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Over the years, I've had several persons who wanted my counseling, whom I found ravished with shame that manifested in an unusual kind of grandiosity. I connected with them because I have it in a different way myself. Over the years, I came to recognize what I call "reverse grandiosity." Sometimes after I had been working the 12 step program (at least five years), I noticed that details of my story had changed. Instead of sneaking out of Catholic seminary (where I was studying for the Catholic priesthood) and walking ten (sometimes 15, once even 20) miles to buy my drug of choice, I was really only walking three blocks! Ten to 15 miles make the story sound more dramatic and made my addiction worse that I really was. I wanted to make it sound worse. In fact I wanted to be the "best worst" in the program. Being the "best worst" was my "reverse grandiosity." I was the Star, Hero child in my dysfunctional family (capitalized because of the family systems need to have its shame diminished).

The clients whom I recognized with "reverse grandiosity" were somewhat different. They were people who claimed that their problems were so complex and unusual that no one had been able to help them. One man expressed it as clearly as possible. He said, "I';m just here to have someone to talk to, my problem is too unique to be alleviated by therapy." In other words, I'm special that I'm beyond what any humanly designed system of therapy can do. I let him rattle on and offered a follow-up visit. When he returned, I told him that after reflecting on his last visit, I found him pretty boring and quite ordinary. He became enraged when I called him ordinary. He started quickly enumerating every possible abuse that he had endured.

When he ran out of steam, I told him "you take pride in your abuse; you've made it sacred and in so doing make yourself superior to everyone else." These truths stung and my client kept coming back. I relentlessly called him ordinary, and one day he broke down crying. He told me how scared and small he felt. He said he realized that his idealization and attachment to his abuse made him feel like he was somebody superior. I took him to a 12 step meeting where he was introduced to the concept of anonymity. He soon realized that there were people of every sort in the group - men, women, rich, poor, middle class, lawyers, university professors, artists, laborers, mothers raising children, even a priest and two ministers. All had the same addiction and while their stories differed in details and they had different IQs, their common problem was the same - they had to stop using the drug they were addicted to that had caused their lives to become unmanageable. We were all simply ordinary human beings ravaged by drug addiction.

Anonymity is the great spiritual gift of the 12 step program. A Tibetan monk, Tara Tulku Rinpoche once said "the intensity of our sorrow will vary in direct proportion to the intensity of our feeling that "I am important.""

The practice of anonymity is the practice of being nobody special and that is the essence of humility. After 46 years of being free from my addiction, I can testify to the fact that those who know they are nobody special are busy doing the work that all ordinary humans are called to do in order to flourish. Gandhi constantly attested to being an average, ordinary person. When Erik Erikson wrote Gandhi's Truth (an autobiographical account) he found that Gandhi's wife and children attested to his flaws and his demanding profections of perfection on them.

Anonymity asks us to give up the idea and energy of trying to be special and different (so that we can be set apart from our fellow humans). Accepting being nobody special freed me from having to live up to demanding images. It freed me to do something I didn't have to work at, just being myself. Think of what you could let go of and the energy you would have if you stop trying to be somebody special, separate from the rest of us. Take on the amazing spiritual gift of anonymity and allow yourself to relish in the freedom of being ordinary.

Mr. Bradshaw has enjoyed a long association with The Meadows as a Senior Fellow, giving insights to staff and patients, speaking at alumni retreats, lecturing to mental health professionals at workshops and seminars, and helping to shape its cutting-edge treatment programs. His New York Times best-selling books include Homecoming: Reclaiming and Championing Your Inner Child, Creating Love, and Healing the Shame That Binds You.

The Meadows is an industry leader in treating trauma and addiction through its inpatient and workshop programs. To learn more about The Meadows' work with trauma and addiction contact an intake coordinator at (866) 856-1279 or visit

For over 35 years, The Meadows has been a leading trauma and addiction treatment center. In that time, they have helped more than 20,000 patients in one of their three inpatient centers and 25,000 attendees in national workshops. The Meadows world-class team of Senior Fellows, Psychiatrists, Therapists and Counselors treat the symptoms of addiction and the underlying issues that cause lifelong patterns of self-destructive behavior. The Meadows, with 24 hour nursing and on-site physicians and psychiatrists, is a Level 1 psychiatric hospital that is accredited by the Joint Commission.

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The political and emotional complexities of PTSD (post-traumatic stress disorder) and TBI (traumatic brain injury) can lead to stigmatization and inaccurate attributions. It has long been assumed that soldiers, especially those who have served in combat, are at higher risk for violence. Following WW II several congressmen introduced proposals to send returning combat troops to islands for "retraining" before returning to civilian life. Following Vietnam we had Rambo movies and veterans "going postal". The facts are both simple and confusing: sudden outbursts of violence are rare and very hard to predict.

The article referenced above summarizes some of what is clear: PTSD and TBI can produce shifts in emotional management and changes in "executive brain function" resulting in possible impulsiveness. Complex phenomena like PTSD and TBI are difficult to study and data is scattered, sometimes inconsistent or contaminated by selective sampling or agency agendas. What is clear is that spectacular episodes of sudden violence are extremely rare, despite media attention. There are often multiple factors involved and these include co-occurring disorders, use of drugs or alcohol, lack of sleep, number of tours, severity of symptom or injury, just to name a few. We would love to have instruments that predict these rare outbursts, but they do not exist. We are reduced to the old maxim I learned decades ago: "the best predictor of future behavior is past behavior".

I do not wish to oversimplify; however, I want to reassure readers, especially military readers, that they are not likely to explode in some horrific headline-grabbing fashion. The title of the Washington Post article is generally accurate. Put aside the complexities of multiple tours, diminished capacity, head injury, partial recall, fugue episodes, sleep deprivation, isolation, and alcohol, and let's focus on the reassuring take-away message. There is no data supporting the worst fear carried by many. Most veterans are well trained, restrained, disciplined, highly ethical, and filled with a sense of justice, loyalty and honor. Most veterans I have treated live with the dread that they could lose control of their impulses and inadvertently hurt someone. Newspaper headlines about sudden violence and suicide add to their burden of fear. As a 66 year old combat Marine with severe health and mobility problems recently stated, "I am still afraid of what I could do to others.- That's why I need to stay away from others." The fear of losing control results in isolation, self-medication, avoidance, and a whole host of symptoms we see with PTSD.

I would argue that the most common symptom is not violence but extreme dedication to work or mission. I do not have the statistics, but from my years of experience I see pro-social zealousness- not antisocial outbursts- as the most common coping mechanism. Over dedication to work/mission becomes almost addictive. It is easy to get lost in working excessive hours, and it is rewarded by recognition and increased revenue. Channeling one's anger is difficult, but workaholism is an extreme response rewarded in our culture. However, family members can be angry and confused, and the internal burden remains hidden. Sleepless nights, avoidance, occasional road rage and other symptoms flourish, often visible only to a few. Spectacular outbursts are rare. PTSD tends to be a condition that most often fits the following: "Great souls suffer in silence." (Friedrich Schiller). The articulation of suffering is often the first step toward recovery.

Jerry Boriskin, Ph.D, has been at the forefront of the treatment of PTSD, addiction, and co-occurring disorders for more than 30 years. He is the author of several books, including PTSD and Addiction: A Practical Guide for Clinicians and Counselors and At Wit's End: What Families Need to Know When a Loved One is Diagnosed With Addiction and Mental Illness. For more information about Dr. Boriskin, please visit his website at

For more about The Meadows' innovative treatment program for PTSD and other disorders, see or call The Meadows at 800-244-4949.

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Monday, 19 March 2012 20:00

What Caused Sgt. Bales to Snap?

A group I facilitate for Vietnam Veterans struggled with this question even before the name of the accused sergeant was released. Violence, injury, death and war stir intense emotions in all, particularly among veterans who have been up close and personal. The issue of atrocity and slaughter of civilians is, naturally, an incredibly intense and sensitive subject.

My group members wrestled with this for 90 minutes; most had extreme empathy for the cumulative damage war has upon warriors. They could not even begin to grasp the immense pressure put upon younger soldiers, some of whom serve three, four, and up to nine tours. They/we are humbled by shocking reports of soldiers committing sudden violence, some of which is toward family, but more often towards self. They embraced the contributing factors that need be considered: alcoholism, traumatic brain injury, post traumatic stress disorder (PTSD), financial problems, issues of unemployment, possible relationship problems, a passed over promotion, an unwanted next tour, recent injury, and experiencing the wounding or killing of fellow warriors.

Reports indicated that Sgt. Bales was suffering from many of these factors; he was also reported to be highly decorated, a model soldier, and has saved lives of civilians and Americans in some of the hottest conflicts in Iraq. How could a highly trained soldier, a member of an elite unit, trained sniper and leader of men possibly commit such an atrocity? Our group struggled with this question and did not come to a clear explanation. They had empathy and contempt; some launched into politics of the current wars, some blamed the military for too many rotations, some defended the military, others discussed the role of combat, loss of recent friends, PTSD, alcohol, and tbi (traumatic brain injury). The discussions were intense and a few favored certain factors, but no consensus or full explanation was derived.

One thing we did derive: in certain situations our usual narratives fall apart. If the conditions are right, we are all capable of sudden violence or extreme behavior. The media will no doubt speculate on which factor(s) were critical in this current horror. Forensic experts will attempt to definitively opine, but we may never fully know why this particular soldier "snapped" in such a dramatic and horrific fashion. Thousands of soldiers carry the burdens of war. Most struggle in silence and harm no one, and if they do injure anyone, they hurt or punish themselves.

We may never know the full explanation of what went wrong. My personal speculation is that alcohol played a large factor. It is the most common variable in violence: domestic, self or toward others. It also works in tandem with PTSD and traumatic brain injury. What will probably emerge is a complex picture of a determined and accomplished soldier worn down by many variables, military and domestic. Early reports suggest Sgt. Bales and others were drinking heavily that evening, against military rules. Those early reports also suggested drinking to levels of blackout. Sgt. Bales allegedly had a drunk driving hit and run episode while stateside. Whereas not the sole factor, alcohol might have been the "tipping point". Alcohol is a common way of "self-medicating" or "de-stressing", but it can have an almost "evil" impact in unleashing primitive emotions. In fact, it is a common but often understated factor in the surging suicide numbers in young soldiers. Alcohol has a long history of violence in so many settings, especially the home. Unfortunately, we continue to deny alcohol's power or even its presence. Mr. Bale's attorney alleged his client had not been drinking.

We will know more as facts emerge, but we may never fully grasp what went wrong or why. We do know that war is ugly; it changes people and distorts mind, body and soul. The results of war can make you feel "untouchable" and unique. My hope is that veterans or military personnel reading this blog will recognize that their worst fears are not reflected in the rare disasters. Most people, even civilians, have a fear of "snapping". Exposure to the horrors of war intensify that fear beyond that which most observers can express or comprehend. The vast majority of those who develop PTSD do not snap. Instead, they suffer quietly and deconstruct their lives. PTSD, especially with co-occurring addiction, is complicated and destructive, but highly treatable. Recovery requires Sleep, Safety and Sobriety, the three "S's" that are the first steps in separating you from the demons of war.

Jerry Boriskin, Ph.D, has been at the forefront of the treatment of PTSD, addiction, and co-occurring disorders for more than 30 years. He is the author of several books, including PTSD and Addiction: A Practical Guide for Clinicians and Counselors and At Wit's End: What Families Need to Know When a Loved One is Diagnosed With Addiction and Mental Illness.

For more about The Meadows' innovative treatment program for PTSD and other disorders, see or call The Meadows at 800-244-4949.

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For information on The Meadows or its Houston-based activities, please contact Melanie Shelnutt, Houston Community Relations Representative, at 877-733-7930, (713-702-7784 local) or email

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My therapist told me most sex addicts have multiple addictions. Is that true?

I have never met a sex addict addicted only to sex. Typically, three to six addictions interact with one another. Most individuals who come into treatment don't realize this. Often they are in denial about the scope of their destructive behaviors, minimizing and rationalizing their patterns. Often they construct and normalize complex lives, allowing one addiction to flow seamlessly into the other.

Professionals who work 80 or 90 hours a week may feel they have earned a weekend of binge drinking and sex. They tell themselves they are not workaholics, because they can take time off to "relax." Similarly, some individuals who work excessive hours take vacations only to pack every minute with activities: scuba diving all day; a volleyball tournament before dinner; an expensive meal; and clubbing with alcohol, drugs, and sex until 3 a.m. - only to start the cycle over the next morning."I don't have a work addiction. I can relax and take time off," they tell themselves. What they don't realize is that they are addicted to intensity. They look for the high or emotional escape that allows them to avoid uncomfortable feelings.

All addicts are "shame-based," meaning they were given negative messages about themselves. A child can experience abuse that is overt (recognizable abuse that can be verbal, physical, or sexual) or covert (in which the child is not typically aware of the subconscious messages). Covert abuse is typically couched in the expectations that parents have for their children. "If I am a good athlete, my parents will be proud." "If I am homecoming queen, I will be popular."

These children believe they must perform in order to have value. Such intensely goal-oriented thinking teaches - and ultimately allows the children to avoid - feelings of shame. This is when patterns of addiction begin.

This need for external gratification sets up the children to have low internal esteem. They feel they are not enough; they are worthless and unlovable... unless they produce. Winning trophies and awards will bring attention and a sense of value. Before they are aware of it, these people establish patterns that allow emotional escape.

After cheating on his wife, the sex addict feels no guilt or remorse about his betrayals, but stops at the local pizza parlor and eats a whole pie. Still numb, he spends several hours gaming on the computer - yet another way to avoid the emotions that lie below the surface.  His patterns satiate his pain and shame.

Food addicts may gain weight so they don't have to be sexual. "I don't need sex," they tell themselves. "I am strong and independent."

The after-work drink with coworkers may turn into a one-night stand. "I wouldn't have done it if I hadn't been drunk."

In treatment, individuals look at the interactive patterns in their lives, the seamless processes they unconsciously devise in order to survive painful feelings. The healing process often overwhelms the individual, because the addict often believes his or her own lies: "I don't really have problem with..." In reality, they have spent a lifetime jumping from one addictive behavior to the next on a roller coaster; the costly consequences can impact their livelihood, relationships, health, and finances - and can even bring death.

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