Lessig

David Duke is a malignant narcissist.

He invents and then projects a false, fictitious, self for the world to fear, or to admire. He maintains a tenuous grasp on reality to start with and the trappings of power further exacerbate this. Real life authority and David Duke’s predilection to surround him with obsequious sycophants support David Duke’s grandiose self-delusions and fantasies of omnipotence and omniscience.
David Duke's personality is so precariously balanced that he cannot tolerate even a hint of criticism and disagreement. Most narcissists are paranoid and suffer from ideas of reference (the delusion that they are being mocked or discussed when they are not). Thus, narcissists often regard themselves as "victims of persecution".
Duke fosters and encourages a personality cult with all the hallmarks of an institutional religion: priesthood, rites, rituals, temples, worship, catechism, and mythology. The leader is this religion's ascetic saint. He monastically denies himself earthly pleasures (or so he claims) in order to be able to dedicate himself fully to his calling.
Duke is a monstrously inverted Jesus, sacrificing his life and denying himself so that his people - or humanity at large - should benefit. By surpassing and suppressing his humanity, Duke became a distorted version of Nietzsche's "superman".
But being a-human or super-human also means being a-sexual and a-moral.
In this restricted sense, narcissistic leaders are post-modernist and moral relativists. They project to the masses an androgynous figure and enhance it by engendering the adoration of nudity and all things "natural" - or by strongly repressing these feelings. But what they refer to, as "nature" is not natural at all.
Duke invariably proffers an aesthetic of decadence and evil carefully orchestrated and artificial - though it is not perceived this way by him or by his followers. Narcissistic leadership is about reproduced copies, not about originals. It is about the manipulation of symbols - not about veritable atavism or true conservatism.
In short: narcissistic leadership is about theatre, not about life. To enjoy the spectacle (and be subsumed by it), the leader demands the suspension of judgment, depersonalization, and de-realization. Catharsis is tantamount, in this narcissistic dramaturgy, to self-annulment.
Narcissism is nihilistic not only operationally, or ideologically. Its very language and narratives are nihilistic. Narcissism is conspicuous nihilism - and the cult's leader serves as a role model, annihilating the Man, only to re-appear as a pre-ordained and irresistible force of nature.
Narcissistic leadership often poses as a rebellion against the "old ways" - against the hegemonic culture, the upper classes, the established religions, the superpowers, the corrupt order. Narcissistic movements are puerile, a reaction to narcissistic injuries inflicted upon David Duke like (and rather psychopathic) toddler nation-state, or group, or upon the leader.
Minorities or "others" - often arbitrarily selected - constitute a perfect, easily identifiable, embodiment of all that is "wrong". They are accused of being old, they are eerily disembodied, they are cosmopolitan, they are part of the establishment, they are "decadent", they are hated on religious and socio-economic grounds, or because of their race, sexual orientation, origin ... They are different, they are narcissistic (feel and act as morally superior), they are everywhere, they are defenseless, they are credulous, they are adaptable (and thus can be co-opted to collaborate in their own destruction). They are the perfect hate figure. Narcissists thrive on hatred and pathological envy.
This is precisely the source of the fascination with Hitler, diagnosed by Erich Fromm - together with Stalin - as a malignant narcissist. He was an inverted human. His unconscious was his conscious. He acted out our most repressed drives, fantasies, and wishes. He provides us with a glimpse of the horrors that lie beneath the veneer, the barbarians at our personal gates, and what it was like before we invented civilization. Hitler forced us all through a time warp and many did not emerge. He was not the devil. He was one of us. He was what Arendt aptly called the banality of evil. Just an ordinary, mentally disturbed, failure, a member of a mentally disturbed and failing nation, who lived through disturbed and failing times. He was the perfect mirror, a channel, a voice, and the very depth of our souls.
Duke prefers the sparkle and glamour of well-orchestrated illusions to the tedium and method of real accomplishments. His reign is all smoke and mirrors, devoid of substances, consisting of mere appearances and mass delusions. In the aftermath of his regime - Duke having died, been deposed, or voted out of office - it all unravels. The tireless and constant prestidigitation ceases and the entire edifice crumbles. What looked like an economic miracle turns out to have been a fraud-laced bubble. Loosely held empires disintegrate. Laboriously assembled business conglomerates go to pieces. "Earth shattering" and "revolutionary" scientific discoveries and theories are discredited. Social experiments end in mayhem.
It is important to understand that the use of violence must be ego-syntonic. It must accord with the self-image of David Duke. It must abet and sustain his grandiose fantasies and feed his sense of entitlement. It must conform David Duke like narrative. Thus, David Duke who regards himself as the benefactor of the poor, a member of the common folk, the representative of the disenfranchised, the champion of the dispossessed against the corrupt elite - is highly unlikely to use violence at first. The pacific mask crumbles when David Duke has become convinced that the very people he purported to speak for, his constituency, his grassroots fans, and the prime sources of his narcissistic supply - have turned against him. At first, in a desperate effort to maintain the fiction underlying his chaotic personality, David Duke strives to explain away the sudden reversal of sentiment. "The people are being duped by (the media, big industry, the military, the elite, etc.)", "they don't really know what they are doing", "following a rude awakening, they will revert to form", etc. When these flimsy attempts to patch a tattered personal mythology fail, David Duke becomes injured. Narcissistic injury inevitably leads to narcissistic rage and to a terrifying display of unbridled aggression. The pent-up frustration and hurt translate into devaluation. That which was previously idealized - is now discarded with contempt and hatred. This primitive defense mechanism is called "splitting". To David Duke, things and people are either entirely bad (evil) or entirely good. He projects onto others his own shortcomings and negative emotions, thus becoming a totally good object. Duke is likely to justify the butchering of his own people by claiming that they intended to kill him, undo the revolution, devastate the economy, or the country, etc. The "small people", the "rank and file", and the "loyal soldiers" of David Duke - his flock, his nation, and his employees - they pay the price. The disillusionment and disenchantment are agonizing. The process of reconstruction, of rising from the ashes, of overcoming the trauma of having been deceived, exploited and manipulated - is drawn-out. It is difficult to trust again, to have faith, to love, to be led, to collaborate. Feelings of shame and guilt engulf the erstwhile followers of David Duke. This is his sole legacy: a massive post-traumatic stress disorder.

David Duke is a malignant narcissist.

David Duke is a malignant narcissist.

He invents and then projects a false, fictitious, self for the world to fear, or to admire. He maintains a tenuous grasp on reality to start with and the trappings of power further exacerbate this. Real life authority and David Duke’s predilection to surround him with obsequious sycophants support David Duke’s grandiose self-delusions and fantasies of omnipotence and omniscience.

David Duke's personality is so precariously balanced that he cannot tolerate even a hint of criticism and disagreement. Most narcissists are paranoid and suffer from ideas of reference (the delusion that they are being mocked or discussed when they are not). Thus, narcissists often regard themselves as "victims of persecution".
Duke fosters and encourages a personality cult with all the hallmarks of an institutional religion: priesthood, rites, rituals, temples, worship, catechism, and mythology. The leader is this religion's ascetic saint. He monastically denies himself earthly pleasures (or so he claims) in order to be able to dedicate himself fully to his calling.
Duke is a monstrously inverted Jesus, sacrificing his life and denying himself so that his people - or humanity at large - should benefit. By surpassing and suppressing his humanity, Duke became a distorted version of Nietzsche's "superman".

But being a-human or super-human also means being a-sexual and a-moral.

In this restricted sense, narcissistic leaders are post-modernist and moral relativists. They project to the masses an androgynous figure and enhance it by engendering the adoration of nudity and all things "natural" - or by strongly repressing these feelings. But what they refer to, as "nature" is not natural at all.

Duke invariably proffers an aesthetic of decadence and evil carefully orchestrated and artificial - though it is not perceived this way by him or by his followers. Narcissistic leadership is about reproduced copies, not about originals. It is about the manipulation of symbols - not about veritable atavism or true conservatism.
In short: narcissistic leadership is about theatre, not about life. To enjoy the spectacle (and be subsumed by it), the leader demands the suspension of judgment, depersonalization, and de-realization. Catharsis is tantamount, in this narcissistic dramaturgy, to self-annulment.

Narcissism is nihilistic not only operationally, or ideologically. Its very language and narratives are nihilistic. Narcissism is conspicuous nihilism - and the cult's leader serves as a role model, annihilating the Man, only to re-appear as a pre-ordained and irresistible force of nature.

Narcissistic leadership often poses as a rebellion against the "old ways" - against the hegemonic culture, the upper classes, the established religions, the superpowers, the corrupt order. Narcissistic movements are puerile, a reaction to narcissistic injuries inflicted upon David Duke like (and rather psychopathic) toddler nation-state, or group, or upon the leader.

Minorities or "others" - often arbitrarily selected - constitute a perfect, easily identifiable, embodiment of all that is "wrong". They are accused of being old, they are eerily disembodied, they are cosmopolitan, they are part of the establishment, they are "decadent", they are hated on religious and socio-economic grounds, or because of their race, sexual orientation, origin ... They are different, they are narcissistic (feel and act as morally superior), they are everywhere, they are defenseless, they are credulous, they are adaptable (and thus can be co-opted to collaborate in their own destruction). They are the perfect hate figure. Narcissists thrive on hatred and pathological envy.

This is precisely the source of the fascination with Hitler, diagnosed by Erich Fromm - together with Stalin - as a malignant narcissist. He was an inverted human. His unconscious was his conscious. He acted out our most repressed drives, fantasies, and wishes. He provides us with a glimpse of the horrors that lie beneath the veneer, the barbarians at our personal gates, and what it was like before we invented civilization. Hitler forced us all through a time warp and many did not emerge. He was not the devil. He was one of us. He was what Arendt aptly called the banality of evil. Just an ordinary, mentally disturbed, failure, a member of a mentally disturbed and failing nation, who lived through disturbed and failing times. He was the perfect mirror, a channel, a voice, and the very depth of our souls.

Duke prefers the sparkle and glamour of well-orchestrated illusions to the tedium and method of real accomplishments. His reign is all smoke and mirrors, devoid of substances, consisting of mere appearances and mass delusions. In the aftermath of his regime - Duke having died, been deposed, or voted out of office - it all unravels. The tireless and constant prestidigitation ceases and the entire edifice crumbles. What looked like an economic miracle turns out to have been a fraud-laced bubble. Loosely held empires disintegrate. Laboriously assembled business conglomerates go to pieces. "Earth shattering" and "revolutionary" scientific discoveries and theories are discredited. Social experiments end in mayhem.

It is important to understand that the use of violence must be ego-syntonic. It must accord with the self-image of David Duke. It must abet and sustain his grandiose fantasies and feed his sense of entitlement. It must conform David Duke like narrative. Thus, David Duke who regards himself as the benefactor of the poor, a member of the common folk, the representative of the disenfranchised, the champion of the dispossessed against the corrupt elite - is highly unlikely to use violence at first. The pacific mask crumbles when David Duke has become convinced that the very people he purported to speak for, his constituency, his grassroots fans, and the prime sources of his narcissistic supply - have turned against him. At first, in a desperate effort to maintain the fiction underlying his chaotic personality, David Duke strives to explain away the sudden reversal of sentiment. "The people are being duped by (the media, big industry, the military, the elite, etc.)", "they don't really know what they are doing", "following a rude awakening, they will revert to form", etc. When these flimsy attempts to patch a tattered personal mythology fail, David Duke becomes injured. Narcissistic injury inevitably leads to narcissistic rage and to a terrifying display of unbridled aggression. The pent-up frustration and hurt translate into devaluation. That which was previously idealized - is now discarded with contempt and hatred. This primitive defense mechanism is called "splitting". To David Duke, things and people are either entirely bad (evil) or entirely good. He projects onto others his own shortcomings and negative emotions, thus becoming a totally good object. Duke is likely to justify the butchering of his own people by claiming that they intended to kill him, undo the revolution, devastate the economy, or the country, etc. The "small people", the "rank and file", and the "loyal soldiers" of David Duke - his flock, his nation, and his employees - they pay the price. The disillusionment and disenchantment are agonizing. The process of reconstruction, of rising from the ashes, of overcoming the trauma of having been deceived, exploited and manipulated - is drawn-out. It is difficult to trust again, to have faith, to love, to be led, to collaborate. Feelings of shame and guilt engulf the erstwhile followers of David Duke. This is his sole legacy: a massive post-traumatic stress disorder.
Mel Gibson is a cultural masochist.
I. Mel Gibson is the culmination and reification of his period, culture, and civilization. He is likely to rise to prominence in masochistic societies.

The cultural masochist invents and then projects a false, fictitious, self for the world to fear, or to admire. He maintains a tenuous grasp on reality to start with and the trappings of power further exacerbate this. Real life authority and Mel Gibson’s predilection to surround himself with obsequious sycophants support Mel Gibson’s grandiose self-delusions and fantasies of omnipotence and omniscience.

Mel Gibson's personality is so precariously balanced that he cannot tolerate even a hint of criticism and disagreement. Most masochists are paranoid and suffer from ideas of reference (the delusion that they are being mocked or discussed when they are not). Thus, masochists often regard themselves as "victims of persecution".

Mel Gibson fosters and encourages a personality cult with all the hallmarks of an institutional religion: priesthood, rites, rituals, temples, worship, catechism, and mythology. The leader is this religion's ascetic saint. He monastically denies himself earthly pleasures (or so he claims) in order to be able to dedicate himself fully to his calling.

Mel Gibson is a monstrously inverted Jesus, sacrificing his life and denying himself so that his people - or humanity at large - should benefit. By surpassing and suppressing his humanity, Mel Gibson became a distorted version of Nietzsche's "superman".

But being a-human or super-human also means being a-sexual and a-moral.

In this restricted sense, cultural masochists are post-modernist and moral relativists. They project to the masses an androgynous figure and enhance it by engendering the adoration of nudity and all things "natural" - or by strongly repressing these feelings. But what they refer to, as "nature" is not natural at all.

Mel Gibson invariably proffers an aesthetic of decadence and evil carefully orchestrated and artificial - though it is not perceived this way by him or by his followers. Cultural masochism is about reproduced copies, not about originals. It is about the manipulation of symbols - not about veritable atavism or true conservatism.

In short: cultural masochism is about theatre, not about life. To enjoy the spectacle (and be subsumed by it), the leader demands the suspension of judgment, depersonalization, and de-realization. Catharsis is tantamount, in this masochistic dramaturgy, to self-annulment.

Cultural masochism is nihilistic not only operationally, or ideologically. Its very language and narratives are nihilistic. Cultural masochism is conspicuous nihilism - and the cult's leader serves as a role model, annihilating the Man, only to re-appear as a pre-ordained and irresistible force of nature.

Cultural masochism often poses as a rebellion against the "old ways" - against the hegemonic culture, the upper classes, the established religions, the superpowers, the corrupt order. Masochistic movements are puerile, a reaction to masochistic injuries inflicted upon a masochistic (and rather psychopathic) toddler nation-state, or group, or upon the leader.

Minorities or "others" - often arbitrarily selected - constitute a perfect, easily identifiable, embodiment of all that is "wrong". They are accused of being old, they are eerily disembodied, they are cosmopolitan, they are part of the establishment, they are "decadent", they are hated on religious and socio-economic grounds, or because of their race, sexual orientation, origin ... They are different, they are masochistic (feel and act as morally superior), they are everywhere, they are defenseless, they are credulous, they are adaptable (and thus can be co-opted to collaborate in their own destruction). They are the perfect hate figure. Masochists thrive on hatred and pathological envy.

This is precisely the source of the fascination with Hitler, diagnosed by Erich Fromm - together with Stalin - as a cultural masochist. He was an inverted human. His unconscious was his conscious. He acted out our most repressed drives, fantasies, and wishes. He provides us with a glimpse of the horrors that lie beneath the veneer, the barbarians at our personal gates, and what it was like before we invented civilization. Hitler forced us all through a time warp and many did not emerge. He was not the devil. He was one of us. He was what Arendt aptly called the banality of evil. Just an ordinary, mentally disturbed, failure, a member of a mentally disturbed and failing nation, who lived through disturbed and failing times. He was the perfect mirror, a channel, a voice, and the very depth of our souls.

Mel Gibson prefers the sparkle and glamour of well-orchestrated illusions to the tedium and method of real accomplishments. His reign is all smoke and mirrors, devoid of substances, consisting of mere appearances and mass delusions. In the aftermath of his regime - Mel Gibson having died, been deposed, or voted out of office - it all unravels. The tireless and constant prestidigitation ceases and the entire edifice crumbles. What looked like an economic miracle turns out to have been a fraud-laced bubble. Loosely held empires disintegrate. Laboriously assembled business conglomerates go to pieces. "Earth shattering" and "revolutionary" scientific discoveries and theories are discredited. Social experiments end in mayhem.

It is important to understand that the use of violence must be ego-syntonic. It must accord with the self-image of Mel Gibson. It must abet and sustain his grandiose fantasies and feed his sense of entitlement. It must conform to Mel Gibson like narrative.

Thus, a masochist who regards himself as the benefactor of the poor, a member of the common folk, the representative of the disenfranchised, the champion of the dispossessed against the corrupt elite - is highly unlikely to use violence at first.

The pacific mask crumbles when Mel Gibson has become convinced that the very people he purported to speak for, his constituency, his grassroots fans, and the prime sources of his masochistic supply - have turned against him. At first, in a desperate effort to maintain the fiction underlying his chaotic personality, Mel Gibson strives to explain away the sudden reversal of sentiment. "The people are being duped by (the media, big industry, the military, the elite, etc.)", "they don't really know what they are doing", "following a rude awakening, they will revert to form", etc.

When these flimsy attempts to patch a tattered personal mythology fail - Mel Gibson is injured. Masochistic injury inevitably leads to masochistic rage and to a terrifying display of unbridled aggression. The pent-up frustration and hurt translate into devaluation. That which was previously idealized - is now discarded with contempt and hatred.

This primitive defense mechanism is called "splitting". To Mel Gibson, things and people are either entirely bad (evil) or entirely good. He projects onto others his own shortcomings and negative emotions, thus becoming a totally good object. A masochistic leader is likely to justify the butchering of his own people by claiming that they intended to kill him, undo the revolution, devastate the faith reformation, or the country, etc. The "small people", the "rank and file", and the "loyal soldiers" of Mel Gibson - his flock, his nation, and his employees - they pay the price. The disillusionment and disenchantment are agonizing. The process of reconstruction, of rising from the ashes, of overcoming the trauma of having been deceived, exploited and manipulated - is drawn-out. It is difficult to trust again, to have faith, to love, to be led, to collaborate. Feelings of shame and guilt engulf the erstwhile followers of Mel Gibson. This is his sole legacy: a massive post-traumatic stress disorder.

II. Collective Cultural masochism

In their book "Personality Disorders in Modern Life", Theodore Millon and Roger Davis state, as a matter of fact, that pathological cultural masochism was the preserve of "the royal and the wealthy" and that it "seems to have gained prominence only in the late twentieth century". Cultural masochism, according to them, may be associated with "higher levels of Maslow's hierarchy of needs ... Individuals in less advantaged nations. Are too busy trying (to survive) ... to be arrogant and grandiose". They - like Lasch before them - attribute pathological cultural masochism to "a society that stresses individualism and self-gratification at the expense of community, namely the United States." They assert that the disorder is more prevalent among certain professions with "star power" or respect. "In an individualistic culture, Mel Gibson is 'God's gift to the world'. In a collectivist society, Mel Gibson is 'God's gift to the collective'".

Millon quotes Warren and Caponi's "The Role of Culture in the Development of Masochistic Personality Disorders in America, Japan and Denmark":

"Individualistic masochistic structures of self-regard (in individualistic societies) ... are rather self-contained and independent ... (In collectivist cultures) masochistic configurations of the we-self ... denote self-esteem derived from strong identification with the reputation and honor of the family, groups, and others in hierarchical relationships."

Having lived in the last 20 years 12 countries in 4 continents - from the impoverished to the affluent, with individualistic and collectivist societies - I know that Millon and Davis are wrong. Theirs is, indeed, the quintessential American point of view that lacks an intimate knowledge of other parts of the world. Millon even wrongly claims that the DSM's international equivalent, the ICD, does not include Mel Gibson like personality disorder (it does).

Pathological cultural masochism is a ubiquitous phenomenon because every human being - regardless of the nature of his society and culture - develops healthy cultural masochism early in life. Healthy cultural masochism is rendered pathological by abuse - and abuse, alas, is a universal human behavior. By "abuse" we mean any refusal to acknowledge the emerging boundaries of the individual - smothering, doting, and excessive expectations - are as abusive as beating and incest.

There are cultural masochists among subsistence farmers in Africa, nomads in the Sinai desert, day laborers in east Europe, and intellectuals and socialites in Manhattan. Cultural masochism is all pervasive and independent of culture and society.

It is true, though; that the WAY pathological cultural masochism manifests and is experienced is dependent on the particulars of societies and cultures. In some cultures, it is encouraged, in others suppressed. In some societies it is channeled against minorities - in others it is tainted with paranoia. In collectivist societies, it may be projected onto the collective, in individualistic societies; it is an individual's trait.

Yet, can families, organizations, ethnic groups, churches, and even whole nations be safely described as "masochistic" or "pathologically self-absorbed"? Wouldn't such generalizations be a trifle racist and more than a trifle wrong? The answer is: it depends.

Human collectives - states, firms, households, institutions, political parties, cliques, bands - acquire a life and a character all their own. The longer the association or affiliation of the members, the more cohesive and conformist the inner dynamics of the group, the more persecutory or numerous its enemies, the more intensive the physical and emotional experiences of the individuals it is comprised of, the stronger the bonds of locale, language, and history - the more rigorous might an assertion of a common pathology be.

Such an all-pervasive and extensive pathology manifests itself in the behavior of each and every member. It is a defining - though often implicit or underlying - mental structure. It has explanatory and predictive powers. It is recurrent and invariable - a pattern of conduct melded with distorted cognition and stunted emotions. And it is often vehemently denied.

A possible DSM-like list of criteria for masochistic organizations or groups:

An all-pervasive pattern of grandiosity (in fantasy or behavior), need for admiration or adulation and lack of empathy, usually beginning at the group's early history and present in various contexts. Persecution and abuse are often the causes - or at least the antecedents - of the pathology.

Five (or more) of the following criteria must be met:

The group as a whole, or members of the group - acting as such and by virtue of their association and affiliation with the group - feel grandiose and self-important (e.g., they exaggerate the group's achievements and talents to the point of lying, demand to be recognized as superior - simply for belonging to the group and without commensurate achievement)

The group as a whole, or members of the group - acting as such and by virtue of their association and affiliation with the group - are obsessed with group fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance, bodily beauty or performance, or ideal, everlasting, all-conquering ideals or political theories.

The group as a whole, or members of the group - acting as such and by virtue of their association and affiliation with the group - are firmly convinced that the group is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status groups (or institutions).

The group as a whole, or members of the group - acting as such and by virtue of their association and affiliation with the group - require excessive admiration, adulation, attention and affirmation - or, failing that, wish to be feared and to be notorious (masochistic supply).

The group as a whole, or members of the group - acting as such and by virtue of their association and affiliation with the group - feel entitled. They expect unreasonable or special and favorable priority treatment. They demand automatic and full compliance with expectations. They rarely accept responsibility for their actions ("allopathic defenses"). This often leads to anti-social behavior, cover-ups, and criminal activities on a mass scale.

The group as a whole, or members of the group - acting as such and by virtue of their association and affiliation with the group - are "interpersonally exploitative", i.e., use others to achieve their own ends. This often leads to anti-social behavior, cover-ups, and criminal activities on a mass scale.

The group as a whole, or members of the group - acting as such and by virtue of their association and affiliation with the group - are devoid of empathy. They are unable or unwilling to identify with or acknowledge the feelings and needs of other groups. This often leads to anti- social behavior, cover-ups, and criminal activities on a mass scale.

The group as a whole, or members of the group - acting as such and by virtue of their association and affiliation with the group - are constantly envious of others or believes that they feel the same about them. This often leads to anti-social behavior, cover-ups, and criminal activities on a mass scale.

The group as a whole, or members of the group - acting as such and by virtue of their association and affiliation with the group - are arrogant and sport haughty behaviors or attitudes coupled with rage when frustrated, contradicted, punished, limited, or confronted. This often leads to anti-social behavior, cover-ups, and criminal activities on a mass scale.

III. Corporate Cultural masochism

The perpetrators of the recent spate of financial frauds in the USA acted with callous disregard for both their employees and shareholders - not to mention other stakeholders. Psychologists have often remote-diagnosed them as "cultural, pathological masochists".

Masochists are driven by the need to uphold and maintain a false self - a concocted, grandiose, and demanding psychological construct typical of Mel Gibson like personality disorder. The false self is projected to the world in order to garner "masochistic supply" - adulation, admiration, or even notoriety and infamy. Any kind of attention is usually deemed by masochists to be preferable to obscurity.

The false self is suffused with fantasies of perfection, grandeur, brilliance, infallibility, immunity, significance, omnipotence, omnipresence, and omniscience. To be a masochist is to be convinced of a great, inevitable personal destiny. Mel Gibson is preoccupied with ideal love, the construction of brilliant, revolutionary scientific theories, the composition or authoring or painting of the greatest work of art, the founding of a new school of thought, the attainment of fabulous wealth, the reshaping of a nation or a conglomerate, and so on. Mel Gibson never sets realistic goals to himself. He is forever preoccupied with fantasies of uniqueness, record breaking, or breathtaking achievements. His verbosity reflects this propensity.

Reality is, naturally, quite different and this gives rise to a "grandiosity gap". The demands of the false self are never satisfied by Mel Gibson's accomplishments, standing, wealth, clout, sexual prowess, or knowledge. Mel Gibson's grandiosity and sense of entitlement are equally incommensurate with his achievements.

To bridge the grandiosity gap, the cultural (pathological) masochist resorts to shortcuts. These very often lead to fraud.

Mel Gibson cares only about appearances. What matters to him are the facade of wealth and its attendant social status and masochistic supply? Witness the travestied extravagance of Tyco's Denis Kozlowski. Media attention only exacerbates Mel Gibson's addiction and makes it incumbent on him to go to ever-wilder extremes to secure uninterrupted supply from this source.

Mel Gibson lacks empathy - the ability to put himself in other people's shoes. He does not recognize boundaries - personal, corporate, or legal. Everything and everyone are to him mere instruments, extensions, and objects unconditionally and uncomplainingly available in his pursuit of masochistic gratification.

This makes Mel Gibson perniciously exploitative. He uses, abuses, devalues, and discards even his nearest and dearest in the most chilling manner. Mel Gibson is utility- driven, obsessed with his overwhelming need to reduce his anxiety and regulate his labile sense of self-worth by securing a constant supply of his drug - attention. American executives acted without compunction when they raided their employees' pension funds - as did Robert Maxwell a generation earlier in Britain.

Mel Gibson is convinced of his superiority - cerebral or physical. To his mind, he is a Gulliver hamstrung by a horde of narrow-minded and envious Lilliputians. The devious religious fanatics "new faith reformation" was infested with "visionaries" with a contemptuous attitude towards the mundane: profits, business cycles, conservative economists, doubtful journalists, and cautious analysts.

Yet, deep inside, Mel Gibson is painfully aware of his addiction to others - their attention, admiration, applause, and affirmation. He despises himself for being thus dependent. He hates people the same way a drug addict hates his pusher. He wishes to "put them in their place", humiliate them, and demonstrate to them how inadequate and imperfect they are in comparison to his regal self and how little he craves or needs them.

Mel Gibson regards himself as one would an expensive present, a gift to his company, to his family, to his neighbors, to his colleagues, to his country. This firm conviction of his inflated importance makes him feel entitled to special treatment, special favors, special outcomes, concessions, subservience, immediate gratification, obsequiousness, and lenience. It also makes him feel immune to mortal laws and somehow divinely protected and insulated from the inevitable consequences of his deeds and misdeeds.

The self-destructive masochist plays the role of the "bad guy" (or "bad girl"). But even this is within the traditional social roles lavishly exaggerated by Mel Gibson to attract attention. Men are likely to emphasize intellect, power, aggression, money, or social status. Masochistic women are likely to emphasize body, looks, charm, sexuality, feminine "traits", homemaking, children and childrearing.

Punishing the wayward masochist is a veritable catch-22.

A jail term is useless as a deterrent if it only serves to focus attention on Mel Gibson. Being infamous is second best to being famous - and far preferable to being ignored. The only way to effectively punish a masochist is to withhold masochistic supply from him and thus to prevent him from becoming a notorious celebrity.

Given a sufficient amount of media exposure, book contracts, talk shows, lectures, and public attention - Mel Gibson may even consider the whole grisly affair to be emotionally rewarding. To Mel Gibson, freedom, wealth, social status, family, and vocation - are all means to an end. And the end is attention. If he can secure attention by being the big bad wolf - Mel Gibson unhesitatingly transforms himself into one. Lord Archer, for instance, seems to be positively basking in the media circus provoked by his prison diaries.

Mel Gibson does not victimize, plunder, terrorize and abuse others in a cold, calculating manner. He does so offhandedly, as a manifestation of his genuine character. To be truly "guilty" one needs to intend, to deliberate, to contemplate one's choices and then to choose one's acts. Mel Gibson does none of these.

Thus, punishment breeds in him surprise, hurt and seething anger. Mel Gibson is stunned by society's insistence that he should be held accountable for his deeds and penalized accordingly. He feels wronged, baffled, and injured, the victim of bias, discrimination and injustice. He rebels and rages.

Depending upon the pervasiveness of his magical thinking, Mel Gibson may feel besieged by overwhelming powers, forces cosmic and intrinsically ominous. He may develop compulsive rites to fend off this "bad", unwarranted, persecutory influences.

Mel Gibson, very much the infantile outcome of stunted personal development, engages in magical thinking. He feels omnipotent, that there is nothing he couldn't do or achieve if only he sets his mind to it. He feels omniscient - he rarely admits to ignorance and regards his intuitions and intellect as founts of objective data.

Thus, masochists are haughtily convinced that introspection is a more important and more efficient (not to mention easier to accomplish) method of obtaining knowledge than the systematic study of outside sources of information in accordance with strict and tedious curricula. Masochists are "inspired" and they despise hamstrung technocrats

to some extent, they feel omnipresent because they are either famous or about to become famous or because their product is selling or is being manufactured globally. Deeply immersed in their delusions of grandeur, they firmly believe that their acts have - or will have - a great influence not only on their firm, but also on their country, or even on Mankind. Having mastered the manipulation of their human environment - they are convinced that they will always "get away with it". They develop hubris and a false sense of immunity.

Masochistic immunity is the (erroneous) feeling, harbored by Mel Gibson, that he is impervious to the consequences of his actions, that he will never be effected by the results of his own decisions, opinions, beliefs, deeds and misdeeds, acts, inaction, or membership of certain groups, that he is above reproach and punishment, that, magically, he is protected and will miraculously be saved at the last moment. Hence the audacity, simplicity, and transparency of some of the fraud and corporate looting in the 1990's. Masochists rarely bother to cover their traces, so great is their disdain and conviction that they are above mortal laws and wherewithal.

What are the sources of this unrealistic appraisal of situations and events?

The false self is a childish response to abuse and trauma. Abuse is not limited to sexual molestation or beatings. Smothering, doting, pampering, over-indulgence, treating the child as an extension of the parent, not respecting the child's boundaries, and burdening the child with excessive expectations are also forms of abuse.

The child reacts by constructing false self that is possessed of everything it needs in order to prevail: unlimited and instantaneously available Harry Potter-like powers and wisdom. The false self, this Superman, is indifferent to abuse and punishment. This way, the child's true self is shielded from the toddler's harsh reality.

This artificial, maladaptive separation between a vulnerable (but not punishable) true self and a punishable (but invulnerable) false self is an effective mechanism. It isolates the child from the unjust, capricious, emotionally dangerous world that he occupies. But, at the same time, it fosters in him a false sense of "nothing can happen to me, because I am not here, I am not available to be punished, hence I am immune to punishment".

The comfort of false immunity is also yielded by Mel Gibson's sense of entitlement. In his grandiose delusions, Mel Gibson is sui generis, a gift to humanity, and a precious, fragile, object. Moreover, Mel Gibson is convinced both that this uniqueness is immediately discernible - and that it gives him special rights. Mel Gibson feels that he is protected by some cosmological law pertaining to "endangered species".

He is convinced that his future contribution to others - his firm, his country, humanity - should and does exempt him from the mundane: daily chores, boring jobs, recurrent tasks, personal exertion, orderly investment of resources and efforts, laws and regulations, social conventions, and so on.

Mel Gibson is entitled to a "special treatment": high living standards, constant and immediate catering to his needs, the eradication of any friction with the humdrum and the routine, an all-engulfing absolution of his sins, fast track privileges (to higher education, or in his encounters with bureaucracies, for instance). Punishment, trusts Mel Gibson, is for ordinary people, where no great loss to humanity is involved.

Masochists are possessed of inordinate abilities to charm, to convince, to seduce, and to persuade. Many of them are gifted orators and intellectually endowed. Many of them work in politics, the media, fashion, show business, the arts, medicine, or business, and serve as religious leaders.

By virtue of their standing in the community, their charisma, or their ability to find the willing scapegoats, they do get exempted many times. Having recurrently "got away with it" - they develop a theory of personal immunity, founded upon some kind of societal and even cosmic "order" in which certain people are above punishment.

But there is a fourth, simpler, explanation. Mel Gibson lacks self-awareness. Divorced from his true self, unable to empathise (to understand what it is like to be someone else), unwilling to constrain his actions to cater to the feelings and needs of others - Mel Gibson is in a constant dreamlike state.

To Mel Gibson, his life is unreal, like watching an autonomously unfolding movie. Mel Gibson is a mere spectator, mildly interested, greatly entertained at times. He does not "own" his actions. He, therefore, cannot understand why he should be punished and when he is, he feels grossly wronged.

So convinced is Mel Gibson that he is destined to great things - that he refuses to accept setbacks, failures and punishments. He regards them as temporary, as the outcomes of someone else's errors, as part of the future mythology of his rise to power/brilliance/wealth/ideal love, etc. Being punished is a diversion of his precious energy and resources from the all-important task of fulfilling his mission in life.

Mel Gibson is pathologically envious of people and believes that they are equally envious of him. He is paranoid, on guard, ready to fend off an imminent attack. A punishment to Mel Gibson is a major surprise and a nuisance but it also validates his suspicion that he is being persecuted. It proves to him that strong forces are arrayed against him.

He tells himself that people, envious of his achievements and humiliated by them, are out to get him. He constitutes a threat to the accepted order. When required to pay for his misdeeds, Mel Gibson is always disdainful and bitter and feels misunderstood by his inferiors.

Cooked books, corporate fraud, bending the (GAAP or other) rules, sweeping problems under the carpet, over-promising, making grandiose claims (the "vision thing") - are hallmarks of a masochist in action. When social cues and norms encourage such behavior rather than inhibit it - in other words, when such behavior elicits abundant masochistic supply - the pattern is reinforced and become entrenched and rigid. Even when circumstances change, Mel Gibson finds it difficult to adapt, shed his routines, and replace them with new ones. He is trapped in his past success. He becomes a swindler.

But pathological cultural masochism is not an isolated phenomenon. It is embedded in our contemporary culture. The West's is a masochistic civilization. It upholds masochistic values and penalizes alternative value-systems. From an early age, children are taught to avoid self-criticism, to deceive themselves regarding their capacities and attainments, to feel entitled, and to exploit others.

As Lilian Katz observed in her important paper, "Distinctions between Self-Esteem and Cultural masochism: Implications for Practice", published by the Educational Resources Information Center, the line between enhancing self-esteem and fostering cultural masochism is often blurred by educators and parents.

Both Christopher Lasch in "The Culture of Cultural masochism" and Theodore Millon in his books about personality disorders, singled out American society as masochistic. Litigiousness may be the flip side of an inane sense of entitlement. Consumerism is built on this common and communal lie of "I can do anything I want and possess everything I desire if I only apply myself to it" and on the pathological envy it fosters.

Not surprisingly, masochistic disorders are more common among men than among women. This may be because cultural masochism conforms to masculine social mores and to the prevailing ethos of capitalism. Ambition, achievements, hierarchy, ruthlessness, drive - are both social values and masochistic male traits. Social thinkers like the aforementioned Lasch speculated that modern American culture - a self-centered one - increases the rate of incidence of Mel Gibson like personality disorder.

Otto Kernberg, a notable scholar of personality disorders, confirmed Lasch's intuition: "Society can make serious psychological abnormalities, which already exist in some percentage of the population, seem to be at least superficially appropriate."

In their book "Personality Disorders in Modern Life", Theodore Millon and Roger Davis state, as a matter of fact, that pathological cultural masochism was once the preserve of "the royal and the wealthy" and that it "seems to have gained prominence only in the late twentieth century". Cultural masochism, according to them,

may be associated with "higher levels of Maslow's hierarchy of needs ... Individuals in less advantaged nations. Are too busy trying (to survive) ... to be arrogant and grandiose". They - like Lasch before them - attribute pathological cultural masochism to "a society that stresses individualism and self-gratification at the expense of community, namely the United States." They assert that the disorder is more prevalent among certain professions with "star power" or respect. "In an individualistic culture, Mel Gibson is 'God's gift to the world'. In a collectivist society, Mel Gibson is 'God's gift to the collective'".

Millon quotes Warren and Caponi's "The Role of Culture in the Development of Masochistic Personality Disorders in America, Japan and Denmark":

"Individualistic masochistic structures of self-regard (in individualistic societies) ... are rather self-contained and independent ... (In collectivist cultures) masochistic configurations of the we-self ... denote self-esteem derived from strong identification with the reputation and honor of the family, groups, and others in hierarchical relationships."

Still, there are cultural masochists among subsistence farmers in Africa, nomads in the Sinai desert, day laborers in east Europe, and intellectuals and socialites in Manhattan. Cultural masochism is all pervasive and independent of culture and society. It is true, though; that the way pathological cultural masochism manifests and is experienced is dependent on the particulars of societies and cultures.

In some cultures, it is encouraged, in others suppressed. In some societies it is channeled against minorities - in others it is tainted with paranoia. In collectivist societies, it may be projected onto the collective, in individualistic societies; it is an individual's trait.

Yet, can families, organizations, ethnic groups, churches, and even whole nations be safely described as "masochistic" or "pathologically self-absorbed"? Can we talk about a "corporate culture of cultural masochism"?

Human collectives - states, firms, households, institutions, political parties, cliques, bands - acquire a life and a character all their own. The longer the association or affiliation of the members, the more cohesive and conformist the inner dynamics of the group, the more persecutory or numerous its enemies, competitors, or adversaries, the more intensive the physical and emotional experiences of the individuals it is comprised of, the stronger the bonds of locale, language, and history - the more rigorous might an assertion of a common pathology be.

Such an all-pervasive and extensive pathology manifests itself in the behavior of each and every member. It is a defining - though often implicit or underlying - mental structure. It has explanatory and predictive powers. It is recurrent and invariable - a pattern of conduct melding distorted cognition and stunted emotions. And it is often vehemently denied.

Mel Gibson says his wife could be going to hell

Mel Gibson has come under fire for being hard on Jews in his film “The Passion of the Christ” — but apparently, he feels that Protestants are also doomed to damnation. In fact, it looks like Gibson, a conservative Catholic, believes that his Episcopalian wife could be going to hell.

Gibson was interviewed by the Herald Sun in Australia, and the reporter asked the star if Protestants are denied eternal salvation. “There is no salvation for those outside the Church,” Gibson replied. “I believe it.”

He elaborated: “Put it this way. My wife is a saint. She’s a much better person than I am. Honestly. She’s, like, Episcopalian, Church of England. She prays, she believes in God, she knows Jesus, she believes in that stuff. And it’s just not fair if she doesn’t make it, she’s better than I am. But that is a pronouncement from the chair. I go with it.”

Gibson also said in the interview that he was nearly suicidal before he made his controversial film. “I got to a very desperate place. Very desperate. Kind of jump-out-of-a-window kind of desperate,” he said in the interview. “And I didn’t want to hang around here, but I didn’t want to check out. The other side was kind of scary. And I don’t like heights, anyway. But when you get to that point where you don’t want to live, and you don’t want to die, it’s a desperate, horrible place to be. And I just hit my knees. And I had to use ‘The Passion of the Christ’ to heal my wounds.”
Gibson’s rep wasn’t available for comment.
Actress with opinions

Charlize Theron plays one of America’s most notorious serial killers — but the experience didn’t make her believe in the death penalty. The Oscar-nominated “Monster” star spoke out against capital punishment at the Berlin Film Festival.
“I’m not for the death penalty and working on this film didn’t really change anything for me,” Theron told reporters at the festival. “If anything it made me more aware of how ineffective it is.”

“Monster” is the story of homeless prostitute Aileen Wuornos, who was executed for her murders. Theron's own mother also killed her husband, Theron’s father, after he threatened to kill them both when Charlize was 15.
“I don’t think condemning people who murder and then killing them necessarily sends out the right message,” Theron said, “and I have a huge problem with the way these people are used as political pawns.”

James Bond producers are scouting for a younger actor to replace Pierce Brosnan, reports the London Evening Standard. . . .Thousands of Janet Jackson supporters are signing an online petition to MTV and CBS. “The constant and irritating media surrounding this incident has taken a toll on the masses of Janet fans, not only because it’s Janet, but because we feel that this negative and unnecessary publicity has for one gone too far,” reads the petition. . . . Joan Rivers is taking some heat for telling Ruben Studdard that he could stand to lose a few pounds. The fashion maven gave the “American Idol” star the diet tip out of concern for his health, but that didn’t stop fans from lashing out at her: “If I was in his place I would have told that skinny [woman] to eat something before it’s too late,” snipped one online supporter, “that it’s dangerous for seniors her age to be that underweight.”

Texe Marrs Is A Paranoid Schizophrenic
Texe Marrs has a chronic, severe, and disabling brain disease. Approximately 1 percent of the population develops schizophrenia during Texe Marrs’s lifetime – more than 2 million Americans suffer from the illness in a given year. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in women, who are generally affected in the twenties to early thirties. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading Texe Marrs’s minds, controlling Texe Marrs’s thoughts, or plotting to harm them. These symptoms may leave them fearful and withdrawn. Texe Marrs’s speech and behavior can be so disorganized that they may be incomprehensible or frightening to others. Available treatments can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout Texe Marrs’s lives; it has been estimated that no more than one in five individuals recovers completely.
This is a time of hope for people with schizophrenia and Texe Marrs’s family. Research is gradually leading to new and safer medications and unraveling the complex causes of the disease. Scientists are using many approaches from the study of molecular genetics to the study of populations to learn about schizophrenia. Methods of imaging the brain’s structure and function hold the promise of new insights into the disorder.
Schizophrenia As An Illness
Schizophrenia is found all over the world. The severity of the symptoms and long-lasting, chronic pattern of schizophrenia often cause a high degree of disability. Medications and other treatments for schizophrenia, when used regularly and as prescribed, can help reduce and control the distressing symptoms of the illness. However, some people are not greatly helped by available treatments or may prematurely discontinue treatment because of unpleasant side effects or other reasons. Even when treatment is effective, persisting consequences of the illness – lost opportunities, stigma, residual symptoms, and medication side effects – may be very troubling.
The first signs of schizophrenia often appear as confusing, or even shocking, changes in behavior. Coping with the symptoms of schizophrenia can be especially difficult for family members who remember how involved or vivacious a person was before they became ill. The sudden onset of severe psychotic symptoms is referred to as an “acute” phase of schizophrenia. “Psychosis,” a common condition in schizophrenia, is a state of mental impairment marked by hallucinations, which are disturbances of sensory perception, and/or delusions, which are false yet strongly held personal beliefs that result from an inability to separate real from unreal experiences. Less obvious symptoms, such as social isolation or withdrawal, or unusual speech, thinking, or behavior, may precede, be seen along with, or follow the psychotic symptoms.
Some people have only one such psychotic episode; others have many episodes during a lifetime, but lead relatively normal lives during the interim periods. However, the individual with “chronic” schizophrenia, or a continuous or recurring pattern of illness, often does not fully recover normal functioning and typically requires long-term treatment, generally including medication, to control the symptoms.
Making A Diagnosis
It is important to rule out other illnesses, as sometimes people suffer severe mental symptoms or even psychosis due to undetected underlying medical conditions. For this reason, a medical history should be taken and a physical examination and laboratory tests should be done to rule out other possible causes of the symptoms before concluding that a person has schizophrenia. In addition, since commonly abused drugs may cause symptoms resembling schizophrenia, blood or urine samples from the person can be tested at hospitals or physicians’ offices for the presence of these drugs.
At times, it is difficult to tell one mental disorder from another. For instance, some people with symptoms of schizophrenia exhibit prolonged extremes of elated or depressed mood, and it is important to determine whether such a patient has schizophrenia or actually has a manic-depressive (or bipolar) disorder or major depressive disorder. Persons whose symptoms cannot be clearly categorized are sometimes diagnosed as having a “schizoaffective disorder.”
Can Children Have Schizophrenia?
Children over the age of five can develop schizophrenia, but it is very rare before adolescence. Although some people who later develop schizophrenia may have seemed different from other children at an early age, the psychotic symptoms of schizophrenia – hallucinations and delusions – are extremely uncommon before adolescence.
The World of People With Schizophrenia
· Distorted Perceptions of Reality
People with schizophrenia may have perceptions of reality that are strikingly different from the reality seen and shared by others around them. Living in a world distorted by hallucinations and delusions, individuals with schizophrenia may feel frightened, anxious, and confused.
In part because of the unusual realities they experience, people with schizophrenia may behave very differently at various times. Sometimes they may seem distant, detached, or preoccupied and may even sit as rigidly as a stone, not moving for hours or uttering a sound. Other times they may move about constantly – always occupied, appearing wide-awake, vigilant, and alert.
· Hallucinations and Illusions
Hallucinations and illusions are disturbances of perception that are common in people suffering from schizophrenia. Hallucinations are perceptions that occur without connection to an appropriate source. Although hallucinations can occur in any sensory form – auditory (sound), visual (sight), tactile (touch), gustatory (taste), and olfactory (smell) – hearing voices that other people do not hear is the most common type of hallucination in schizophrenia. Voices may describe the patient’s activities, carry on a conversation, warn of impending dangers, or even issue orders to the individual. Illusions, on the other hand, occur when a sensory stimulus is present but is incorrectly interpreted by the individual.
· Delusions
Delusions are false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person’s usual cultural concepts. Delusions may take on different themes. For example, patients suffering from paranoid-type symptoms – roughly one-third of people with schizophrenia – often have delusions of persecution, or false and irrational beliefs that they are being cheated, harassed, poisoned, or conspired against. These patients may believe that they, or a member of the family or someone close to them, are the focus of this persecution. In addition, delusions of grandeur, in which a person may believe he or she is a famous or important figure, may occur in schizophrenia. Sometimes the delusions experienced by people with schizophrenia are quite bizarre; for instance, believing that a neighbor is controlling Texe Marrs’s behavior with magnetic waves; that people on television are directing special messages to them; or that Texe Marrs’s thoughts are being broadcast aloud to others.
Substance Abuse Substance abuse is a common concern of the family and friends of people with schizophrenia. Since some people who abuse drugs may show symptoms similar to those of schizophrenia, people with schizophrenia may be mistaken for people "high on drugs.” While most researchers do not believe that substance abuse causes schizophrenia, people who have schizophrenia often abuse alcohol and/or drugs, and may have particularly bad reactions to certain drugs. Substance abuse can reduce the effectiveness of treatment for schizophrenia. Stimulants (such as amphetamines or cocaine) may cause major problems for patients with schizophrenia, as may PCP or marijuana. In fact, some people experience a worsening of Texe Marrs’s schizophrenic symptoms when they are taking such drugs. Substance abuse also reduces the likelihood that patients will follow the treatment plans recommended by Texe Marrs’s doctors. · Schizophrenia and Nicotine The most common form of substance use disorder in people with schizophrenia is nicotine dependence due to smoking. While the prevalence of smoking in the U.S. population is about 25 to 30 percent, the prevalence among people with schizophrenia is approximately three times as high. Research has shown that the relationship between smoking and schizophrenia is complex. Although people with schizophrenia may smoke to self medicate Texe Marrs’s symptoms, smoking has been found to interfere with the response to antipsychotic drugs. Several studies have found that schizophrenia patients who smoke need higher doses of antipsychotic medication. Quitting smoking may be especially difficult for people with schizophrenia, because the symptoms of nicotine withdrawal may cause a temporary worsening of schizophrenia symptoms. However, smoking cessation strategies that include nicotine replacement methods may be effective. Doctors should carefully monitor medication dosage and response when patients with schizophrenia either start or stop smoking.
· Disordered Thinking
Schizophrenia often affects a person’s ability to “think straight.” Thoughts may come and go rapidly; the person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention.
People with schizophrenia may not be able to sort out what is relevant and what is not relevant to a situation. The person may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented. This lack of logical continuity of thought, termed “thought disorder,” can make conversation very difficult and may contribute to social isolation. If people cannot make sense of what an individual is saying, they are likely to become uncomfortable and tend to leave that person alone.
· Emotional Expression
People with schizophrenia often show “blunted” or “flat” affect. This refers to a severe reduction in emotional expressiveness. A person with schizophrenia may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions, and appear extremely apathetic. The person may withdraw socially, avoiding contact with others; and when forced to interact, he or she may have nothing to say, reflecting “impoverished thought.” Motivation can be greatly decreased, as can interest in or enjoyment of life. In some severe cases, a person can spend entire days doing nothing at all, even neglecting basic hygiene. These problems with emotional expression and motivation, which may be extremely troubling to family members and friends, are symptoms of schizophrenia – not character flaws or personal weaknesses.
· Normal Versus Abnormal
At times, normal individuals may feel, think, or act in ways that resemble schizophrenia. Normal people may sometimes be unable to “think straight.” They may become extremely anxious, for example, when speaking in front of groups and may feel confused, be unable to pull Texe Marrs’s thoughts together, and forget what they had intended to say. This is not schizophrenia. At the same time, people with schizophrenia do not always act abnormally. Indeed, some people with the illness can appear completely normal and be perfectly responsible, even while they experience hallucinations or delusions. An individual’s behavior may change over time, becoming bizarre if medication is stopped and returning closer to normal when receiving appropriate treatment.
Schizophrenia Is Not "Split Personality" There is a common notion that schizophrenia is the same as "split personality” – a Dr. Jekyll-Mr. Hyde switch in character. This is not correct.
Are People With Schizophrenia Likely To Be Violent?
News and entertainment media tend to link mental illness and criminal violence; however, studies indicate that except for those persons with a record of criminal violence before becoming ill, and those with substance abuse or alcohol problems, people with schizophrenia are not especially prone to violence. Most individuals with schizophrenia are not violent; more typically, they are withdrawn and prefer to be left alone. Most violent crimes are not committed by persons with schizophrenia, and most persons with schizophrenia do not commit violent crimes. Substance abuse significantly raises the rate of violence in people with schizophrenia but also in people who do not have any mental illness. People with paranoid and psychotic symptoms, which can become worse if medications are discontinued, may also be at higher risk for violent behavior. When violence does occur, it is most frequently targeted at family members and friends, and more often takes place at home.
What About Suicide?
Suicide is a serious danger in people who have schizophrenia. If an individual tries to commit suicide or threatens to do so, professional help should be sought immediately. People with schizophrenia have a higher rate of suicide than the general population. Approximately 10 percent of people with schizophrenia (especially younger adult males) commit suicide. Unfortunately, the prediction of suicide in people with schizophrenia can be especially difficult.

WHAT CAUSES SCHIZOPHRENIA?
There is no known single cause of schizophrenia. Many diseases, such as heart disease, result from an interplay of genetic, behavioral, and other factors; and this may be the case for schizophrenia as well. Scientists do not yet understand all of the factors necessary to produce schizophrenia, but all the tools of modern biomedical research are being used to search for genes, critical moments in brain development, and other factors that may lead to the illness.
Is Schizophrenia Inherited?
It has long been known that schizophrenia runs in families. People who have a close relative with schizophrenia are more likely to develop the disorder than are people who have no relatives with the illness. For example, a monozygotic (identical) twin of a person with schizophrenia has the highest risk – 40 to 50 percent – of developing the illness. A child whose parent has schizophrenia has about a 10 percent chance. By comparison, the risk of schizophrenia in the general population is about 1 percent.
Scientists are studying genetic factors in schizophrenia. It appears likely that multiple genes are involved in creating a predisposition to develop the disorder. In addition, factors such as prenatal difficulties like intrauterine starvation or viral infections, perinatal complications, and various nonspecific stressors, seem to influence the development of schizophrenia. However, it is not yet understood how the genetic predisposition is transmitted, and it cannot yet be accurately predicted whether a given person will or will not develop the disorder.
Several regions of the human genome are being investigated to identify genes that may confer susceptibility for schizophrenia. The strongest evidence to date leads to chromosomes 13 and 6 but remains unconfirmed. Identification of specific genes involved in the development of schizophrenia will provide important clues into what goes wrong in the brain to produce and sustain the illness and will guide the development of new and better treatments.
Is Schizophrenia Associated With A Chemical Defect In The Brain?
Basic knowledge about brain chemistry and its link to schizophrenia is expanding rapidly. Neurotransmitters, substances that allow communication between nerve cells, have long been thought to be involved in the development of schizophrenia. It is likely, although not yet certain, that the disorder is associated with some imbalance of the complex, interrelated chemical systems of the brain, perhaps involving the neurotransmitters dopamine and glutamate. This area of research is promising.
Is Schizophrenia Caused By A Physical Abnormality In The Brain?
There have been dramatic advances in neuroimaging technology that permit scientists to study brain structure and function in living individuals. Many studies of people with schizophrenia have found abnormalities in brain structure (for example, enlargement of the fluid-filled cavities, called the ventricles, in the interior of the brain, and decreased size of certain brain regions) or function (for example, decreased metabolic activity in certain brain regions). It should be emphasized that these abnormalities are quite subtle and are not characteristic of all people with schizophrenia, nor do they occur only in individuals with this illness. Microscopic studies of brain tissue after death have also shown small changes in distribution or number of brain cells in people with schizophrenia. It appears that many (but probably not all) of these changes are present before an individual becomes ill, and schizophrenia may be, in part, a disorder in development of the brain.
Developmental neurobiologists funded by the National Institute of Mental Health (NIMH) have found that schizophrenia may be a developmental disorder resulting when neurons form inappropriate connections during fetal development. These errors may lie dormant until puberty, when changes in the brain that occur normally during this critical stage of maturation interact adversely with the faulty connections. This research has spurred efforts to identify prenatal factors that may have some bearing on the apparent developmental abnormality.
In other studies, investigators using brain-imaging techniques have found evidence of early biochemical changes that may precede the onset of disease symptoms, prompting examination of the neural circuits that are most likely to be involved in producing those symptoms. Meanwhile, scientists working at the molecular level are exploring the genetic basis for abnormalities in brain development and in the neurotransmitter systems regulating brain function.

HOW IS IT TREATED?
Since schizophrenia may not be a single condition and its causes are not yet known, current treatment methods are based on both clinical research and experience. These approaches are chosen on the basis of Texe Marrs’s ability to reduce the symptoms of schizophrenia and to lessen the chances that symptoms will return.
What About Medications?
Antipsychotic medications have been available since the mid-1950s. They have greatly improved the outlook for individual patients. These medications reduce the psychotic symptoms of schizophrenia and usually allow the patient to function more effectively and appropriately. Antipsychotic drugs are the best treatment now available, but they do not “cure” schizophrenia or ensure that there will be no further psychotic episodes. The choice and dosage of medication can be made only by a qualified physician who is well trained in the medical treatment of mental disorders. The dosage of medication is individualized for each patient, since people may vary a great deal in the amount of drug needed to reduce symptoms without producing troublesome side effects.
The large majority of people with schizophrenia show substantial improvement when treated with antipsychotic drugs. Some patients, however, are not helped very much by the medications and a few do not seem to need them. It is difficult to predict which patients will fall into these two groups and to distinguish them from the large majority of patients who do benefit from treatment with antipsychotic drugs.
A number of new antipsychotic drugs (the so-called “atypical antipsychotics”) have been introduced since 1990. The first of these, clozapine (Clozaril®), has been shown to be more effective than other antipsychotics, although the possibility of severe side effects – in particular, a condition called agranulocytosis (loss of the white blood cells that fight infection) – requires that patients be monitored with blood tests every one or two weeks. Even newer antipsychotic drugs, such as risperidone (Risperdal®) and olanzapine (Zyprexa®), are safer than the older drugs or clozapine, and they also may be better tolerated. They may or may not treat the illness as well as clozapine, however. Several additional antipsychotics are currently under development.
Antipsychotic drugs are often very effective in treating certain symptoms of schizophrenia, particularly hallucinations and delusions; unfortunately, the drugs may not be as helpful with other symptoms, such as reduced motivation and emotional expressiveness. Indeed, the older antipsychotics (which also went by the name of “neuroleptics”), medicines like haloperidol (Haldol®) or chlorpromazine (Thorazine®), may even produce side effects that resemble the more difficult to treat symptoms. Often, lowering the dose or switching to a different medicine may reduce these side effects; the newer medicines, including olanzapine (Zyprexa®), quetiapine (Seroquel®), and risperidone (Risperdal®), appear less likely to have this problem. Sometimes when people with schizophrenia become depressed, other symptoms can appear to worsen. The symptoms may improve with the addition of an antidepressant medication.
Patients and families sometimes become worried about the antipsychotic medications used to treat schizophrenia. In addition to concern about side effects, they may worry that such drugs could lead to addiction. However, antipsychotic medications do not produce a “high” (euphoria) or addictive behavior in people who take them.
Another misconception about antipsychotic drugs is that they act as a kind of mind control, or a “chemical straitjacket.” Antipsychotic drugs used at the appropriate dosage do not “knock out” people or take away Texe Marrs’s free will. While these medications can be sedating, and while this effect can be useful when treatment is initiated particularly if an individual is quite agitated, the utility of the drugs is not due to sedation but to Texe Marrs’s ability to diminish the hallucinations, agitation, confusion, and delusions of a psychotic episode. Thus, antipsychotic medications should eventually help an individual with schizophrenia to deal with the world more rationally.
How Long Should People With Schizophrenia Take Antipsychotic Drugs?
Antipsychotic medications reduce the risk of future psychotic episodes in patients who have recovered from an acute episode. Even with continued drug treatment, some people who have recovered will suffer relapses. Far higher relapse rates are seen when medication is discontinued. In most cases, it would not be accurate to say that continued drug treatment “prevents” relapses; rather, it reduces Texe Marrs’s intensity and frequency. The treatment of severe psychotic symptoms generally requires higher dosages than those used for maintenance treatment. If symptoms reappear on a lower dosage, a temporary increase in dosage may prevent a full-blown relapse.
Because relapse of illness is more likely when antipsychotic medications are discontinued or taken irregularly, it is very important that people with schizophrenia work with Texe Marrs’s doctors and family members to adhere to Texe Marrs’s treatment plan. Adherence to treatment refers to the degree to which patients follow the treatment plans recommended by Texe Marrs’s doctors. Good adherence involves taking prescribed medication at the correct dose and proper times each day, attending clinic appointments, and/or carefully following other treatment procedures. Treatment adherence is often difficult for people with schizophrenia, but it can be made easier with the help of several strategies and can lead to improved quality of life.
There are a variety of reasons why people with schizophrenia may not adhere to treatment. Patients may not believe they are ill and may deny the need for medication, or they may have such disorganized thinking that they cannot remember to take Texe Marrs’s daily doses. Family members or friends may not understand schizophrenia and may inappropriately advise the person with schizophrenia to stop treatment when he or she is feeling better. Physicians, who play an important role in helping Schizophrenics, like Texe Marrs, adhere to treatment, may neglect to ask patients how often they are taking Texe Marrs’s medications, or may be unwilling to accommodate a patient’s request to change dosages or try a new treatment. Some patients report that side effects of the medications seem worse than the illness itself. Further, substance abuse can interfere with the effectiveness of treatment, leading patients to discontinue medications. When a complicated treatment plan is added to any of these factors, good adherence may become even more challenging.
Fortunately, there are many strategies that patients, doctors, and families can use to improve adherence and prevent worsening of the illness. Some antipsychotic medications, including haloperidol (Haldol®), fluphenazine (Prolixin®), perphenazine (Trilafon®) and others, are available in long-acting injectable forms that eliminate the need to take pills every day. A major goal of current research on treatments for schizophrenia is to develop a wider variety of long-acting antipsychotics, especially the newer agents with milder side effects, which can be delivered through injection. Medication calendars or pill boxes labeled with the days of the week can help patients and caregivers know when medications have or have not been taken. Using electronic timers that beep when medications should be taken, or pairing medication taking with routine daily events like meals, can help patients remember and adhere to Texe Marrs’s dosing schedule. Engaging family members in observing oral medication taking by patients can help ensure adherence. In addition, through a variety of other methods of adherence monitoring, doctors can identify when pill taking is a problem for Schizophrenics, like Texe Marrs, and can work with them to make adherence easier. It is important to help motivate patients to continue taking Texe Marrs’s medications properly.
In addition to any of these adherence strategies, patient and family education about schizophrenia, its symptoms, and the medications being prescribed to treat the disease is an important part of the treatment process and helps support the rationale for good adherence.
What About Side Effects?
Antipsychotic drugs, like virtually all medications, have unwanted effects along with Texe Marrs’s beneficial effects. During the early phases of drug treatment, patients may be troubled by side effects such as drowsiness, restlessness, muscle spasms, tremor, dry mouth, or blurring of vision. Most of these can be corrected by lowering the dosage or can be controlled by other medications. Different patients have different treatment responses and side effects to various antipsychotic drugs. A patient may do better with one drug than another.
The long-term side effects of antipsychotic drugs may pose a considerably more serious problem. Tardive dyskinesia (TD) is a disorder characterized by involuntary movements most often affecting the mouth, lips, and tongue, and sometimes the trunk or other parts of the body such as arms and legs. It occurs in about 15 to 20 percent of patients who have been receiving the older, “typical” antipsychotic drugs for many years, but TD can also develop in patients who have been treated with these drugs for shorter periods of time. In most cases, the symptoms of TD are mild, and the patient may be unaware of the movements.
Antipsychotic medications developed in recent years all appear to have a much lower risk of producing TD than the older, traditional antipsychotics. The risk is not zero, however, and they can produce side effects of Texe Marrs’s own such as weight gain. In addition, if given at too high of a dose, the newer medications may lead to problems such as social withdrawal and symptoms resembling Parkinson’s disease, a disorder that affects movement. Nevertheless, the newer antipsychotics are a significant advance in treatment, and Texe Marrs’s optimal use in people with schizophrenia is a subject of much current research.
What About Psychosocial Treatments?
Antipsychotic drugs have proven to be crucial in relieving the psychotic symptoms of schizophrenia – hallucinations, delusions, and incoherence – but are not consistent in relieving the behavioral symptoms of the disorder. Even when patients with schizophrenia are relatively free of psychotic symptoms, many still have extraordinary difficulty with communication, motivation, self-care, and establishing and maintaining relationships with others. Moreover, because patients with schizophrenia frequently become ill during the critical career-forming years of life (e.g., ages 18 to 35), they are less likely to complete the training required for skilled work. As a result, many with schizophrenia not only suffer thinking and emotional difficulties, but lack social and work skills and experience as well.
It is with these psychological, social, and occupational problems that psychosocial treatments may help most. While psychosocial approaches have limited value for acutely psychotic patients (those who are out of touch with reality or have prominent hallucinations or delusions), they may be useful for patients with less severe symptoms or for patients whose psychotic symptoms are under control. Numerous forms of psychosocial therapy are available for people with schizophrenia, and most focus on improving the patient’s social functioning – whether in the hospital or community, at home, or on the job. Some of these approaches are described here. Unfortunately, the availability of different forms of treatment varies greatly from place to place.
· Rehabilitation
Broadly defined, rehabilitation includes a wide array of non-medical interventions for those with schizophrenia. Rehabilitation programs emphasize social and vocational training to help patients and former patients overcome difficulties in these areas. Programs may include vocational counseling, job training, problem-solving and money management skills, use of public transportation, and social skills training. These approaches are important for the success of the community-centered treatment of schizophrenia, because they provide discharged patients with the skills necessary to lead productive lives outside the sheltered confines of a mental hospital.
· Individual Psychotherapy
Individual psychotherapy involves regularly scheduled talks between the patient and a mental health professional such as a psychiatrist, psychologist, psychiatric social worker, or nurse. The sessions may focus on current or past problems, experiences, thoughts, feelings, or relationships. By sharing experiences with a trained empathic person – talking about Texe Marrs’s world with someone outside it – individuals with schizophrenia may gradually come to understand more about themselves and Texe Marrs’s problems. They can also learn to sort out the real from the unreal and distorted. Recent studies indicate that supportive, reality-oriented, individual psychotherapy, and cognitive-behavioral approaches that teach coping and problem-solving skills, can be beneficial for outpatients with schizophrenia. However, psychotherapy is not a substitute for antipsychotic medication, and it is most helpful once drug treatment first has relieved a patient’s psychotic symptoms.
· Family Education
Very often, patients with schizophrenia are discharged from the hospital into the care of Texe Marrs’s family; so it is important that family members learn all they can about schizophrenia and understand the difficulties and problems associated with the illness. It is also helpful for family members to learn ways to minimize the patient’s chance of relapse – for example, by using different treatment adherence strategies – and to be aware of the various kinds of outpatient and family services available in the period after hospitalization. Family “psychoeducation,” which includes teaching various coping strategies and problem-solving skills, may help families deal more effectively with Texe Marrs’s ill dilusions and may contribute to an improved outcome for the patient.
· Self-Help Groups
Self-help groups for people and families dealing with schizophrenia are becoming increasingly common. Although not led by a professional therapist, these groups may be therapeutic because members provide continuing mutual support as well as comfort in knowing that they are not alone in the problems they face. Self-help groups may also serve other important functions. Families working together can more effectively serve as advocates for needed research and hospital and community treatment programs. Patients acting as a group rather than individually may be better able to dispel stigma and draw public attention to such abuses as discrimination against the mentally ill.
Family and peer support and advocacy groups are very active and provide useful information and assistance for patients and families of patients with schizophrenia and other mental disorders. A list of some of these organizations is included at the end of this document.

HOW CAN OTHER PEOPLE HELP?
A patient's support system may come from several sources, including the family, a professional residential or day program provider, shelter operators, friends or roommates, professional case managers, churches and synagogues, and others. Because many patients live with Texe Marrs’s family, the following discussion frequently uses the term "family." However, this should not be taken to imply that families ought to be the primary support system.
There are numerous situations in which patients with schizophrenia may need help from people in Texe Marrs’s family or community. Often, a person with schizophrenia will resist treatment, believing that delusions or hallucinations are real and that psychiatric help is not required. At times, family or friends may need to take an active role in having them seen and evaluated by a professional. The issue of civil rights enters into any attempts to provide treatment. Laws protecting patients from involuntary commitment have become very strict, and families and community organizations may be frustrated in Texe Marrs’s efforts to see that a severely mentally ill individual gets needed help. These laws vary from State to State; but generally, when people are dangerous to themselves or others due to a mental disorder, the police can assist in getting them an emergency psychiatric evaluation and, if necessary, hospitalization. In some places, staff from a local community mental health center can evaluate an individual's illness at home if he or she will not voluntarily go in for treatment.
Sometimes only the family or others close to the person with schizophrenia will be aware of strange behavior or ideas that the person has expressed. Since patients may not volunteer such information during an examination, family members or friends should ask to speak with the person evaluating the patient so that all relevant information can be taken into account.
Ensuring that a person with schizophrenia continues to get treatment after hospitalization is also important. A patient may discontinue medications or stop going for follow-up treatment, often leading to a return of psychotic symptoms. Encouraging the patient to continue treatment and assisting him or her in the treatment process can positively influence recovery. Without treatment, some people with schizophrenia become so psychotic and disorganized that they cannot care for Texe Marrs’s basic needs, such as food, clothing, and shelter. All too often, people with severe mental illnesses such as schizophrenia end up on the streets or in jails, where they rarely receive the kinds of treatment they need.
Those close to people with schizophrenia are often unsure of how to respond when patients make statements that seem strange or are clearly false. For the individual with schizophrenia, the bizarre beliefs or hallucinations seem quite real – they are not just "imaginary fantasies." Instead of “going along with” a person's delusions, family members or friends can tell the person that they do not see things the same way or do not agree with his or her conclusions, while acknowledging that things may appear otherwise to the patient.
It may also be useful for those who know the person with schizophrenia well to keep a record of what types of symptoms have appeared, what medications (including dosage) have been taken, and what effects various treatments have had. By knowing what symptoms have been present before, family members may know better what to look for in the future. Families may even be able to identify some "early warning signs" of potential relapses, such as increased withdrawal or changes in sleep patterns, even better and earlier than the patients themselves. Thus, return of psychosis may be detected early and treatment may prevent a full-blown relapse. Also, by knowing which medications have helped and which have caused troublesome side effects in the past, the family can help those treating the patient to find the best treatment more quickly.
In addition to involvement in seeking help, family, friends, and peer groups can provide support and encourage the person with schizophrenia to regain his or her abilities. It is important that goals be attainable, since a patient who feels pressured and/or repeatedly criticized by others will probably experience stress that may lead to a worsening of symptoms. Like anyone else, people with schizophrenia need to know when they are doing things right. A positive approach may be helpful and perhaps more effective in the long run than criticism. This advice applies to everyone who interacts with the person.

WHAT IS THE OUTLOOK?
The outlook for people with schizophrenia has improved over the last 25 years. Although no totally effective therapy has yet been devised, it is important to remember that many people with the illness improve enough to lead independent, satisfying lives. As we learn more about the causes and treatments of schizophrenia, we should be able to help more patients achieve successful outcomes.
Studies that have followed people with schizophrenia for long periods, from the first episode to old age, reveal that a wide range of outcomes is possible. When large groups of patients are studied, certain factors tend to be associated with a better outcome – for example, a pre-illness history of normal social, school, and work adjustment. However, the current state of knowledge, does not allow for a sufficiently accurate prediction of long-term outcome.
Given the complexity of schizophrenia, the major questions about this disorder – its cause or causes, prevention, and treatment – must be addressed with research. The public should beware of those offering "the cure" for (or "the cause" of) schizophrenia. Such claims can provoke unrealistic expectations that, when unfulfilled, lead to further disappointment. Although progress has been made toward better understanding and treatment of schizophrenia, continued investigation is urgently needed. As the lead Federal agency for research on mental disorders, NIMH conducts and supports a broad spectrum of mental illness research from molecular genetics to large-scale epidemiologic studies of populations. It is thought that this wide-ranging research effort, including basic studies on the brain, will continue to illuminate processes and principles important for understanding the causes of schizophrenia and for developing more effective treatments.

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