1 The Author’s Premises -- Character Traits Can Change -- Treatment Is a Means of Changing Character -- Treatment and the Needs of the Individual -- Society’s Unreasonable Expectations -- Social Pressures and Impulsive Behavior -- Staff Attitude and Impulsive Behavior -- Drug Addiction as a Manifestation of Impulsive Behavior -- Specific Premises about Drug-Addicted Impulsive Individuals -- 2 The Settings and the People -- Lexington -- The Composite Patient at Lexington -- A Psychiatric Hospital Setting -- An Outpatient Clinic for Drug Abusers -- 3 Character Disorders -- Personality Disorders -- Paranoid -- Schizoid -- Explosive -- Antisocial -- Passive-Aggressive -- Borderline Personalities -- Depression -- Low Self-Esteem -- Inability to Form Close Personal Relationships -- Manipulation -- Nonpsychotic Techniques of Avoidance -- Inability to Examine One’s Own Behavior -- Action to Avoid Feeling -- Other People Are Unreal -- No Continuity in Patterns of Events -- Inability to Tolerate Criticism -- Inability to Plan -- Inability to Delay Gratification -- Entitlement -- No Experience Bearing Anxiety or Discomfort -- Self-Destruction -- Examples of Depression -- 4 Developmental Defect -- Normal Development -- Loss -- Reactions to the Loss -- Guilt and Conscience -- Inadequate Personal Relationships -- Summary -- 5 Games -- Kinds of Games -- Killing with Kindness -- Contracts -- Peace at Any Price -- Secret Deals -- Distractions -- “I’m No Racist” -- Poor Communication -- Goal Disharmony -- “Uh, Huh,I Knew It AU Along” -- Sliding by, or “I’m No Trouble” -- Good Guy-Bad Guy, or Splitting -- Jailhouse Lawyer -- The Lame Game -- Forget the Past -- Sulk -- Stir Him Up -- Confrontation Avoidance -- Focus on the Specific to Avoid the General Issue -- A Rose by Any Other Name -- No Loss Allowed -- Do as I Say, Not as I Do.-Going Through the Motions -- False Optimism -- Summary -- 6 Violence -- Destructiveness Outside of Treatment -- The Inherent Nature of Violence -- 7 A Graphic Approach to Understanding Intrapersonal Processes -- 8 Treatment -- Preconceived Distortions -- Gaining the Patient’s Attention -- Structure, Limits, Goals -- Transference-Countertransference -- “Different Strokes for Different Folks” -- Alcohol -- Sedative-Hypnotic Addiction -- Opiates -- Treatment Modalities -- Conclusion.

I began this book with two purposes. One goal was to present clinical information to support the belief that many of society's allegedly unh'eatable people could be helped to change their de­ structive patterns of living. A second purpose was to present a clear and simple primer for two groups of workers in the field. Most treatment institutions depend upon the services of nurses, aides, guards, and corrections officers. These people, who are the least prepared, do the hulk of the treatment. Because impulsive people learn much from their daily interactions out­ side of formal therapy, the understanding and the training of this "front-line" working staff are crucial. These staff members may find the second part of the book more helpful because of its use of clinical examples and techniques. The other group for whom this book is written includes those who are beginning in the mental health or corrections field. The concept of useful treatment of impulse-ridden people has only begun to be introduced into professional training pro­ grams. The assumption that these individuals were untreatable has kept many professionals at the fringes of this field. For this reason, I hope that the book will find its way into the hands of psychiatric residents, psychologists, social workers, nurses, pro­ bation officers, prison guards, youth workers, policemen, judges, etc.

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