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Which is worse and why?
Pain patients or Addicts?
- Thread starter Billy Jack
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There is a huge overlap but, clearly the most manipulative are the many addicts masquerading as a pain patients.
Common Themes:
1. Minimization -- e.g. "I barely touched her. She doesn't even have a bruise. She's just being a crybaby."
2. Lying –- Covert-aggressive people have no compunctions about lying, and indeed will say anything at all that gets them out of facing the consequences of their behavior.
3. Denial -- Simply saying the aggression didn't happen, doesn't happen, the victim is just crazy, the child has false memories, or whatever.
4. Selective Inattention -– Refusing to pay attention to anything said about the person’s aggression, to any attempt to address the problem. Being too busy to listen right now. Stonewalling.
5. Rationalization -- e.g. "She hit me once so she's only getting what she deserves. Beating kids teaches them how to protect themselves from bullies they'll meet in life. I'm teaching her fighting skills." Things that sound just plausible enough to turn aside the wrath of any accuser.
6. Diversion -- e.g. "What about what you did yesterday?" Any change of subject, especially to put the other person on the defensive, that has the effect of confusing the issue at hand and letting the aggressor off the hook.
7. Evasion (deliberate vagueness) -– e.g. “I’m not sure. We did a lot of things,” when asked a direct question. Any answer that isn’t a straight answer, particularly one meant to deceive by implying something that isn’t true.
8. Covert Intimidation (veiled threats) -– e.g. “jokes” about firing you (a boss), physically harming you (an abusive family member), euthanizing pets, abandoning children, self-harm, etc. Can sometimes be implied through posture or facial expressions. Often subtle.
9. Guilt-tripping –- Aggressive people are aware that others are more conscientious than they are, so they play on this to keep them insecure and on the defensive. If they suggest, even imply, that the person who's trying to address their aggression may be an imperfect spouse, parent, boss, or worker, their feelings of responsibility and conscientiousness kick in and keep them from pressing the original issue. The aggressor has no such concerns or compunctions about their own behaviors, but they’ve learned to use the fact that others do worry about such things to sidestep their own issues when confronted.
10. Shaming –- Use of subtle sarcasm and put-downs to increase self-doubt and decrease self-esteem of the people being manipulated. Sometimes this can be conveyed in glances or sighs, without even using words.
11. Playing the victim role – sometimes aggressive people can recast defense against their aggression as aggression by others toward themselves. They then pretend to be the victim of the aggression instead of the perpetrator, e.g. “You hate me. Why are you always picking on me?”
12. Vilifying the victim – In an attempt to gain the upper hand, the aggressor may simply resort to insults, e.g. “you’re a terrible spouse (parent), you suck, you’re boring, ugly, stupid, you have Asperger’s, you don’t understand people” etc.
13.Playing the Servant Role –- apparently some aggressors can gain control by pretending to be the servant. (One of the few of these tactics I haven’t personally experienced.)
14. Seduction –- apparently some aggressors gain trust and cover their aggressive intent by praising or flattering the victim. (Another tactic I haven’t seen in use.)
15. Projecting the blame –- this is finding someone else who is at fault for whatever the problem may be. It could be birth parents, friends, coworkers, ex-spouses, or the one who's bringing the issue forward. Anyone else will do to get the discussion off track and leave the manipulative person's own choices out of the question.
16. Feigning Innocence –- Sometimes all it takes to not be held accountable for aggressive behavior is simply to look innocent and pretend it never happened. Since such people have no compunctions about lying or deceiving, they’re quite likely to fool others in this way.
17. Feigning Ignorance or Confusion –- the same basic tactic as in 16 above.
18. Brandishing Anger –- people who manipulate can sometimes deflect accountability by flaring up in anger whenever they’re confronted. This keeps other people timid and off-kilter and prevents the true problem from being addressed.
19. Threatening self-harm –- this last one is one I added, something depressed or suicidal people can use to manipulate those who love them. It’s used often enough that I think it deserves its own number. Since the suicidal person cares less about their own well-being than others do, they can use direct or implied threats of suicide or self-harm to prevent anyone from upsetting them by calling them out on their aggressive behavior. In a sense, they hold themselves hostage, “Do what I want or I’ll injure your loved one (myself).”
Common Themes:
1. Minimization -- e.g. "I barely touched her. She doesn't even have a bruise. She's just being a crybaby."
2. Lying –- Covert-aggressive people have no compunctions about lying, and indeed will say anything at all that gets them out of facing the consequences of their behavior.
3. Denial -- Simply saying the aggression didn't happen, doesn't happen, the victim is just crazy, the child has false memories, or whatever.
4. Selective Inattention -– Refusing to pay attention to anything said about the person’s aggression, to any attempt to address the problem. Being too busy to listen right now. Stonewalling.
5. Rationalization -- e.g. "She hit me once so she's only getting what she deserves. Beating kids teaches them how to protect themselves from bullies they'll meet in life. I'm teaching her fighting skills." Things that sound just plausible enough to turn aside the wrath of any accuser.
6. Diversion -- e.g. "What about what you did yesterday?" Any change of subject, especially to put the other person on the defensive, that has the effect of confusing the issue at hand and letting the aggressor off the hook.
7. Evasion (deliberate vagueness) -– e.g. “I’m not sure. We did a lot of things,” when asked a direct question. Any answer that isn’t a straight answer, particularly one meant to deceive by implying something that isn’t true.
8. Covert Intimidation (veiled threats) -– e.g. “jokes” about firing you (a boss), physically harming you (an abusive family member), euthanizing pets, abandoning children, self-harm, etc. Can sometimes be implied through posture or facial expressions. Often subtle.
9. Guilt-tripping –- Aggressive people are aware that others are more conscientious than they are, so they play on this to keep them insecure and on the defensive. If they suggest, even imply, that the person who's trying to address their aggression may be an imperfect spouse, parent, boss, or worker, their feelings of responsibility and conscientiousness kick in and keep them from pressing the original issue. The aggressor has no such concerns or compunctions about their own behaviors, but they’ve learned to use the fact that others do worry about such things to sidestep their own issues when confronted.
10. Shaming –- Use of subtle sarcasm and put-downs to increase self-doubt and decrease self-esteem of the people being manipulated. Sometimes this can be conveyed in glances or sighs, without even using words.
11. Playing the victim role – sometimes aggressive people can recast defense against their aggression as aggression by others toward themselves. They then pretend to be the victim of the aggression instead of the perpetrator, e.g. “You hate me. Why are you always picking on me?”
12. Vilifying the victim – In an attempt to gain the upper hand, the aggressor may simply resort to insults, e.g. “you’re a terrible spouse (parent), you suck, you’re boring, ugly, stupid, you have Asperger’s, you don’t understand people” etc.
13.Playing the Servant Role –- apparently some aggressors can gain control by pretending to be the servant. (One of the few of these tactics I haven’t personally experienced.)
14. Seduction –- apparently some aggressors gain trust and cover their aggressive intent by praising or flattering the victim. (Another tactic I haven’t seen in use.)
15. Projecting the blame –- this is finding someone else who is at fault for whatever the problem may be. It could be birth parents, friends, coworkers, ex-spouses, or the one who's bringing the issue forward. Anyone else will do to get the discussion off track and leave the manipulative person's own choices out of the question.
16. Feigning Innocence –- Sometimes all it takes to not be held accountable for aggressive behavior is simply to look innocent and pretend it never happened. Since such people have no compunctions about lying or deceiving, they’re quite likely to fool others in this way.
17. Feigning Ignorance or Confusion –- the same basic tactic as in 16 above.
18. Brandishing Anger –- people who manipulate can sometimes deflect accountability by flaring up in anger whenever they’re confronted. This keeps other people timid and off-kilter and prevents the true problem from being addressed.
19. Threatening self-harm –- this last one is one I added, something depressed or suicidal people can use to manipulate those who love them. It’s used often enough that I think it deserves its own number. Since the suicidal person cares less about their own well-being than others do, they can use direct or implied threats of suicide or self-harm to prevent anyone from upsetting them by calling them out on their aggressive behavior. In a sense, they hold themselves hostage, “Do what I want or I’ll injure your loved one (myself).”
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Addicted pain patients are the worst because they justify their addictive behavior on the basis of pain.
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Pain patients are to be pitied and addicts are to be despised.
Pain patients have pathological CNS sensory systems. Addicts have pathological CNS reward systems. Coincidentally, sensory and reward systems overlap in human nervous systems. Still, the epigenesis of disordered reward systems & addictive disorders is equal parts genetics and poor parenting (adverse childhood events) and the associated sociopathy that is both modeled and learned in that environment is a barrier to cultivating trusting, healing relationships with health care providers.
The day-to-day work of taking care of addicts is more like being a parole officer or prison guard than a doctor.
Pain patients have pathological CNS sensory systems. Addicts have pathological CNS reward systems. Coincidentally, sensory and reward systems overlap in human nervous systems. Still, the epigenesis of disordered reward systems & addictive disorders is equal parts genetics and poor parenting (adverse childhood events) and the associated sociopathy that is both modeled and learned in that environment is a barrier to cultivating trusting, healing relationships with health care providers.
The day-to-day work of taking care of addicts is more like being a parole officer or prison guard than a doctor.
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"Pain patients have pathological CNS sensory systems." this is not true. Most fMRI studies of chronic pain patients - regardless of the anatomic locus - show abnormalities
outside the somatosensory system, ie, the limbic system and prefrontal cortices. The vast majority of chronic pain patient's aren't victims deserving of pity any more than addicts are.
outside the somatosensory system, ie, the limbic system and prefrontal cortices. The vast majority of chronic pain patient's aren't victims deserving of pity any more than addicts are.
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Why the Disease Definition of Addiction Does Far More Harm Than Good
"If we stop confusing addiction with pathology, then we can focus much more clearly on the specific needs of specific individuals. That seems a huge advantage over dumping everyone in a basket that fits almost no one."
The distinguishing clinical characteristic of addiction is sociopathy.
The pain patient--deactivated, depressed, and demoralized--only rarely can muster the energy to act out on the environment instead preferring to be solicitous and dependent. The addict--activated by hedonism--will do almost anything, including commit crimes against people and property, to secure their fix. In my experience addicts have forged prescriptions, committed identity theft, impersonated office staff, and stalked providers. In other words, the addict will literally kill you to feed their addiction but the pain patient only makes you wish you were dead.
Still, the best part is that the latter can be conjured from the former. Like Rumpleskiltskin, the "Suboxone Pimp" can spin gold from straw through gentle extortion, leading questions, and consistent pressure. The Suboxone Mill business model requires capping out on the X-number waiver in order to achieve economies of scale. And, conveniently, OUD is a life-long, life-threatening, relapsing condition. Once "on" Suboxone most addicts never come "off."
The medicalization of addiction--and the conversion of pain pain patients into addicts--driven to the constant drumbeat of "dose is death" mantra has enriched many, many more people than "pain as a fifth vital sign" movement ever did. Pain as a fifth vital sign created "winner takes all" economics enriching the Sackler family and a cadre of opioid thought leaders and high prescribers. But, "dose is death" narrative has literally launched thousands of academic careers, political careers, created opportunities for advancement and tenure in private and public sectors, and enriched the addiction industry by billions.
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Agonal breathing from a proponent of the failed ASIPP 4P model: Pills, Procedures, PA’s, & Pee processing fees🙂
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Nora Volkow says addiction is a "brain disease."
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Article was written by:
Marc Lewis
Marc Lewis is a neuroscientist and professor emeritus in developmental psychology at the University of Toronto, currently writing and speaking on the science and experience of addiction. His latest book is The Biology of Desire: Why Addiction is Not a Disease.
Didn't realize this guy was a leader of ASIPP, thanks for the information.
All he is saying is the addiction industry is a 35 billion dollar revenue generator with zero evidence behind long term benefit using meta analysis data to back up his claims.
Seems pretty scientific to me. Maybe if they added in integrative shaman, naturopaths and pet therapy, the success rate would skyrocket.
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Shh don't speak like that about 101N Sub for cash model with pet therapy, shaman and voo doo dolls being "evidence based". There are MANY of naturopaths and Dr Nurses that have proven this method through integrative "research"!
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Addiction is just another disease. It's treatable, some people get better and some don't, the results are better with treatment than without. Just look at the literature for medication assisted treatment and it's pretty clear that it's better than nothing, even though it's not perfect.
