would they rather do an unpleasant activity than no activity at all?" The results show that many would.

Participants were given the same circumstances as most of the previous studies, with the added option of also administering a mild electric shock to themselves by pressing a button. Twelve of 18 men in the study gave themselves at least one electric shock during the study's 15-minute "thinking" period. By comparison, six of 24 females shocked themselves. All of these participants had received a sample of the shock and reported that they would pay to avoid being shocked again.

"What is striking," the investigators write, "is that simply being alone with their own thoughts for 15 minutes was apparently so aversive that it drove many participants to self-administer an electric shock that they had earlier said they would pay to avoid."

Wilson and his team note that men tend to seek "sensations" more than women, which may explain why 67 percent of men self-administered shocks to the 25 percent of women who did.

Wilson said that he and his colleagues are still working on the exact reasons why people find it difficult to be alone with their own thoughts.

RG: Really? Considering the truly vast array of discourse on this precise topic in the professional literature since Freud's day -- and especially since Albert Ellis and (later) Wayne Dyer began to harp about it in a series of popular books at mid-century -- such mystery as to the "exact reasons" seems difficult to comprehend. Are we as influenced, conditioned, socialized and normalized to "find it difficult to be alone with our thoughts" for the sake of preventing us from recognizing, acknowledging, accepting and owing how robotic our minds are as so many sociologists, psychologists and others have been asserting since the days of Rousseau and Kant (see Author List No. 5 below)?

Everyone enjoys daydreaming or fantasizing at times, he said, but these kinds of thinking may be most enjoyable when they happen spontaneously, and are more difficult to do on command.

"The mind is designed to engage with the world," he said. "Even when we are by ourselves, our focus usually is on the outside world. And without training in meditation or thought-control techniques, which still are difficult, most people would prefer to engage in external activities."

Commentator's Author Lists 

1) "From the perspective one may gain from looking into the literature available on cultural influence, power elite imperatives, cults and thought control, one might even come to the conclusion that hand-held mind occupiers like smart phones and tablets are at least as -- and possibly far more -- effective as mental distraction systems than the transistor radios, magazines and pocket books that preceded them, beginning about 125 years ago." 

Alpert, Berger & Luckman, Block & Block, Bloom, Bozarth, Cooley, Deikman, De Mello, Ewen, S. Freud, Fromm, Galanter, Goleman, Hassan, Henry, Huxley, Kramer & Alstad, Krishnamurti, Langone, Lasch, Mills, Ornstein, Packard, Peck, Postman, Schaef, Shaffer et al, Singer, Singer et al, Skinner, Sproule, Stein et al, Taylor, Woodward & Denton. 

2) "Descriptions and/or references to being discontent about being physically and mentally idle are very hard to find in published material much before the "jazz age" that followed the First World War." 

S. Freud, Freud in Gay, Horney, Howe & Strauss, Veblen, Weber.

3) "Most people appear to be conditioned, influenced, socialized and normalized to do anything but observe the flow of their inherently temporary thoughts, evaluations, appraisals, interpretations, considerations, judgments, analyses, opinions or attributions of meaning, much less link them up to their more permanent -- but more subconsciously stored -- core beliefs, ideas, ideals, assumptions, presumptions, convictions, prejudices, rules, requirements and general dogma." 

Alpert, Altemeyer, Baumrind, Berger & Luckman, Bloom, Cooley, Deikman, De Mello, Dyer, Ellis, Ellul, Ewen, A. Freud, S. Freud, Fromm, Goleman, Gurdjieff, Hegel, Henry, Hoeft et al, Hoffer, Horney, Huxley, Kabat-Zinn, Kramer, Kramer & Alstad, Krishnamurti, Laing, Levine, Lippman, Maslow, Milgram, Miller, Mills, Ornstein, Packard, Peck, Rokeach, Siegel, Simon et al, Stein et al, Sproule, Stein et al, Taylor, Van Hiel et al, Weiner.

4) "Nor are they disposed in this culture (and most others, including the ostensibly "older, wiser, and more thoughtful" of the Asian east) to observe their feelings, bodily sensations or emotions... We pay a price for ignoring all this stuff in terms of lost consciousness, creativity and problem-solving capacities..." 

Alpert, Bandura, Block & Block, Bloom, Brach, Chodron, Damasio, Deikman, De Mello, Dodes, Forsyth & Eifert, Goleman, Gratz, Gurdjieff, Gurdjieff in Speeth, Hayes et al, Holzel et al, Kabat-Zinn, Kramer, Kramer & Alstad, Krishnamurti, Laing, Lang, Ludwig & Kabat-Zinn, McGilchrist, McKay, Ogden & Minton, Orsillo & Roemer, Peck, Perls, Russell, Segel et al, Siegel, Simon et al, Somov, Stahl, Tangney et al, Trungpa, Van Dijk, Williams et al.

5) "Are we as influenced, conditioned, socialized and normalized to 'find it difficult to be alone with our thoughts' for the sake of preventing us from recognizing, acknowledging, accepting and owing how robotic our minds are as so many sociologists, psychologists and others have been asserting since the days of Rousseau and Kant?" 

Altemeyer, Baumrind, Beck, Berger & Luckman, Bloom, Bozarth, Byrne & Whiten, Chodron, Cialdini, Cooley, Deikman, De Mello, Dodes, Dyer, Ellis, Ellul, Ewen, A. Freud, S. Freud, Fromm, Goenka in Hart, Goleman, Gurdjieff, Gurdjieff in Speeth, Hegel, Henry, Hoffer, Huxley, Kant, Kramer, Kramer & Alstad, Krishnamurti, Laing, Lakoff, Lasch, Lears, Lippman, McGilchrist, Miller, Packard, Peck, Postman, Rokeach, Rousseau, Russell, Schaef, Singer et al, Somov, Stein et al, Taylor, Trungpa, Van Hiel et al, Weiner. 

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Sproule, J. M.: Propaganda and Democracy: The American Experience of Media and Mass Persuasion, London: Cambridge U. Press, 1997.

Stahl, B.; Goldstein, E.: A Mindfulness-Based Stress Reduction Workbook, Oakland CA: New Harbinger, 2010.

Stein, M.; Vidich, A.; White, D. (editors): Identity and Anxiety: Survival of the Person in Mass Society, Glencoe, IL: The Free Press of Glencoe, Illinois, 1960.

Tangney, J. P.; Wagner, P.; et al: Relation of Shame and Guilt to Constructive Versus Destructive Responses to Anger Across the Lifespan, in Journal of Personality and Social Psychology, Vol. 70, No. 4, 1996.

Tangney, J. P.; Dearing, R.: Shame and Guilt, New York: Guilford Press, 2002.

Tangney, J.; Stuewig, J.; Martinez, A.: Two Faces of Shame: The Roles of Shame and Guilt in Predicting Recidivism, in Psychological Science, Vol. 25, (online pre-print) January 2014; DOI:10.1177/0956797613508790

Taylor, K.: Brainwashing: The Science of Thought Control, London: Oxford University Press, 2004.

Trungpa, C.: The Myth of Freedom and the Way of Meditation, Boston: Shambala, 1976, 2001.

Trungpa, C.: Cutting Through Spiritual Materialism, Boston: Shambala: 1973, 2002.

Tye, L.: The Father of Spin: Edward L. Bernays and the Birth of Public Relations, New York: Henry Holt, 1998.

Van Dijk, S.: Calming the Emotional Storm, Oakland, CA: New Harbinger, 2012. 

Van Dijk, S.: DBT Made Simple: A Step-by-Step Guide to Dialectical Behavior Therapy, Oakland, CA: New Harbinger, 2013. 

Van Hiel, A.; Onraet, E.; De Pauw, S.: The relationship between social-cultural attitudes and behavioral measure of cognitive style: A meta-analytic integration of studies, in Journal of Personality, Vol. 78, No. 6, December 2010.

Veblen, T.: The Theory of the Leisure Class, orig. pub. 1899, New York: Penguin Classics, 1994.

Watson, J.: Behaviorism, Revised Edition, Chicago: University of Chicago Press, 1930.

Weber, M.; Parsons, T. (translator): The Protestant Ethic and the Spirit of Capitalism, Oxford: Oxford Univ. Press, 1930.

Weiner, B.: An attributional theory of motivation and emotion. New York: Springer-Verlag, 1986.  

Williams, M.; Teasdale, J.; Segal, Z.; Kabat-Zinn, J.: The Mindful Way through Depression, New York: Guilford Press, 2007.

Woodward, G.; Denton, R.: Persuasion & Influence in American Life, 4th Ed., Prospect Heights, IL: Waveland Press, 2000.

Wu, T.: The Master Switch: The Rise and Fall of Information Empires, New York: Vintage, 2011.

Young, J.: Cognitive Therapy for the Personality Disorders: A Schema-Focused Approach, 3rd Ed., Sarasota, FL: Professional Resource Press, 1999.

© 2014 by Rodger Garrett; all rights reserved. Links are permitted. Please contact with comments or questions. Thank you.

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Friday, June 06, 2014

Books: The Myth of Freedom and the Way of Meditation

Wisdom Between the Covers, June 6, 2014
By Not Moses (Loma Linda, CA USA)
This review is from: The Myth of Freedom and the Way of Mieditation (Shambhala Classics) (Paperback) by Chogyam Trungpa (1976)

Please note my brief remarks under nerdyguy1618's 2-star review at and... here are some indicative quotations that may serve to help prospective buyers understand what's between the covers:

"The whole approach of Buddhism is to develop transcendental common sense, seeing things as they are. without magnifying what is or dreaming about what we would like to be."

"It is an attitude of fundamental acceptance of oneself while still retaining critical intelligence."

"The experience of oneself relating to other things is actually a... fleeting thought. If we generate these fleeting thoughts fast enough. we can create the illusion of continuity and solidity. It is like watching a movie, the individual film frames are played so quickly that they generate the illusion of continual movement. So we build up an idea... that self and other are solid and continuous. And once we have this idea, we manipulate our thoughts to confirm it, and are afraid of any contrary evidence. It is this... denial of impermanence that imprisons us."

"Mindfulness is the process of relating with individual situations directly, precisely, definitely. You... connect with... situations in a simple way. There is ignorance, there is restlessness, there is passion, there is aggression. They need not be praised or condemned. They are just regarded as fits."

"In mindfulness practice there is no goal, no journey,; you are just mindful of what is happening... There is no promise of love and light or visions of any kind -- no angels, no devils. Nothing happens; it is absolutely boring... You are not onto something... Boredom is important because boredom is anti-credential (meaning anti-attestation of qualification, competence, or authority)."

"If we seek to relieve our loneliness, we will be distracted from our path. Instead, we must make a relationship with loneliness until it becomes aloneness."

"Sanity lies somewhere between the inhibitions of conventional morality and the looseness of extreme impulse, but the area in between is very fuzzy... The [student] does not side with rejecting convention... Nor does he side with blind dogma."

Much of what has been quoted here serves today as the philosophical underpinnings of the mindfulness movement in modern, evidence-based psychotherapy, by the way.

© 2014 by Rodger Garrett; all rights reserved. Links are permitted. Please contact with comments or questions. Thank you.

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Tuesday, June 03, 2014

Asynchronous Development of Gifted Children

The KDT Drama of the Gifted Child through Karpman's, Piaget's and Erikson's Filters

"If development is perceived as a life-long process, giftedness can then be understood as producing atypical development throughout the lifespan in terms of awareness, perceptions, emotional responses, and life experiences. This places the gifted individual developmentally out of sync both internally, in relation to the different aspects of development, and externally, in relation to cultural expectations." -- Martha Morelock

Thesis of my comments to Morelock's complete article below: 

Stephen Karpman's "drama triangle," as well as Jean Piaget's and Erik Erikson's developmental stages figure mightily in "asynchronous development" and help to bring the concepts explained in Morelock's article into much sharper focus. Especially for those who "get" Karpman, Piaget and Erikson in depth because we have utilized their nosologies to help ourselves and our patients understand the developmental course that has brought them to the seat across the table. 

(Do I need to explain again how vital it is to understand the patient's developmental course? I have seen such understanding provide the essential release from the parent-, peer- and common culture-induced shame, guilt, anxiety, worry, remorse, and regret hiding immediately behind the patient's denial / pre-contemplation and resistance to treatment. Suffice it for the moment to simply say this: When patients come to see that they did not invent their neurosis, but rather, "bought" it quite innocently from the agents of the common culture, they often become energized by a reactive resentment that can be steered very usefully into introspection, "extrospection," understanding and de-fusion from their self-destructive ego defenses.)

"Kaylyn" is a devised amalgam of several people I have known, including myself. She is a poster child of asynchronous development of the gifted child. She comes from a bootstrapping working-to-middle-class family headed by an entrepreneural mother and a craftsman father locked in a wholly denied, but nevertheless co-dependent, rat race around the Karpman Drama Triangle. Mother's fast-growing business also provided an effective means of distraction from the upshots on the children of a textbook classic alcoholic father who vomited his own developmental deficits upon them (see Anonymous, and Woititz). 

Kaylyn's IQ was professionally estimated at "approximately 165" when she was three years old. Her behavior was classically precocious (see Jankech-Caretta), relentlessly energy-discharging and (unfortnately) seen as hugely over-stimulating by her grossly insensitive, "restless, irritable and discontented" father (see Wilson). She grew up to be the classic case of intellectual and professional achievement combined with emotional dyscontrol, obsession to control others, relentless anxiety (expressed as something like "eternal, hyper-dramatic adolescence"), and recurring episodes of disabling panic attacks.

I will refer further to Kaylyn in my comments below in dark red; Morelock's text is in black. Before moving into Morelock's work, however, I want to run down the characteristics of "precociously intellectual children" as developed by Terrassier, et al:

Very high memory recall capacity
Categorical thought much higher than normal
Very good abstract thought
Attracted by what is more complex
Uninterested by what appears simple and repetitive
“Embarrassing clearness,” over-anticipates (hyper-vigilance)
Revolts strongly against perceived injustice
Excessively perfectionistic
Devalues self, too conscious of own limits
Badly manages aggressiveness
Centered on adult, who readily answers his questions
Inclined to rationalisation
Sometime conforms excessively to his entourage 
Often very passionate, but sometimes hides it at school
Internal Dys-synchrony: between intelligence and emotion, intelligence and motor functioning, real age and mental age
External Dys-synchrony: between intelligence and social development

Signs of intellectually gifted children, according to Terrassier:

Learned how to read before the first primary school year
Read a lot and quickly without attaching importance to pictures
Expressed an interest in dictionaries, thesaureses and encyclopedias
Read quickly but finds more difficulties in writing
Likes talking with adults
Asks lots of questions, that are varied, original, and/or relevant
Wants to know “Why” 
Can multi-task
Can make relevant observations, even if he seems not to be listening or paying attention
Readily judges other people, especially adults
Annoyed by routine and repetitive activities, especially when they are easy
Very sensitive to injustice
Has a sense of humor
Has a very rich vocabulary, but the level of thought is especially astonishing
Likes and is successful in complex games
Popular, especially in small classes
Prefers to work alone
Interested in the origin of man and the universe
Is at the top of the class without making an effort
Has a strong sense of very developed aesthetics
Not passionate about one hobby, often changes

- - - 

Morelock, Martha J.: 
Understanding Our Gifted 
Open Space Communications
Vol. 4, No. 3, pp. 1, 11-15,
January/February 1992

This article by Martha Morelock introduces the Columbus Group's definition of giftedness as asynchronous development. The reader is also given a developmental picture of giftedness that extends beyond achievement. The author focuses on giftedness "from the inside out," demonstrating how advanced cognitive development shapes the rest of the personality.

Ten-year-old Greg Barnes was acknowledged by school personnel as highly gifted. His scholastic achievement test scores placed him in the 99.9th percentile, as did his score on the Stanford-Binet Intelligence Scale. On this particular day, when he returned home from school, Mrs. Barnes knew immediately from his despondent expression that the day had been less than ideal.
"Something wrong?" she probed gently.
"Yeah," he said in a tone of thorough disgust, "I got into trouble. We'll have to see the principal tomorrow."
"What for?"
"I got into a fight with Joe and beat him up."
Mrs. Barnes was shocked. Greg was not an aggressive child. He had never reported such an incident before. In fact, he was an extraordinarily sensitive boy who genuinely cared about other people.
"What happened?" she inquired further.
Greg explained that he and Joe had exchanged insults during music class. Both boys, Greg insisted, were at fault. Later, Joe had cornered Greg by the lockers, taunting him, threatening to beat him up, and egging Greg on to fight. Greg responded by punching Joe, who punched Greg back. When the teacher came onto the scene, Joe was crying while Greg continued to rain punches upon him.
"Well, it sounds like you stood up for yourself…" began Mrs. Barnes. She was surprised at Greg's immediate and heated denial.
"No, Mom - it wasn't that simple."
"But wasn't he threatening to beat you up?"
"No, Mom! You don't understand!"
Greg was getting visibly more upset as Mrs. Barnes attempted to convey that she was not being judgmental. Unable to comprehend why her efforts to convey caring and understanding were being met with mounting frustration, Mrs. Barnes decided to defuse the issue.
"OK. Why don't you write down what happened and explain how you feel about it. Obviously you were there and you know why it happened better than I do."
Greg willingly took a seat at the typewriter and laboriously typed out his story and explanation. An hour and a half later, he handed the pages to his mother: "It all began in third grade..." started the first paragraph. Greg went on to describe in careful detail how he and Joe had met and embarked upon a rocky friendship. At certain times, Joe seemed to want to be friends. At other times, Joe refused to allow Greg to participate in ongoing playground activities. Greg admitted to sometimes levelling "insults" at Joe in retaliation for these playground rejections.
Greg listed incidents from 3rd and 4th grades as well as the 5th grade incident that precipitated the immediate problem. For each incident, he detailed each child's behaviours with painful accuracy in an effort to render an objective view of what had happened. Greg's outburst was, according to him, not only a response to the day's happenings, but a reaction to the entire pattern of incidents composing their relationship over the past two years. The argument of the day was simply "the straw that broke the camel's back".
The next day, Joe, too, wrote out his version of the fight. He wrote simply, "Greg hit me and then I hit him back and he kept hitting me."
RG: At ten years of age, Greg and Joe can be expected to be dealing with the challenges of Erikson's late Initiative, mid-Competence and (possibly) early Identity stages of development. They can also be expected to be essentially Concrete Operational, but the observant mental health professional will see that Greg is well into Formal Operational processing. 

The diversion here is essentially that while Joe seems to be age-appropriately working through Competence with Concrete Operational cognitive processing skills, Greg is trying to deal with Autonomy, Initiative, Competence and Identity issues with Formal Operational processing that is beyond Joe's grasp, as well as Greg's emotional maturity and capacities for self-control under stress. Joe is likely to see Greg as running the gamut from disgustingly immature to mystifyingly "nerdy" because Joe's Concrete Operational skills limit his ability to hypothesize and test theories about Greg's behavior. Greg, on the other hand, becomes disgusted with Joe's inability to hypothesize and test when Greg is operating in Identity, but dependent upon (and even anxiously attached to?) Joe for support and protection. 

Greg's need for support and protection likely stem from the unfinished business at Autonomy, Initiative and Competence that are so characteristic of many "Precocious Poindexters" well into their 20s and even beyond. Many of these children and adolescents are both too separation-seeking, driven and capable... and too attachment-seeking, afraid to initiate and (at least seemingly) in-capable and (socially) incompetent. To their less precocious and typically more Concrete Operational parents and peers, they are very confusing.

The Different Reality that Marks Giftedness
Greg and Joe had participated in the same fight. Yet, Greg was fighting over a broader and more complex issue than was Joe. Greg had an unusually retentive memory and an extraordinary ability to analyse the roles played by both boys in an ongoing series of incidents composing a two year relationship. Joe, a child with more average cognitive abilities, lived each incident as it occurred and forgot it when it was resolved for the day. Apparently Greg and Joe were reacting to very different and individual realities.
- - -
Or, consider four-year-old Jennie. Jennie's grandfather died several months ago; Jennie is asking questions about death and showing evidence of emotional upset. Her mother tries to reassure her by telling her that she need not worry - she and Mommy and Daddy will live a long time. She will grow up and have children and Mommy will be a grandmother. Jennie responds in trembling voice, "But you don't know, Mommy. Even children die sometimes. Nobody knows for sure...
Most four year olds would simply accept the mother's reassurance. Jennie, however, like Greg, is highly gifted. Consequently, her logical and abstract reasoning abilities far exceed those of most four year olds. They create for her a reality more complex and threatening than that facing her age mates. Like average four year olds, she needs to believe her mother in order to feel emotionally secure. However, her advanced cognitive capacities allow her to see too clearly the faulty logic. She is left vulnerable and bereft of comfort.
RG: Probably because Kaylyn's mother very regularly modeled a remarkable capacity to deny and/or forgive her alcoholic husband's rage-vomiting tirades, Kaylyn herself acquired a second-hand version of her mother's reality denial. At first, she focused on developing an almost schizoid obsession with crafts-level artisanship (not unlike her mother's). But as an adolescent, she found drugs and boys. Sporadic revisits to her previous creativity took place, but until she was married and herself a mother, her interests in artistic productivity waned. She direly needed an escape from the verbal abuse at home, as well as across the street at her aunt's. (The aunt loathed Kaylyn's father, ranting on about him in front of all who'd listen, including Kaylyn, but was herself a boistrous control freak.) 

Possibly as the result of daily cannabis ingestion, Kaylyn's obvious capacities for Formal Operation seemed to go sub-rosa behind a mask of co-dependent, go-along-to-get-along Concrete Operation... and her path through Autonomy became split into too much and too little, as did her Initiative and Competence. Her sense of Identity looked like a borderline-organized tussle between wall-eyed teenage hussy and secret observer of the (to her facile mind) "obvious insanity all around her." Kaylyn became a "social submarine" (insofar as anyone other than her very closest friend was concerned) and remained that way into her early 30s.
Giftedness as Asynchronous Development

Greg and Jennie exhibit a lack of synchronicity in the rates of their cognitive, emotional and physical development. Jennie's physical development is similar to that of an average four year old, while her cognitive development more nearly approximates that of a child at least twice her age (Morelock, 1991). The emotional needs that must be fulfilled for Jennie's healthy emotional development to take place are similar to those of other four year olds. In order to feel secure, to trust in the world and to begin to develop her own identity, Jennie requires a certain comfortable predictability in her daily existence. She also needs to have a simple, solid trust in the strength and reliability of her parents. However, the fulfilment of those four-year-old emotional needs is complicated by Jennie's extraordinary capacity for abstract thought. Her internally imposed demand for logical consistency leaves her emotionally unable to accept anything contradicting it. Children do die. Mommies and Daddies aren't omnipotent and omniscient. For Jennie -- and for other gifted children like her -- the world can threaten to dissolve into unpredictable and frightening chaos.

RG: Kaylyn's developmental track seemed to go into "arrest" for a decade until she followed her mother into something like "mass production artisanship" and began to design -- as well as produce or oversee the production of -- an ever-broadening line of craft products that sold like hotcakes. She remained split between loci of self-esteem via developmental catch-up through functional Initiative and Competence leading to remarkable Generativity... and loci of continuing self-criticism at Identity, as well as criticism on others in increasingly dysfunctional Intimacy. She remained largely Concrete Operational at a social level while moving well into a sort of spatial-symbolic version of Formal Operational processing in something resembling "fiercely private schizoidism." 

Kaylyn finally broke out of her self-limitations when her long-time best friend finished college and became professionally certified. Kaylyn saw the possibilities, went to college herself, graduated with honors, and is today a highly esteemed professional in a very challenging workplace... albeit a person with continuing insecurities, reactive control obsessions, florid anxiety and psychosomatic upshots. Well into adulthood, Kaylyn remains stuck in unfinished business with respect to Erikson's Trust, Autonomy, Initiative, Competence, Identity and Intimacy hurdles, though she is so solidly grounded in psychoeducation and Formal Operational processing that she can speak expertly on her own developmental deficits.

- - -

Roedell (1988) points out that young gifted readers or children who watch the television news can be exposed to highly complex, emotionally charged information that they may not be mature enough to deal with.
The parent of an intellectually advanced four year old described how he came upon his daughter looking terrified as she read the Bible. When he inquired about her concern, she replied, "I'm reading The Book of Revelations, and it's really scary!"(p. 7)
Children like Jennie, and the four year old cited by Roedell, lack the life experience necessary for interpreting the cognitive realities that confront them.

A number of theorists and researchers have independently written about asynchronous development. Gowan (1974) discussed the implications of cognitive capacities that outstrip emotional (affective) development. He referred to asynchronous development as "dysplasia":
.....a disagreement, dissonance, or disparity either between the age of the individual, which should place him in one stage, and the ... stage he is actually in, ...or disparity between the cognitive stage he is in and the affective stage he is in... (p. 165).
Gowan emphasized the trauma that can result when an individual is thrust prematurely and abruptly into a higher level of cognitive awareness...
Just as the baby developing within the womb is surrounded by a placenta, we are all shielded from external reality by an envelope which protects us from it. Development, hence, consists (in post-uterine as in prenatal existence) in growth and specialization which will allow for the appropriate penetration of the placental envelope so that the individual can gain greater freedom and interaction with the external world. But if this placental shell is ruptured too soon, then chaos results, and special means are required to save the individual and nurse him back to healthy development. (p. 188)

Terrassier's (1985) "dyssynchrony," is another related theory. It includes both internal aspects, involving disparate rates of development among the various capacities of the child, and social or external aspects, involving gifted children's resultant relationships with environmental circumstances.

External dyssynchrony refers to the lack of natural fit between the gifted child and a school curriculum geared to average children of the same chronological age. It also suggests any experience when a gifted child does not "fit" the cultural expectations of how a child of his or her chronological age "should" think, feel, or act.

Remember Greg, for example, in the scenario about the fight with Joe. Mrs. Barnes' initial difficulty in characterizing what had happened stemmed from her viewing the incident from the perspective she assumed a child Greg's age to have taken. Greg's emotionally intense denial was a clue that she had to listen more carefully if she wanted to get a glimpse of Greg's unique personal reality. Greg's understanding of the incident was out of sync with Mrs. Barnes' expectations.

RG: The teacher or therapist (or parent) dealing with gifted children and adolescents simply has to look at and listen to the student or patient -- as well as at his or her own resonating -- to see and hear where the issues are from both Paigetian and Eriksonian standpoints. I have seen and heard adolescents who can proceed along rational ladders of abstraction at light speed owing to IQs above 150, 160 and even 170, who are clearly snagged again and again by unfinished business at Trust, Autonomy, Initiative, Competence and Identity. Virtually all of them had parents who were simply not equipped by education or experience to respond appropriately to the child's confusing displays of irrefutable and/or authority-challenging logic and disquieting emotional dysregulation. The child is typically frustrated to the point of rage (via amygdalar > hypothalamic > pituitary > adrenal triggering into fight or flight) when he or she cannot make him- or herself understood to those who matter. 

Given the essentially Germanistic and authoritarian values of our culture, most parents (who grew up themselves with such parents, after all) resort to demands, restrictions, limitations and punishments (verbal as well as physical). And the reciprocal reactivity (a.k.a. "parataxic integration," see Sullivan) is underway, often leading over time to very unfortunate piling on of mutual resentment, resulting mis-communication and wholesale dis-connection. The gifted child sees him- or herself as a victim, and sees the parents as persecutors -- and the parents see themselves as frustrated rescuers forced into victimhood -- in a never-ending, but disturbingly culturally normal power struggle on the Karpman Drama Triangle. A few years of this can be expected to produce the symptoms of post-traumatic stress disorder I have seen again and again in these families, albeit typically far more severely in the adolescent and young adult offspring thereof.

The cultural expectations aspect of external dyssynchrony is also exemplified in the story that one mother told about trying to find books for her three-year-old son who was reading on a second grade level. She recounted her frustration when she discovered that the books available on his reading level all dealt with stories about experiences common to older children, such as losing one's first tooth or going to school. The cultural expectations with regard to which story themes would be appropriate for a child reading on a second grade level were simply out of sync with the needs of her preschooler.

In addition, external dyssynchrony involves problems gifted children have in developing friendships. When gifted children find other children who have similar intellectual abilities and interests, their newfound companions are likely to be older and more physically mature (Terrassier, 1985). In such cases, the older child will have considerable advantage in terms of real-world experience and physical capabilities.


As Stephanie Tolan has indicated, asynchronous development places gifted individuals outside normal developmental patterns from birth to adulthood. Their experiences are dramatically different from the norm because of their expanded awareness. Additionally, they may never get feedback corroborating and validating their perceptions. This can lead to self-doubt and a precarious sense of self.

In the scenario above, Greg was especially fortunate in that he could convey through his writing his precise view of the incident with Joe.

Furthermore, his previous experience with his mother and his principal led him to feel confident that his version of reality would be taken seriously by the adults in his life. It was this trust that freed him to write the story exactly as he had experienced it.

Clearly, in order to help children like Greg and Jennie, we need to explore their inner worlds - the inner experience and reality of giftedness. Clearly as well we cannot hope to understand the nature of giftedness without understanding those inner worlds.

Surprisingly, however, up until now, definitions of giftedness, and research based on those definitions, have dealt minimally with reality as seen through the eyes of the gifted. In a recent major book covering contemporary conceptions of giftedness, all of the approaches mentioned emerged out of definitions based on some aspect of achievement or performance (Sternberg & Davidson, 1986). Nevertheless, some researchers have begun to investigate giftedness from an internal perspective. These studies deal mainly with the emotional lives of the gifted.

Emotionality and the Gifted

Manifested in Jennie's and Greg's responses to the issues confronting them is an intensity of emotion. Both of them felt an emotionally infused need to understand the truth of their situation and to communicate that truth to others. This was manifested in Jennie's fearful yet strong insistence that her mother acknowledge the limits of what she could promise in the way of longevity. It was manifested as well in Greg's frustration when the account his mother offered did not agree with what he knew to be the truth. It was also manifested in the intensity with which he committed himself to the writing of his story.

Dabrowski (1972) found emotional intensity and sensitivity to be the predominant characteristics of the intellectually and artistically gifted. He outlined five dimensions through which this intensity can be displayed and called them "forms of psychic over-excitability" to underline the enhancement and intensification of mental activity much beyond the ordinary:

PSYCHOMOTOR - an augmented capacity for being active and energetic, expressed as movement, restlessness, drivenness
SENSUAL - an enhanced differentiation and aliveness of sensual experience
INTELLECTUAL - avidity for knowledge and the search for truth - expressed as discovery, questioning, and love of ideas and theoretical analysis
IMAGINATIONAL - the power of thought creation - expressed through vividness of imagery, richness of association, liking for the unusual, and a facility for dreams, fantasies, and inventions
EMOTIONAL - the heart - recognized in the great depth and intensity of emotional life expressed through a wide range of feelings, attachments, compassion, heightened sense of responsibility, and scrupulous self-examination. (Piechowski, 1991, p. 287)
Dabrowski introduced the concept of "developmental potential", which he saw as talents and intellectual abilities infused and motivated through the psychic over-excitabilities. The stronger these psychic over-excitabilities are in a particular individual, the more developmental potential he or she possesses.
While the Dabrowskian framework addresses emotional intensity, the work of Sommers (1981) links the breadth of emotional responsiveness to cognitive complexity. She introduced the concept of "emotional range" to denote the number and variety of emotions experienced by an individual. Sommers found that college students evidencing advanced cognitive organization had a wider "emotional range." She concludes:
The picture of the more emotional person, as it is emerging from this research ... reveals that a high level of emotional responsiveness may be associated with advanced cognitive organization. All of the cognitive skills that were found to be related to the ability to respond with more emotions are marks of a highly organized awareness - an awareness that might be governed by a well-structured system of values, oughts, and beliefs, but not by momentary excitements. (p. 560)
Thus, we have the beginnings of internal view of giftedness. The heightened and broadened emotionality of the gifted, the role played by a well-structured system of values in evoking emotional reactions, and the asynchronicity of development leads us to two important questions. The first is a very practical one, while the second is theoretical: (1) How does this "view from within" help us to deal with the Jennies and Gregs of the world? (2) How do we incorporate the "view from within" into our definition of giftedness?
The Practical Implication of the View From Within

The view from within allows us to see a three dimensional gifted child rather than giftedness simply as manifested through "two-dimensional" achievement criteria. When we set about to teach, counsel, or parent Jennie or Greg, we do so knowing that we must allow the child to communicate to use that unique personal reality rich with ascribed meaning constructed by a complex awareness. When children like Jennie and Greg experience a situation, they superimpose on it their remembrances of past experiences and their projections of future ramifications should they act in a number of different ways. They live life by analysing it step by step while emotionally responding to that analysis.

Thus, we allow a Greg to write out his impressions if that is the best way for him to convey them to us. And we are not impatient with the detail he insists must be a part of his account. Greg must be helped to see, of course, that others do not always perceive experiences with such detailed clarity or infused with such emotional intensity and significance especially other children his age. Nevertheless, this should not be conveyed as a defect on his part, such as "oversensitivity" or a tendency to "carry a grudge." Rather, he needs first to have his view of reality validated, and second, to be helped to find ways of building bridges with other children and not faulting them because of their differing level of awareness. We can think out with Greg what he could have done differently at various points in the relationship to prevent things from escalating to the point where a fight occurred. We can also elicit his aid in projecting the best way to handle his future interactions with Joe.

At the same time, children like Joe need to be made aware of the role they play in instigating unnecessary ill feelings. Joe does not have the extensive memory and keen analytical ability that would allow him to understand the relationship in the same way Greg does. Nevertheless, we can help him to understand more completely the dynamics leading to the most recent conflict and to think out with him what he could have done differently to prevent the fight. We can also design some clear rules for his future interactions with Greg.

Because of the differences in Greg's and Joe's reality picture about the fight, these initial explorations should be conducted separately with each boy. That way, we can confine - or expand - the discussion to focus on whichever reality we are dealing with.

Afterwards, if we choose, we can bring the two boys together to talk about the aspect of the situation that both boys will share - the "rules" for their interaction in the future.

When we approach Jennies, we must keep in mind that we must satisfy her advanced cognitive needs while remaining attuned to her four-year-old emotional ones - no easy task! In the scenario presented, her mother can point out to Jennie that everyone in Jennie's family is well, that they have periodic check-ups at the doctor's office to make sure that they stay well and that there is, therefore, little probability that anyone will die in the immediate future. They also keep their car in very good condition, wear their seatbelts, and take other safety precautions to prevent accidents. Even so, of course, the bottom line, as Jennie knows on some level, is that "No one knows for sure." For this, all Mom can offer is reassuring hugs, and her conveyed confidence that all will be well. In Jennie's case, however, the conveyed confidence must be couched within a context of taking Jennie's questions very seriously, acknowledging the inevitability and unpredictability of death. Otherwise, her logic will not allow her to accept the offered comfort.

Defining Giftedness from Within

Recently, a meeting of theorists, practitioners, and parents in Columbus, Ohio, proposed that asynchronous development - and the emotional consequences and altered quality of life stemming from it - is at the very heart of giftedness (Columbus Group, 1991). The Columbus Group asserts that the contemporary tendency to define giftedness as behaviours, achievement, products or school placements, external to the individual, necessarily misses the essence of giftedness - how it alters the meaning of life experience for the gifted individual. Consequently, the Group offers the following preliminary attempt at a phenomenological definition, which at this point, may apply best to the highly gifted:

Giftedness is asynchronous development in which advanced cognitive abilities and heightened intensity combine to create inner experiences and awareness that are qualitatively different from the norm. This asynchrony increases with higher intellectual capacity. The uniqueness of the gifted renders them particularly vulnerable and requires modifications in parenting, teaching and counselling in order for them to develop optimally. (The Columbus Group, 1991)
If development is perceived as a life-long process, giftedness can then be understood as producing atypical development throughout the lifespan in terms of awareness, perceptions, emotional responses, and life experiences. This places the gifted individual developmentally out of sync both internally, in relation to the different aspects of development, and externally, in relation to cultural expectations.

RG: In the realms of both substance abuse and personality disorder treatment, I have encountered numerous examples of astonishingly capable and competent professionals and performing artists who are very obviously "emotional children" (see Goleman). Their capacities for left hemispheric, hypothesis-and-test, Formal Operational processing, as well as right hemispheric insight (see McGilchrist) into the characters they are portraying, doing business with, competing against or contesting in court demonstrate their 130, 140, 150 and higher intelligence quotients. 

But their private lives demonstrate the interpersonal crippling they suffered from having been so over-developed intellectually while having flunked out at (for example) observation-based Trust, balanced Autonomy, considered Initiative, interpersonal Competence, and integrated Identity. They over-Trust those who don't deserve it, under-Trust those who do; try way too hard to be Autonomous "individuals" here while crashing into gross co-dependence there (see Mellody, and Schaef); Initiatively work themselves to death for the sake of approval here and give up on what really matters there; become celebratedly Competent at their professions here and media celebrities repeatedly subjected to public ridicule for their lack of Competence there; and either Integrated into narcissistic defensive schemes (see Golomb, and Vaknin) or dis-Integrated into borderlinism (see Gunderson, and Searles) making them social pariahs. 

The fast processor processes only as realistically, appropriately, functionally and effectively as his or her programming allows. If Piaget's processor is out of sync with Erikson's developmental programming because that programming on Karpman's drama triangle is inadequate for the processor's capacities, look out. 

This definition of giftedness allows penetration beyond behavioural achievement or non-achievement. Achievement remains an interesting and significant expression of giftedness, and it continues to be important to examine whether it occurs and why or why not. Nevertheless, it is neither the essence of giftedness nor the most important aspect of it. The Columbus Group definition calls for a shift of focus from the external products of giftedness to the true nature of the phenomenon itself. This shift to a view from within is an important move towards both understanding giftedness and understanding our gifted.

Can the Asynchronously Developed be Re-Synchronized?

RG: In short, yes. But it will take time. Ego defenses that have served them as coping mechanisms will have to be "observed, noticed, recognized, acknowledged, accepted, owned, appreciated and understood" so that a lifetime of unprocessed emotions can be "digested" and systemic cognitive schemata "reframed" in the manner of the 10 Steps of Experiential Processing (10StEP, see Garrett). The modern mindfulness-based cognitive psychotherapies of the millennial era can be adapted for such re-synchronization, but they must be adapted with understanding of the issues described in Morelock's article. 

Morelock's References

Columbus Group (1991, July). Unpublished transcript of the meeting of the Columbus Group. Columbus, Ohio.

Dabrowski, K. (1972). Psychoneurosis is not an illness. London: Gryf.

Gowan, J.C. (1974). Development of the psychedelic individual. Northridge, CA.: John Curtis Gowan.

Morelock, M.J. (1991). The case study of Jennie, a profoundly gifted child. Unpublished manuscript Tufts University, Eliot-Pearson Department of Child Study, Medford, MA.

Piechowski, M.M. (1991). Emotional development and emotional giftedness. In N. Colangelo & G.A. Davis (Eds.), Handbook of gifted education (pp. 285306). Boston: Allyn and Bacon.

Roedell, W.C. (1988). "I just want my child to be happy": Social development and young gifted children. Understanding Our Gifted, 1(1), 1, 7, 9-11.

Sommers, S. (1981). Emotionality reconsidered: The role of cognition in emotional responsiveness. Journal of Personality and Social Psychology, 41, 553-561.

Sternberg, R. & Davidson, J. (1986). Conceptions of giftedness. New York: Cambridge University Press.

Terrassier, J-C. (1985). Dyssynchrony - uneven development. In J. Freeman (Ed.), The psychology of gifted children (pp. 265-274). New York: John Wiley. 

Permission Statement 

This is an edited version of the Keynote Address given by Martha J. Morelock of the CHIP Unit at the University of Melbourne at the NSWAGTC State Conference in Sydney in April 1995. It was first published in Understanding Our Gifted, Open Space Communications, Inc. Reprinted with permission of the author.

This article is provided as a service of the Davidson Institute for Talent Development, a 501(c)3 nonprofit dedicated to supporting profoundly gifted young people 18 and under. To learn more about the Davidson Institute’s programs, please visit

Commentator's References

Anonymous: Adult Children of Alcoholics: Alcoholic / Dysfunctional Families, Torrance, CA: ACA World Service Office, 2006.

Garrett, R.: Karpman Drama Triangle Summary, 2008, online at

Garrett, R.: The 10 StEPs of Experiential Processing, 2014, online at

Goleman, D.: Emotional Intelligence, New York: Bantam, 1980.

Golomb, E.: Trapped in the Mirror: Adult Children of Narcissists in Their Struggle for Self, New York: William Morrow, 1992.

Gunderson, J.: Borderline Personality Disorder, New York: American Psychiatric Publishing, 1984.

Jankech-Caretta, C.: The characteristics of precocious children, online .pdf at

McGilchrist, I.: The Master and his Emissary: The Divided Brain and the Making of the Western World, Cambridge, MA: Yale U. Press, 2011.

Mellody, P.; Miller, A. W.: Facing Codependence: What It Is, Where It Come From, How It Sabotages Our Lives, San Francisco: Harper, 1989.

Putallaz, M., ed. in chief, et al: Challenges of Being Gifted, in Digest of Gifted Research, Duke University Talent Education Program, online at

Searles, H.: My Work with Borderline Patients, New York: Jason Aronson, 1986.

Schaef, A. W.: Co-dependence: Misunderstood, Mistreated, New York: HarperOne, 1992.

Sullivan, H. S.: The Interpersonal Theory of Psychiatry, New York: W. W. Norton, 1968.

Vaknin, S.; Rangelovska, L.: Malignant Self Love - Narcissism Revisited, Prague: Narcissus, 2003.

Wilson, B.: Alcoholics Anonymous, New York, A. A. World Services, 1939, 1955, 1976, 2001.

Woititz, J. G.: Adult Children of Alcoholics, Pompano Beach. FL: Health Communications, 1983.

Woititz, J. G.; Garner, A.: Life Skills for Adult Children of Alcoholics, Pompano Beach, FL: Health Communications, 1990.

Commentator's remarks (c) 2014 by Rodger Garrett; all rights reserved. Links are permitted. Please inquire or comment to Thank you.  

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