Facebook is not helping either. I now have multiple ex-girlfriends as friends on there, and the photos of their children break my heart. Well, one in particular. My first love. We still Email from time to time, but I dare never mention feelings. Interstingly, I made amends to her during that whole Cult fiasco many years ago. Yet, no mention was ever made of the fact that it was she who betrayed me, lied to me, and harmed me. I bite my tongue on these things. They appear only here. And, such is the making of depressed mood. So be it. Martyrdom is what I do best. I deserve it. I am unloveable.

How righteously indignant I can be. What arrogance to think that I might be of some value to a woman; my love a merit to be achieved. Myself, a prize? A darstardly cognition of the evil, diseased self. I tighten the screws, and bleed from the temples. I fight with this, here, now. My unexpressed, shameful anger at those who have wronged me. I do not blame them entirely. I never have. I tend to blame myself most. Yet, it grows in me--this feeling of retribution or drive for validation. I matter, damnit. My feelings matter. They have value even if only as opinion.

The Starbuck's down the road was sent by God to have a 24 hour drive-thru window so I can get my coffee and keep the fire burning all night with you,
No baby, the cops aren't surrounding the house, you're high, remember?
Yeah, that's the crack, or the heroine, or I'm not sure but the combination maybe
Why don't you go lay down? No? You want to finger that little piece of paper for another ten minutes?
Will you come lay down with me when you're done?
We stay up for hours and all you talk about is that shit as I become increasingly less optimistic
I study your face and your body - all changing
Your eyes are glassy, red, you look like someone else
Not my sexy, vibrant man - but his decaying shell perhaps
I used to feel small in your arms, but that was last week
Now you fold into a button and I tuck you into my pocket
I hold you long and tight, but feel uneasy as you twitch and twist
I hold you calm and serene and silently ask your body to find harmony with mine
I pray the prayer of desperation
"God, if you're really there, are you listening?"
A tear escapes but you don't notice
We go to sleep like this
When you wake, it is not to me you turn, but to the darkened glass tube
With the black then the white - that big evil looks so tiny
And you consider it the highest bliss

Relapse is a process, amovement of ideas and events that empower the concept of being unable to deal with abstinence. The relapse process may lead to a return to drug and alcohol use, emotional or physical deterioration, suicide or accidental death.

The course is identified by material, predictable and identifiable relapse warning signs that begin quite some time before a return to use or collapse occurs. Relapse prevention planning teaches people to identify and create plans to manage these signs and symptoms. The main objective is to prevent the progression early in the process and return to the path of recovery.

Relapse , emphatically does not have to be a part of sobriety, there are folks who do not go back to drinking or drugging. Studies of life-long history of relapse and recovery indicate that not all patients relapse. Approximately one third attain enduring abstinence from their first serious attempt at abstinence. Another third have a period of brief relapse episodes but eventually achieve long-term abstinence. An additional one third have chronic relapses that result in eventual death from .

These statistics are compatible with the life-long recovery rates of any chronic lifestyle-related illness. About half of all relapse-prone people eventually achieve enduring abstinence. Many others lead healthier, more stable lives despite occasional relapse incidences.

Bonus Tip: And now I would like to invite you to access our free mini-course on the 5 most common mistakes people make in addiction recovery. To gain instant access, visit us at: http://TheRecoveryClub.com

There is a gallery of sober living and life skill information available in the Free, 103 Page Resource Guide. Lot's of '10 tips to...' and 'How to' articles. These are all solution oriented. We have been in the problem long enough.
Click Here: Free Addiction Recovery Help Guide,

In spite of the best motives, a great number of folks entering addiction recovery will relapse.

Entering sobriety can be viewdas having 3 phases, each with its goals and growth opportunities. At each point in the processthere are certain dangers present that need to be identified and planned for. Let’s analyze each of these 3 phases.

Phase 1, Early Recovery Phase

In early recovery the object at its simplest is abstinence from all mood altering chemicals. Stop using. Needed to do that, certain areas of new knowledge need to be addressed to establish a relapse prevention plan:

1. The acquisition of addiction knowledge and its effects.
2. Skills to refuse drink and drugs and to cope with abstinence must be learned and practiced.
3. A large sober social support system must be started and created.

People entering early recovery need to learn how to enhance, feelings, thinking and behaviors based in recovery principles to replace those formed while actively using their drug of choice.

The major cause of going back to drinking and drugging during the phase 1, or the early recovery period is not developing effective recovery and social skills that are needed to build an abstinence and recovery based syle of life.

Phase 2, Middle Recovery Phase

The major goal of development in middle recovery is establishingbalance in ones lifestyle. A major objective is to start to identify the wreckage of the past and start to address it. Having stopped the drinking and drugging in phase 1, it is time to turn to developing personal growth and maturity. Stress can sometimes increase as the person returns to ‘the real world’. Items often addressed to establish a relapse prevention plan:

1. Doing personal work to reestablish self-esteem and self-worth.
2. Repairing damaged relationships with .
3. Moving back into society in a healthy and productive way.

The major cause of relapse during the middle recovery period is learning to work with the emotional drama of life problems.

Phase 3, Later Recovery Phase

In the later phase of recovery, people strive to make changes in ongoing issues that have continued to block or inhibit life satisfaction. This is the arrival at a ‘serene and tranquil’ place in life. Choices are made according to a sound and newly developed sense of ethics, morality and purpose. This is a phase of personal growth and movement forward in life. Items worked to establish a relapse prevention plan include:

1.Indentifying and processing and changingself-sabotaging and self-defeating behaviors.
2. Looking at the sources of personality development.
3. Working through family of origin issues.

The major cause of going back to drinking and drugging during phase 3, or the late recovery period, is either the lack of ability to cope and work through the emotional stress of unresolved childhood issues or avoiding the need to change one’s personality and lifestyle into one of growth and health.

And those are just the major relapse hazards in each phase of recovery. To learn about the 5 mistakes most often encountered in recovery click Relapse Prevention Plan to claim our free 5 part mini-course.

Along with Unsane and Helmet, Today Is The Day represent one of the few active acts associated with AmRep.  While they never had a hit like "Unsung" or "Scrape", they were still able to find their audience and tour/record new music, even after AmRep fell apart.

They formed in the early 90s in Nashville, Tennessee and debuted with self-released EP called "How To Win Friends And Influence People" in 1992, which attracted attention of AmRep. They were signed to label in February of 1993 and released "Supernova" later that year. The following year they released "Willpower", followed by "Clusterfuck" EP with labelmates Chokebore and Guzzard.  Their self-titled album released in March of '96 became their final record for AmRep.

In 1997, they signed to metal label Relapse Records, which released "Temple Of The Morning Star" (1997), "In The Eyes Of God" (1999), "Sadness Will Prevail" (2002), and "Kiss The Pig" (2003), as well as compilation called "Live Till You Die" (2000). "Kiss The Pig" was the last record that they did for Relapse, while "Axis Of Eden" (2007) came out on band leader Steve Austin own label Supernova Records.

Musically, they post-AmRep sound shifted in more metallic direction (not surprising, given the fact that they were signed to Relapse), but they never abandoned trademark quirkiness - compilation album "Live Till You Die" included cover versions of songs by Bad Company, Chris Isaac and The Beatles, while double album "Sadness Will Prevail" is mixing noise/ambient and heavy metal in equal proportions.

Associated Bands - Mastodon, Aurora Borealis, Blotted Science, Divine Empire, Hate Eternal, Malevolent Creation, Nile, Esoteric, Circle Of Dead Children, Lethargy, Taipan

Fun Facts

- TTID are well known for their use of samples from movies, songs and commercials. Snippets of dialogue from movies "Rebel Without A Cause", "Paradise Lost", "Carrie", "The Last Temptation of Christ", "The Illustrated Man", "Memento", "Rosemary's Baby" (among many others) can be heard on their records.

- Former members Brann Dailor and Bill Kelliher went on to play with Mastodon

- Steve Austin is not related in any way to WWF figher Steve "Stone Cold" Austin

- Steve owns "Austin Enterprise" studio in Nashville, TN and he also runs his own label Supernova Records. Some of Supernova acts include TTID side project Taipan, Defcon 4 and Roanoke.

- TTID portrayed a christian rock band in black comedy "Duck! A Carbine High School Massacre" (1999)

Discography:

How To Win Friends And Influence People EP (1992)

I Bent Scared 7" (1993)

Supernova (1993)

Willpower (1994)

In These Black Days Volume 3 (Split With Coalesce) 7" (1997)

Temple Of The Morning Star (1997)

In The Eyes Of God (1999)

Live Till You Die (2000)

Sadness Will Prevail (2002)

Kiss The Pig (2003)

Zodiac Dreaming (Split With 16) Mini-CD (2001)

Descent (Split With Metatron) (2001)

Axis Of Eden (2007)

Descent

This Machine Kills Fascists

Spotting A Unicorn

I asked him why. He said because he wanted to (Ah, NOW I know where my son gets it from!) I told him that wasn't good enough. I said there are a lot of things that I want to do, yet before I do them I consider the effect it will have on other people. I want to go shopping. Before I spend our money I consider how much I can spend and on what and what will happen if I spend too much.

I asked him why he didn't tell me earlier that he was going to drink and if he was trying to hide it, doesn't that mean he knows he was wrong? I didn't get an answer to this one. I am considering that to mean he knows that I am correct.

All in all, it was not a productive discussion. He got snarky and rude. He was defensive. I did tell him that I was disappointed in him, and I was so proud of him when he had made it two weeks without drinking.

I had already thrown my fit here, so I was able to speak to him dispassionately.  I was calm and showed very little emotion. He's not used to that. I think it freaked him out a little.

He hasn't started drinking again, yet. I'm watching it though. I don't want things to go back to the way they were before.

Go ahead.  Be the person who doesn't take responsibility.  You remember what that's like:  disappointing friends, alienating your loved ones, moving into isolation. 

Okay, be removed.  Remove yourself from that which brings you pure joy and contentment.  It's still strong in your memory so re-play that clip--the times you longed for something more and wanted to turn back. 

Go on!  Satisfy your desires and find some temporary pleasure.  Going backwards is always an option.

Whatever it is that you're feeling now, you won't be feeling that while you're high and out of touch. 

Just do it!  You only live once right?  Why not reward yourself for doing well.  You deserve it.

Come on... you're going through a rough patch.  It won't get any easier so you might as well have some fun in the meantime.  Who would know anyway? 

Yes, I could do that.  I could throw away my progress and dive into the ocean of oblivion.  I could run from myself, just float above for a while and turn a callous ear to conscience.  I might even enjoy myself for a moment.  I could do that. . .

About a year ago, while sitting in a lecture on learning and memory, the idea that certain drugs can affect the emotional responses to memory long after the memory itself has been formed came up. As someone interested in addiction research, the implication for treatment immediately came up in my head:

Could we possibly reduce the effect of drug-triggers by giving people a pill?

The answer is not, in fact, that simple. Even in the studies already done in PTSD patients, the memories have to be triggered and the drug given at exactly the right time to be affective. In fact, in humans, some of the best work has been done in PTSD patients immediately after the traumatic event.

Still, a recent study in animals suggests that the theory is sound. By interfering with the activity of a neurotransmitter important in the formation of memories, researchers were able to stop animals trained to self-administer cocaine from doing so. The animals, which had been trained to push a lever for cocaine when a light went on, reduced, or even stopped the responding after a single dose of a substance that blocked memory formation. Again, this only worked if the drug was given while the light (as in the drug-trigger) was presented at the same time.

Either way, given the powerful role of triggers in relapse, this avenue of research has some promising possibilities for future treatment of drug addiction.

I'll keep you updated as more research comes out.

He just looked at me and covered his head. I'm really disappointed. In both of us. In him for caving in and drinking and in myself. I KNOW better than to get my hopes up. Every time I do, they are crushed. I feel a little silly too, given my recent post about being excited and not knowing how to deal with it. After nearly 11 years, I should know better.

Now I'm expecting are going to go back to the way they were, 14 days ago. The drinking when I'm at work, the drinking as soon as he gets home. The arguments and tears. I feel stupid and duped. He knows that he could have called me at work. He had to have purchased it before I left for work. On his way home. He KNEW he was going to drink last night. I leave for work around 9. He got home about 6. The kids were in bed by 8. I was so happy.

The worst of it is, today is my son's birthday. It should be a happy day. But I feel like crying.

I already hit publish, but you know what? I'm not done. I promised honesty, so lets go all the way. I hate him as much as I love him. I hate him for being weak. I hate him for putting me and our children through this. I hate him when he's drunk and I hate him for the uncertainty. I hate him for getting my hopes up and then dashing them to the ground. I hate that I brag about him not drinking and that I'm proud of him and then he makes an ass out of himself. I hate him for ruining holidays and special days with his drinking. I hate him (and myself) for being so fixated on it that I allow it to over run all of my waking thoughts. I hate him for ruining the person I once was, before I got involved with an alcoholic. I was full of hope. I laughed, I was carefree. I didn't have to worry about my home burning down because of a forgotten cigarette. I didn't have to worry about how my kids are going to grow up. I didn't have to tip toe around until I ascertained what mood someone was in. I was happy damn it. I was a 16 year old girl who got in over her head. 11 years later I am a bitter, pissed off 27 year old who is still in over her head. I've had to deal with suicide attempts. I've sat up all night listening to him breathe because I'm scared he's poisoned himself with alcohol. I've poured out bottles, cried, cursed and turned into a harpy. i've watched him embarass himself in front of friends and family. I've made excuses and cleaned up messes. I've ignored the issues, addressed the issues, delivered ultimatums and bared my heart. And he still drinks. And i hate him for it.

I asked him how long it had been since he had a drink, and he stated a week and a half. I decided not to bring up the day that I thought he had hidden it from me and took it at face value. I asked him if he was going to quit drinking. He said he didn't know. I asked if he was going to try. He said he didn't know. I told him that I was proud of him for stopping for this long (trust me, it's an achievement) and that I wanted him to go to AA. I reminded him that I'm not sure I want to take the step of purchasing a house with him still drinking. That is a big point with me, since I found out our credit is not as bad as I thought and we will be approved for a large amount.

He asked me why, and I again explained that I don't want holes in the walls, or him breaking things due to falling down or having a fit. Here's where his most common evasive tactic comes in. He turns it around on me. Tells me I don't clean enough, don't keep up with laundry and what not. He does have a small point, but that's not what we were talking about. I told him that he was welcome to bring up  my short comings at a later date, however, at this very moment, we are not discussing me, we are discussing him.

It sort of degenerated into a small spat from there. Which again, is how he evades actually talking about it. If he can turn the focus on to me, or start a fight, he can ignore the issues that we are discussing. I wouldn't let him distract me. In the end I told him that I was not looking for a fight, that I do love him, but I can't work his problems out for him. I again told him that I want him to go to AA meetings on a regular basis and if he was scared to go, I would go with him (if they allow it) for moral support. That I will not be swayed from this course.

We will revisit the issue in the next couple of days. I'm trying to discuss it with him before the mood swings start. He has drank so much, for so long that he will begin to get shaky soon. He will twich violently in his sleep and get the tremors while he is awake. He will get extremely grumpy and touchy. We've been at this point before. I think the longest he has gone without a drink was 3 weeks. When he gets to the point where DT sets in (Delerium Tremors, I believe is how it's spelled) he usually breaks down and the whole long ordeal begins again.

I'm hoping, that with AA he can work through them this time.

Unfortunately, work has brought on a downwards spiral.  It turns out that my previous manager, who's on leave, will still effectively be managing me from home.  I had a number of documents reworked to the effect that stuff was rearranged, but no real value was added.  It has the effect of making me feel like a worthless piece of shit.  I know intellectually that's not true, but try telling my fucked-up brain that.  'Knowing' and 'believing' are two different things.

Anyhow, the good thing is it's reinforced the fact my decision to job-hunt was the correct one.  I should really trust my gut instincts more.  Now all I have to do is find a new job, and I'll be set.  Wish me luck.

On a happier note, SO's birthday last Saturday went well.  He loved his presents, and he was thoroughly spoiled by everyone, except his mother's side of the family, who ignored him.  I love him so much and it hurts me when people treat him badly.  He deserves so much better.

Anyhow, I'm off to stare vacantly at the walls for another few hours.  Good times.

I am not aware of the idea that a person's choice of suboxone vs methadone should be dictated by their tolerance level, and I certainly do not agree with that idea.  I also do not see any advantages of methadone over suboxone when it comes to maintenance treatment of addiction, except for cases where suboxone is problematic-- say in people who have frequent surgeries or frequent need to go on and off pain medications.  This may be the case in a person with a relapsing physical illness that causes severe pain, such as severe migraine or cluster headaches, or sickle cell anemia.  Buprenorphine takes forever to leave the body, and until it is mostly gone it is difficult to acheive analgesia even with very high doses of narcotics.  Patients with sickle cell crisis usually require potent narcotic pain medication, and it would be horrible to have to wait for three, four, or even five days in severe pain, waiting for the buprenorphine to dissociate from the receptors and get out of the way of the morphine, oxycodone, or fentanyl.

Methadone is just another opiate agonist.  Agonists are molecules that have a dose-related effect at the receptor, whereas antagonists block receptors without activating them (the classic opiate antagonists are naloxone and naltrexone).  Buprenorphine, the active drug in Suboxone, is a 'partial agonist', 'mixed agonist', or 'agonist/antagonist'-- it has both a blocking effect and an activating effect.  The dose/response curve for agonists would be a diagonal straight line going upward to the right; for a partial agonist like buprenorphine the graph is similar in low doses, but at about 4 mg or so the line comes off of the diagonal to flatten out-- the 'ceiling effect'. 

I do not see methadone as being better at filling that 'hole' that we were talking about (the 'hole' was in reference to the chronic empty feeling that many opiate addicts talk about having-- sometimes for their entire life, even before opiate use).  Methadone has the same problem that all agonists have-- tolerance.  At first, methadone will provide a euphoria... but then tolerance rises and the effect goes away, unless the dose is increased.  And that is how it goes... no matter how high the methadone goes, tolerance will ALWAYS catch up eventually.  That is why there is just no 'future' in opiate agonists-- no future in using them for chronic pain, and no future in using them to fix 'emptiness'.  In ALL cases, tolerance will take away any positive effect.  That is why people end up on ridiculously high doses of methadone or oxy if they use long enough.

Bupe is different.  The tolerance is 'static'-- it does not keep changing.  There is an initial change of tolerance-- depending on the patient's tolerance, the suboxone will pull the tolerance down, or push it up, so that it is set at about equal to the tolerance caused by 30 mg of methadone per day.  But once there, the tolerance stays the same even after months and months go by.  Moreover, because of the 'ceiling effect' the tolerance doesn't change much even if the suboxone dose changes, as long as the suboxone dose is above 4 mg.  This is why there is little withdrawal when tapering suboxone until one gets to about 4 mg per day or less. 

We don't know why cravings go away on suboxone.  The effect seems to be dose related, occurring more as doses increase beyond 8 mg per day.  Cravings are manifest by many different things-- depression, irritability, or just plain old desire to use... and so many patients say that on Suboxone they feel happier, less moody, less irritable, etc.

I have treated over 150 people with buprenorphine over several years, and I am still learning more about the medication and about how people respond over time.  It is not a 'sure thing'-- people will still relapse if they don't make changes in their lives.  The most important thing, in my opinion, is to remember the misery of being trapped by addiction.  People should be told that it is still there waiting for them-- it will always be there.  People should also be aware that once they have used on Suboxone they are in deep trouble-- the Suboxone seems to represent a commitment to a new life that helps keep people clean, and once a person crosses the line and uses, that commitment goes 'poof' and is gone.  Suddenly the person is back to trying to find the 'will power' to stop using... and will power simply does not work.  Even worse, residential treatment no longer works well either-- residential treatment relies on the patient becoming so desperate that the mind opens to a new way of thinking.  Addicts who 'know suboxone' don't get to that level of desperation-- when they get anywhere close to desperation they say they have had enough, and they run from treatment. 

Opiate addiction is a fatal illness-- a horrible, fatal illness.  It will wait, dormant, until the addict becomes complacent or thinks he/she is 'cured', then become active and take the addict's career, money, house, family, freedom, and life.  It will change the addict's thought process to allow rationalization of almost anything.  I encourage people to avoid complacency; use Suboxone as one tool of a recovery program, and make every day another step toward a better life.  Seek out positive experiences.  Take a daily inventory.  Find non-using friends.  Keep busy and always have at least one job.  Read something every day.

  And finally, fear opiates.  Always be afraid of opiates-- see the substances for what they are, and what they have done to you.  Fear them and hate them.

If you have a minute check out my hobby of putting together web pages:  http://warmalglobing.com  is one; another is http://dsm-v.com .  And of course my home at http://wisconsinopiates.com .

Under painful circumstances.

So, of course, I'm hurting. Just a little.

Last night, it hurt a lot more. So I hurt myself quite a bit.

Yup, a relapse. A bad one.

It resulted in a six hour stay in the ER, along with my mother's intentions of making me a patient at the psychiatric hospital.

And then I went to bible study.

Hell, it's two AM, and it hurts thinking about him. I guess it's supposed to, a little bit.

But I've begun looking for God again. That means something, doesn't it?

Damn, I know a boyfriend isn't healthy for me. He just made me feel so. damn. good.

Then again, so does cutting. And it isn't healthy for me either.

I ain't healthy, period. See? Period.

So now I'm going to go let it stop hurting, and finally surrender this hellish game to a power that can turn the tables in my favor.

See? It already feels better...

More posts later.

Listen Here

Pre-order Traitors here

University Will Welcome New Students with Alcohol Lessons; Yes, alcohol lessons!

New students arriving at the University of Virginia this summer have the option to participate in the university's first-ever orientation session devoted specifically to alcohol abuse, the Daily Progress in Charlottesville reported July 20.

In addition to the orientation seminar, students will be asked to go online in the weeks before classes start in late August to complete an hour-long course focusing on facts about binge drinking, alcohol poisoning and sexual assault. "Every year we hear about students across the country dying from alcohol poisoning," said Susan Bruce, director of the university's Center for Alcohol and Substance Education. "We don't want that to happen here."

University officials say their efforts are focusing largely on correcting student misconceptions about the level of drinking taking place on campus. The orientation session is entitled "UVa Students: Is Everybody Drinking?", and it already has demonstrated that students tend to overestimate drinking prevalence among peers.

Each of a group of 15 students who attended a recent session held in conjunction with fall class registration believed the school had an equal mix of heavy drinkers and non-drinkers. Yet student surveys on campus have shown that 75 percent of first-year students either drink only modest amounts of alcohol or none at all.

The orientation session also makes reference to other risky behaviors, including sex and smoking. Bruce said that 81 percent of students reported no recent smoking, and for the others the university will introduce a campaign to appeal to students' financial interests. The campaign's posters read, "What's the difference between a smoker and a non-smoker? $1,766" (the annual estimated cost of cigarettes in the local community).

"We find that the monetary perspective resonates with college kids," Bruce said.

From Join Together Online

See also;

• Tips for Teens: The Truth About Alcohol
• Alcohol and Sexuality
• Drugs That Affect Sex

However I am once again attempting to kick the habit and as of tomorrow Sunday July 20th I will once again try to quit cold turkey. I will document my struggles and relapses on a regular basis and I will attempt to reach the 2 week mark without a cigarette. It is my belief that making it two weeks help me shake the habit. I realize that it will be an day by day, perhaps minute by minute ordeal and I am not looking forward to it. However in the greater interest of my future health I believe 2 weeks of hell will be worth it.

If anyone has any tips or guidance I am all ears.

After searching for a while, and finding not that much about goals in the peer-reviewed pain management literature, it's nice to have an article that specifically discussed goals and the effect of not meeting goals on participants. This article by Guck and colleagues from the University of Nebraska, examines how a group of participants in a pain management programme view their achievement of goals - do they blame themselves, or external factors for their 'lapse' or 'relapse'.
It's interesting that this piece of research is based around the concepts of relapse prevention, because one of the main reasons for considering the place of goal-setting is to ensure participants make changes in their lives that matter to them - and retain those changes over time. So relapse prevention theory will have much to add for therapists wanting to help their clients stick with the 'programme'. I'm not sure that many therapists would have really considered this body of knowledge in relation to physical exercise or using coping skills, because much of the theory is directly related to smoking cessation, dietary change or alcohol abstinence.

Anyway, onto the research.
In this study 100 particpants from 263 people who entered an interdisciplinary programme over a five-year period were asked to participate. Of the original 263, 30 failed to complete the programme, and of the remaining people, 100 provided complete information.

From the description, the programme sounds very similar generic and consisted of a four-week programme of exercise, medication review, active coping strategies and other issues such as work, family and social issues were also addressed in both individual and group sessions.

In the final week of the programme, relapse prevention sessions were held, covering high risk situations, and how to reduce the likelihood of the rule violation effect.

Interestingly, the group developed their goals for after the programme at the time of this discussion - in full awareness of the role of 'slips' and 'lapses'. Participants develop between 4 - 6 goals, and staff assisted them to ensure goals met the 'SMART' goal schema. The goals were to be achieved in the next six months.

Six months after discharge from the programme, participants were contacted with a copy of their goals list, and were asked to identify whether they had met the goal, and for each unmet goal, to record on four attributional rating scales, the reason for not doing so. The attributional scales were 1 - 7 likert-type scales, with 'internal' to 'external', 'stable' to 'unstable', 'gobal' to 'specific' and 'uncontrollable' to 'controllable' factors as the anchors.

Results - Overall, the 100 participants identified 487 goals they intended to meet - 322 of these goals were recorded as met, while 165 goals were not. 46 of the 100 participants met most of their goals, while 16 failed to meet more than 2/3 of their goals. Chi-squared analysis indicated that more goals than not were met in most of the goals categories - except for work.

The causes for not meeting work and social activity goals were attributed to external rather than internal factors more often than were causes for not meeting coping skills, medication change, or exercise goals. Work goals were more often to be thought to be uncontrollable.

So, it seems that goals that were set during this programme by and large were met - except in the two areas that depend a lot on other people (social and work). And the attributions that people made as to why these goals were met or not met differed depending on the type of goal. This suggests that it's not helpful to use the same relapse prevention model for some of the goals - that is, people do tend to believe that when they can't manage work or social goals, it's about external factors, uncontrollable factors, and global factors that are stable.

This makes it very difficult for people to reconsider how to cope with these demands, and from other research in relapse prevention, makes it more likely for them to feel there is nothing they can do to change the situation, and reduce the likelihood they will attempt again.

The researchers in this study suggest that people who need to set goals in social and work areas need to be taught how to cope with factors that affect work and social goals that are external and uncontrollable - unfortunately, as many pain management programmes don't even consider return to work as a goal, and certainly don't seem to break that goal into manageable 'chunks', this may remain a concern within New Zealand at least.

Once again I'm left with the impression that developing pain management skills and goals to help people return to work despite chronic pain is different from and more complex than simply helping people develop generic pain management skills. The workplace is different from the home - and goals made for using pain coping strategies, exercise and medication at home seem to be much more easily achieved than those about using them at work. Food for thought: perhaps pain management at work is a specialised area for pain management, and not simply the same as 'any old pain management'?

Gluck, T.P., Willcockson, J.C., Schmidt, R.L., Criscuolo, C.M. (2008). Attributions regarding unmet treatment goals after interdisciplinary chronic pain rehabilitation. Clinical Journal of Pain, 24(5), 415-420.

How does this happen?

You were going to meetings, when you weren't away on work,but if possible while on work. You didn't call your sponsor everyday. You weren't working the steps. You were trying hard, as hard as you could which wasn't hard enough. You are getting stronger with time, with every day, even if its not the best you are stronger than the one before.

Before I knew it, you'd be sleeping all day. I'd sleep with you just to be with you. You didn't like that, it wasn't healthy. I knew it too. So you left me. You wanted more for me then you could give me. You wanted me to expect more from you, you are right, I should have.

I wish you never had to fall to get where you are. I hope you never fall again. I'm falling in my own way I wish you could pick me up. But you're not strong enough yet. Expecting that of you is like expecting a newborn to walk and talk.

I let you fall. I didn't want you to get used to me picking you up you'd never get stronger. I had to let you fall like you had to let me go. You need to learn how to stand on  your own 2 feet alone. But you've told me right now you're not all alone completely. I guess you still need a temporary replacement in lieu of me. But you'll never be able to replace me.

We're not together. But still please don't ever get sick again either way please find away to be strong.

But right now, I want to FUCKING MURDER HIM!!

I told him, I promised him, I would stand by his side through good times and bad. Always. I have my own shit to deal with, and I needed a little time away from him making me feel like shit ( talking to me about other girls he was going on dates with, because "they make me anxious, so I talk to you to get my anxious feelings out") When middle of March we had agreed to be "together" he relapses and fucks me off. Middle of June he shows up because he "misses me" tells me he can't have a relationship but somehow ends up "kinda/sorta dating"some girl, and tells me "we are too close to ever date"

FUCK YOU.

I am a rapid cycling bi-polar manic depressive with a borderline personality disorder chucked in for good measure. He is a Hebephrenic Schizophrenic. Do you see where this is going? Ya, that's right.

I had a relapse myself and told him I could not be a part of his new dating life, that to expect me to talk him through his dates and shit with girls that DO NOT KNOW he has Schizophrenia, so all they have to do is show up, is cruel and unfair to me. These girls don't know, I am one of the few people he has ever told, and when we met he told me in the first 3 hours of us talking. He said "I don't know why I brought it up, I don't usually tell people" He loved me in March, and now he can't even speak to me. He can talk to every other girl, fuck them, take them for coffee...hell he can even DATE them, but me...I get fucked off again. He said to me "You know that I am not closer to anyone than I am to you" which does me a lot of nothing. Jessor was mine, he used to tell me he loved me, he adored me, I was beautiful etc etc. Since his relapse and subsequent return he has been a total cunt to me. I don't know how to talk to him. I chose to distance myself from him ( I tried, and failed) I tried speaking to him a few days after emailing him and he won't answer me, and this was 7 days ago.

I cringed and waited for the blahblabhl has deleted you message to pop up, but it didn't.

I'm still waiting for him to do it.

i am trying, but fuck...I love him. and yes, I think I might also be in love with him, but no one has ever stood by him. I wonder if he thinks my emailing him and saying I needed a break, felt like I was abandoning him. He said he has never stayed in touch with someone this long and that it's scary how calm and comfortable he is with me, that he has never felt that way with another person, ever.

So why doesn't he want me?

The person he has waited for, he fucks off. Stupid twat that only wants him for sex, and a very shallow relationship is the one he falls in love with.

give me a break.

For once, I would like to get the boy, instead of someone else getting my hard work. I tried to talk to him tonight, but I think he is relapsing again and he didn't respond just went offline. This has been going on for the last 6 days. He can see me signed in, and I can see him. What is he doing? Sitting there staring at my name? Trying to get the courage to click my name? Waiting to delete me, or waiting for me to delete him?

I was so close to outting him as a SZ on his facebook when he changed his status to "Jesse is in love with the girl - with the dirty feet" and then yesterdays "Jesse misses her" he knows I see this shit, and he just rubs my face in it.

When she dumps him, he'll come back. I think he is having a relapse, he is up at weird hours, up till 4 AM when he should be asleep. He was working 12 hour shifts at a graphic design place, it's 24 hours and whatnot, so I don't know if he lost his job, but something is up.

I can feel it.

LOTS

ZILCH

That has been the story of me trying to move out of here. Last night I put all my might into setting up the stuck dresser. No such luck. Judy volunteered her boyfriend, Rex, to help. ALL by himself he got the dresser into place! I was awed and amazed.

99% of the stuff is out of the apartment. When Judy came over this morning I was telling her I needed sewing machine needles...looked down at my feet...and there was a package! Cool :-)

Today I am sick again. I can't stop coughing. Seems that every time I think I am better, I relapse. I also thought my period was slowing down and after the work I did today, it started up anew at flood stage. Grrrrrrr.....

My head hurts bad, my chest hurts worse. I choke so bad I start to heave. My strength-o-meter says zilch. I HAVE TO leave tomorrow morning no matter what.

Eating disorders are different from drug / alcohol addictions, but there are definitely a lot of similarities. There are a lot of components of addiction treatment that I believe in and think are important, and should be applied to eating disorders:

Recovery is a lifelong, daily process -- You may not struggle with food every day (heck, you could go years of being A-OK with it), but there's always that risk. You don't have the luxury of playing food games (and by playing food games, I mean even casual diets or schedules that don't allow for normal eating). I would compare "I can have a couple of drinks" with "I can lose a couple of pounds."

Denial, and not necessarily that you have a problem, but that you need help -- Denial with EDs is particularly tough because they are not as black and white as other addictions... At what point does a lot of food become a binge? Where's the line between health-consciousness and disordered eating? You may somehow know that your thoughts and behaviors aren't completely normal... but not to a point where you require help. You're still trying to convince yourself that you're okay enough or that you can handle this on your own.

The importance of personal accountability -- All the support in the world isn't going to help you if you don't take responsibility for the disorder. This means somehow sidestepping or pushing past the denial. No one is going to monitor your food intake forever, or follow you to the bathroom forever. If you're not in a place where you can hold yourself accountable, then this means being responsible enough to arrange necessary help and support.

There's no magic cure -- 30 days of residential treatment doesn't mean you're recovered. Simply attending therapy doesn't somehow fix things.

The disorder should be taken as seriously as any potential fatal disease -- I really think that with eating disorder treatment, "slips" are much more tolerated and accepted than in addictions treatment. You can really get away with only putting forth a half-ass effort, because treatment isn't necessarily your top priority. With drugs and alcohol, using once or twice is a big deal. With eating disorders... skipping a couple meals or losing a couple of pounds = not a big deal.

I personally find it interesting that you can dismiss so many little eating disordered things, because hey -- people diet, you're doing pretty well, it's only a couple of pounds, purging every other month is insignificant compared to 3 times a day, etc. I respect Dr. Drew a lot because I always feel that he is saying, "no, these little things count -- recovery is so important that any signs of disorderedness are significant."

You are only as sick as your secrets...

Ce troisième album des américains de Genghis Tron, je l'ai découvert par le biais du single Things Don't Look Good. Ce que je vais dire est très subjectif, mais j'ai tout de suite pensé que ce morceau représentait tout ce que je n'aimais pas dans le metal: les riffs techniques comme il faut, les passages calmes en contraste à la System Of A Down, la batterie (j'apprendrai ensuite que c'est en fait une boîte à rythme) qui pilonne. Et pourtant, de façon inexplicable, j'ai immédiatement accroché. Parce que Genghis Tron a quelque chose en plus, d'indescriptible, qui fait que leur musique dégage des émotions fortes - et pas seulement de la colère et de la haine, même si le chanteur hurle d'une manière super saturée qui n'est pas sans rappeler Jacob Bannon de Converge.

Le trio a eu la bonne idée de se démarquer de tous les clichés du metal, nottament via l'intégration réussie de machines électroniques (boites à rythmes, synthétiseurs...). D'ailleurs, ce n'est pas leur seule bonne idée: ce Board Up The House en regorge, du début à la fin. Tout en ruptures (les changements de tempo sont d'ailleurs très fréquents), tous les morceaux sont l'occasion pour le groupe de nous prouver un peu plus son originalité, en brisant toutes les limites qu'on pourrait chercher à lui imposer: vous trouverez donc ici tout aussi bien des passages foudroyants d'une brutalité extrême (par exemple sur un The Feast terrassant, à la basse très rythmique et où le chanteur me rappelle celui des regrettés Lowercase) qu'un morceau se rapprochant presque d'un hip hop oppressant, avant de devenir stellaire (The Whips Blow Back), voire des synthés proches de Boards Of Canada sur le couple Recursion / I Won't Come Back Alive, sans doute l'un des meilleurs moments du disque, tout en tension retenue, vertigineuse, avant des explosions furieuses et dévastatrices. Genghis Tron ose tout, même l'incorporation d'une section festive aux beats dansants juste après une intro très metal (City On A Hill). Surtout, le groupe a la très bonne initiative de laisser de l'espace dans la musique, laissant à l'auditeur de respirer durant des passages chill-out plus contemplatifs dont on ne peut qu'admirer la beauté, plutôt que de nous assaillir continuellement avec une violence étouffante (même si cela a son charme chez certains groupes, cela serait probablement lassant dans le cas présent): ainsi sur Colony Collapse, les deux explosions sont séparées par une structure electronica, une nouvelle fois proche de Boards Of Canada; de même, Ergot, transition expérimentale planante, apparait indispensable avant l'époustouflant final: l'album se termine en effet sur un Relief magnifique et épique, composition post-rock céleste et hypnotique dont on ne ressort pas indemne, et qui achève de nous convaincre que cet album est décidément unique et n'est pas un simple recueil de violence vaine: ces Genghis Tron sont vraiment des compositeurs doués. Je ne peux pas prétendre être un grand fan de metal, mais cet album est réellement ce que j'ai entendu de mieux dans le genre depuis un bout de temps. Surprenant à tout instant, incluant des choses que l'on n'aurait même pas osé imaginer, c'est un vrai trésor d'inventivité qu mérite toute votre attention, un voyage sonore passionant et fascinant: attention au décollage. Vivement recommandé.

Genghis Tron - Board Up The House (2008, Relapse)

1. Board Up The House
2. Endless Teeth
3. Things Don't Look Good
4. Recursion
5. I Won't Come Back Alive
6. City On A Hill
7. The Whips Blow Back
8. Colony Collapse
9. The Feast
10. Ergot
11. Relief

Vidéo: Genghis Tron - Things Don't Look Good

Myspace: Genghis Tron