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What is Positive Disintegration?

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Introduction

The theory of positive disintegration (TPD) is an idea of personality development developed by Polish psychologist Kazimierz Dąbrowski.

Unlike mainstream psychology, the theory views psychological tension and anxiety as necessary for personal growth. These “disintegrative” processes are “positive”, whereas people who fail to go through positive disintegration may stop at “primary integration”, possessing individuality but nevertheless lacking an autonomous personality and remaining impressionable. Entering into disintegration and subsequent higher processes of development occurs through developmental potential, including over-excitability and hypersensitivity.

Unlike other theories of development such as Erikson’s stages of psychosocial development, it is not assumed that even a majority of people progress through all levels. TPD is not a theory of stages, and levels do not correlate with age, nor do tension and anxiety correlate to maturity.

Origins

Dąbrowski’s worldview was likely influenced by his life experiences. As a teenager in World War I, he witnessed a major battle near his village. He walked among the bodies of the dead soldiers and later recalled that the looks on their faces were wildly different—some expressed fear, some horror, while some looked calm and peaceful.

During World War II, he was imprisoned by the Nazi police several times and his wife paid ransom for his release; when Stalin seized Poland, Dąbrowski and his wife were imprisoned for 18 months. Dąbrowski said he wrote his theory to encapsulate the lowest human behaviours he had observed during the war, as well as the highest acts of self-sacrifice. He said that no other psychological theory had captured this wide range of human behaviour. After his release, his behaviour was closely monitored by the Polish authorities until at least the early 60s. In 1965 he established a base in Edmonton, Alberta, and spent the rest of his life alternating between Canada and Poland.

Dąbrowski’s Theory

The development of the theory of positive disintegration began in Dąbrowski’s earliest Polish works, as reflected in his 1929 doctoral thesis. His first work in English also contained seeds of the theory. His next major English work was his 1964 book Positive Disintegration. He proposed that the key to mental growth was having strong “developmental potential”: a constellation of psychological factors often leading to the disintegration of existing psychological structures. These disintegrations allow the individual to voluntarily reorganize their priorities and values, leading to psychological growth.

Dąbrowski’s theory of personality development emphasizes several major features, including that having a unique personality is not a universal trait: it must be created and shaped by the individual to reflect their own unique character. Personality develops as a result of developmental potential (DP), including overexcitability and the autonomous (third) factor; not everyone displays sufficient DP to move through the process of mental growth via positive disintegration.

Dąbrowski used a multilevel approach to describe the continuum of developmental levels seen in the population. In his theory, developmental potential creates crises characterised by strong anxieties and depressions (which he called psychoneurosis) that precipitate disintegrations. For personality to develop, initial integrations based on instinct and socialisation must disintegrate through a process Dąbrowski called positive disintegration. He said that the development of a hierarchy of individual values and emotional reactions was a critical component in developing one’s personality and autonomy; thus, in contrast to most psychological theories, emotions play a major role.

Emotional reactions guide the individual in creating their individual “personality ideal”, an autonomous standard that acts as the goal of individual development. Individuals must examine their essence and develop their own unique personality ideal. Only then can they make existential choices that emphasize the aspects of self that are higher and “more myself”, and inhibit those aspects that are lower or “less myself”, based upon their ideal personality; thus shaping their personality and creating an authentic self based upon the fundamental essence of the individual. Critical components of individual development include: self-education, subject-object, personality ideal, self-perfection, and autopsychotherapy.

Factors in Personality Development

Dąbrowski observed that most people live their lives in a state of “primary or primitive integration” largely guided by biological impulses (“first factor”), by uncritical endorsement and adherence to social conventions (“second factor”), or by both at once. He called this initial integration Level I. Dąbrowski observed that at this level, there is no true individual expression of the autonomous human self; the individual has no autonomous personality, and rather, they exhibit Nietzsche’s idea of the herd personality. Individual expression at Level I is influenced and constrained by the first and second factors.

The first factor directs energy and talents toward self-serving goals that reflect the “lower instincts” and biological needs, as its primary focus is on survival and self-advancement. The second factor, the social environment (milieu) and peer pressure, constrains individual expression and creativity by encouraging mob mentality and discouraging individual thought and expression. The second factor externalises values and morals, thereby externalising conscience; social forces shape behaviour. Behaviour, talents and creativity are funnelled into forms that follow and support the existing social milieu. As conscience is derived from an external social context, so long as social standards are ethical, people influenced by the second factor will behave ethically. However, if a society becomes corrupt, people strongly influenced by the second factor will not dissent. Socialisation without individual examination leads to a rote and robotic existence (the “robopath” described by Ludwig von Bertalanffy). Individual reactions are not unique, as reactions are based on the social context. According to Dąbrowski, people primarily motivated by the second factor represent a significant majority of the general population.

Dąbrowski felt that society was largely influenced by these two factors and could be characterised as operating at Level I, where the external value system absolves the individual of actual responsibility. He also described groups of people who display a different developmental course—an individualised developmental pathway. Such people break away from an automatic, rote, socialised view of life (which Dąbrowski called negative adjustment) and move into, and through, a series of personal disintegrations. Dąbrowski saw these disintegrations as a key element in the overall developmental process. Crises challenge the status quo and cause people to review the self, their ideas, values, thoughts, ideals, etc.

If development continues, one goes on to develop an individualized, conscious and critically evaluated hierarchical value structure (called positive adjustment). This hierarchy of values acts as a benchmark by which all things are now seen, and behaviour is directed by these internal values, rather than by external social mores. At these higher levels, individual values characterize an eventual second integration reflecting individual autonomy and the arrival of the individual’s true personality; each person develops their own vision of how life ought to be and lives according to that vision. This is associated with strongly individualised approaches to problem solving and creativity. One’s talents and creativity are applied in the service of these higher individual values and visions of how life could, and should, be. The person expresses their “new” autonomous personality energetically through action, art, social change, and so on.

Development Potential

Advanced development is often seen in people who exhibit strong developmental potential. Developmental potential represents a constellation of features: it may be positive or negative, it may be strong or weak. If it is strong, the input of the environment is minimal. If it is weak, the environment will play a critical role. Many factors are incorporated into developmental potential but three major aspects are overexcitability, one’s specific abilities and talents, and a strong drive toward autonomous growth (a feature Dąbrowski called the “third factor”).

Overexcitability

The most evident aspect of developmental potential is overexcitability (OE), a heightened physiological experience of stimuli resulting from increased neuronal sensitivities. The greater the OE, the more intense the day-to-day experiences of life. Dąbrowski outlined five forms of OE: psychomotor, sensual, imaginational, intellectual, and emotional. These overexcitabilities, especially the last three, often cause a person to experience daily life more intensely and to feel the joys and sorrows of life more profoundly. Dąbrowski studied human exemplars and found that heightened overexcitability was a key part of their developmental and life experience. These people are steered and driven by their values and their experiences of emotional OE. Combined with imaginational and intellectual OE, these people have an intense and multilevel perception of the world.

Although based in the nervous system, overexcitabilities are expressed psychologically through the development of structures that reflect the emerging autonomous self. The most important of these are “dynamisms”—the biological or mental forces that control behaviour and development. As used by Dąbrowski, dynamisms are instincts, drives, and intellectual processes combined with emotions. With advanced development, dynamisms increasingly reflect movement toward personal autonomy.

Abilities and Talents

The second aspect of developmental potential—specific abilities, and talents—tends to conform to the developmental level. At lower levels people use talents to support egocentric goals or to climb the social and corporate ladders. At higher levels, specific talents and abilities become an important force as the person uses their hierarchy of values to express, and achieve, their vision of their ideal personality and their view of how the world should be.

The Third Factor

According to Dąbrowski, the third factor of developmental potential (DP) is a drive toward individual growth and autonomy. He saw this as a critical factor in applying one’s talents and creativity toward autonomous expression, and in providing motivation to strive for more and to try to imagine (and achieve) goals currently beyond one’s grasp. Dąbrowski was clear to differentiate this third factor from free will. He felt that free will did not go far enough in capturing the motivating aspects that he attributed to this third factor, for example, an individual can exercise free will and show little motivation to grow or change as an individual. The third factor specifically describes motivation—a motivation to become one’s own true self. This motivation is often so strong that a person can find that they must develop themself, despite putting themself in danger by doing so. This feeling of “I’ve gotta be me”, especially when it is “at any cost”, and is expressed as a strong motivator for self-growth, is beyond the usual conceptualisation free will.

Dąbrowski’s theory says that a person whose DP is high enough will generally undergo disintegration, despite any external social or family efforts to prevent it; whereas person whose DP is very low will generally not undergo disintegration (or positive personality growth) even in a conducive environment. Dąbrowski’s notion of overexcitability appears to have been developed independently of Elaine Aron’s highly sensitive person, as her approach is substantially different.

Developmental Obstacles

Dąbrowski called overexcitability “a tragic gift” to reflect that the road of the person with strong OE is not a smooth or easy one. Potentials to experience great highs are also potentials to experience great lows. Similarly, potentials to express great creativity come with the potential of experiencing a great deal of personal conflict and stress. This stress drives development and is a result of conflict—both socially and within oneself. Suicide is a significant risk in the acute phases of this stress, and the isolation often experienced at this stage may also heighten the risk of self-harm.

Dąbrowski advocated autopsychotherapy, educating the person about his theory and the disintegrative process to give them a context within which to understand their intense feelings and needs. Dąbrowski suggested giving people support in their efforts to develop and find their own self-expression. According to Dąbrowski, both children and adults with high DP (and OE) have to find and walk their own path, often at the expense of fitting in with their social peers and even with their families. At the core of autopsychotherapy is the awareness that no one can show anyone else the “right” path—everyone has to find their own path for themselves. Alluding to the knights on the Grail Quest, the Jungian analyst, Joseph Campbell allegedly said: “If a path exists in the forest, don’t follow it, for though it took someone else to the Grail, it will not take you there, because it is not your path.”

Levels

The first and fifth levels of Dąbrowski’s theory of Positive Disintegration are characterized by psychological integration, harmony, and little inner conflict. There is little internal conflict at Level I because at this level one can almost always justify their behaviour – it is either for their own good and is therefore “right”, or society endorses it and it is therefore “right”. In either case, the individual confidently acts as they think anyone else would and does what everyone is “supposed to do”. Dąbrowski compared this to Level V, where there is no internal conflict because what a person does is in harmony with their own internal sense of values. Regardless of internal conflict, external conflict can, and does, still occur.

Dąbrowski used Levels II, III, and IV to describe various degrees and types of disintegration. He was very clear that the levels he presents “represent a heuristic device”. Accordingly, in the process of developing the structures, two or even three contiguous levels may exist side by side, although they exist in conflict. The conflict is resolved when one of the structures is eliminated, or comes under complete control of another structure.

Level I: Primary Integration

The first level is called primitive or primary integration. People at this level are often influenced primarily by either the first factor (heredity/impulse), the second factor (social environment), or both. The majority of people at Level I are integrated at the environmental or social level (Dąbrowski called them average people). Dąbrowski distinguished the two subgroups of Level I by degree: “the state of primary integration is a state contrary to mental health. A fairly high degree of primary integration is present in the average person; a very high degree of primary integration is present in the psychopath.” Marked by selfishness and egocentrism (both covert and explicit), those at level one generally seek self-fulfilment above all else, justifying their pursuits through a sort of “it’s all about me” thinking. They adhere strongly to the phrase “the ends justifies the means”, and may disregard the severity of the “means”. Many people who are considered “leaders” fall into this category.

The vast majority of people do not break down their primitive integration at all, and those who do after a relatively short period of disintegration, usually during adolescence and early youth, either reintegrate at level one, or partially integrate of some of the functions of higher levels, but do not experience a transformation of their whole mental structure. Dąbrowski thought that primary integration in the average person could be of value as it is stable and predictable, and, when accompanied by kindness and good-will, could represent those who can provide support and stability to people experiencing disintegration.

Level II: Unilevel Disintegration

The prominent feature of this level is an initial, brief, and often intense crisis, or series of crises. Crises are spontaneous and occur on only one level—though they may appear to be different choices, they are ultimately on the same, horizontal, level.

Unilevel disintegration occurs during developmental crises such as puberty or menopause, in periods of difficulty handling an external stressful event, or under psychological conditions such as nervousness and psychoneurosis. Unilevel disintegration occurs on a single structural and emotional level; there is a prevalence of automatic dynamisms with only slight self-consciousness and self-control.

Horizontal conflicts produce ambitendencies and ambivalences: one is equally attracted by different but equivalent choices (ambitendencies) and is not able to decide what to do as they have no real preference between the choices (ambivalences). Ultimately, if developmental forces are strong enough, the person is thrust into an existential crisis as their social rationales no longer account for their experiences and there is no alternative explanation. During this phase, existential despair is the predominant emotion. The resolution of this phase begins as individually chosen values start to replace rote, ingrained, social mores and are integrated into a new hierarchy of personal values. These new values often conflict with the person’s previous social values. Many of the status quo explanations for the “way things are”, learned through education and society, collapse under this scrutiny. This causes additional conflicts focused on the person’s analysis of their reactions to the world at large and the behaviour of themself and others. Common behaviours, and the ethics of the prevailing social norm, come to be seen as inadequate, wrong or hypocritical; positive maladjustment prevails. For Dąbrowski, these crises represent a strong potential for development toward personal growth and mental health. Using a positive definition, mental health reflects more than social conformity: it involves a careful, personal examination of the world and of one’s values, leading to the development of an individual personality.

Level II is a transitional period. Dąbrowski said a person will either fall back (reintegration on a lower level), move ahead to Level III, or the crises will end negatively, in suicide or psychosis. The transition from Level II to Level III involves a fundamental shift that requires a phenomenal amount of energy. This period is the crossroads of development, from here one must either progress or regress. The struggle between Dąbrowski’s three factors reflects this transitional crisis: “Do I follow my instincts (first factor), my teachings (second factor) or my heart (third factor)?” The developmental answer is to transform one’s lower instincts (automatic reactions like anger) into positive motivation, to resist rote and social answers, and to listen to one’s inner sense of what one ought to do.

Level III: Spontaneous Multilevel Disintegration

Level III describes a new type of conflict—a vertical conflict between two alternatives that are not simply different, but that exist on different levels; one is genuinely higher and the other lower. These vertical conflicts initially arise from involuntary perceptions of higher versus lower choices in life. In the words of G.K. Chesterton: “You just look at something, maybe for the 1000th time, and it strikes you—you see this one thing differently and once you do, it changes things. You can no longer ‘go back and see it the way you did before.'” Dąbrowski called this vertical dimension multilevelness, and saw it as a gradual realization of the “possibility of the higher” (a phrase Dąbrowski used frequently), and of the contrasts between the higher and the lower in life. These vertical comparisons often contrast the lower, actual, behaviour of a person with the higher, imagined ideals, and to alternative idealised choices. Dąbrowski believed that the authentic individual would choose the higher path as the clear and obvious one to follow, erasing the ambivalences and ambitendencies of unilevel conflicts. If the person’s actual behaviour subsequently falls short of the ideal, internal disharmony and a drive to review and reconstruct one’s life will often follow. Multilevelness thus represents a new and powerful type of conflict that drives development.

Vertical conflicts are critical in leading to autonomy and advanced personality growth. If the person is to achieve higher levels, the shift to multilevelness must occur. If a person does not have the developmental potential to move into a multilevel view, then they will fall back from the crises of Level II to reintegrate at Level I. In the shift to multilevelness, the horizontal (unilevel) stimulus-response model of life is replaced by a vertical and hierarchical analysis. This vertical view becomes anchored by the individual’s emerging value structure, and all events are now seen in relation to their ideal values and how they want to live their life. As events in life are seen in relation to this multilevel, vertical view, it becomes impossible to support positions that favour a lower course of action when higher goals can be imagined and identified.

Level IV: Directed Multilevel Disintegration

In Level IV the person takes full control of their development. The involuntary spontaneous development of Level III is replaced by a deliberate, conscious, self-directed review of life from the multilevel perspective. This level marks the emergence of the third factor, described by Dąbrowski as an autonomous factor “of conscious choice (valuation) by which one affirms or rejects certain qualities in oneself and in one’s environment.” The person consciously reviews their existing belief system and tries to replace lower, automatic views and reactions with carefully thought out, examined and chosen ideals. These new values will increasingly be reflected in the person’s behaviour. Behaviour becomes less reactive, less automatic and more deliberate as choices increasingly fall under the influence of the person’s higher, chosen, ideals.

Social mores are reviewed and may be consciously re-accepted and internalised, or rejected and replaced by a self-determined alternative value system. One’s social views come to reflect a deep responsibility based on both intellectual and emotional factors. At the highest levels, “individuals of this kind feel responsible for the realization of justice and for the protection of others against harm and injustice. Their feelings of responsibility extend almost to everything.” This perspective results from seeing life in relation to one’s hierarchy of values (the multilevel view) and the subsequent appreciation of the potential of how life could, and ought to, be lived. Disagreements with a world operating at a lower level are expressed compassionately by doing what one can to help achieve the “ought”.

Given their genuine, authentic, prosocial outlook, people achieving higher developmental levels also raise the level of their society; prosocial, as used here, is not just support of the existing social order. If the social order is lower and you are adjusted to it, then you also reflect the lower (negative adjustment in Dąbrowski’s terms, a Level I feature). Here, prosocial means a genuine cultivation of social interactions based on higher values. These positions often conflict with the status quo of a lower society (positive maladjustment). In other words, to be maladjusted in a low-level society is a positive feature.

Level V: Secondary Integration

The fifth level displays an integrated and harmonious character, but one vastly different from that at the first level. At this highest level, one’s behaviour is guided by conscious, carefully weighed decisions based on an individualised and chosen hierarchy of personal values. Behaviour conforms to the person’s inner standard of how life ought to be lived, and thus little inner conflict arises.

Level V is often marked by creative expression. Especially at Level V, problem solving and art represent the highest and most noble features of human life. Art captures the innermost emotional states and is based on a deep empathy and understanding of the subject, often human suffering and sacrifice are the subjects of these works. Truly visionary works, works that are unique and novel, are created by people expressing a vision unrestrained by convention. Advances in society, through politics, philosophy and religion, are therefore commonly associated with strong individual creativity and personal accomplishments.

Applications in Therapy

The theory of positive disintegration has an extremely broad scope with many implications. One central application applies to psychological and psychiatric diagnosis and treatment. Dąbrowski advocated a comprehensive, multidimensional diagnosis of the person’s situation, symptoms and developmental potential. Accordingly, if the disintegration appears to fit into a developmental context, then the person is educated in the theory and encouraged to take a developmental view of their situation and experiences. Rather than being eliminated, symptoms are reframed to yield insight and understanding into life and the person’s unique situation.

The Importance of Narratives

Dąbrowski illustrated his theory through autobiographies of and biographies about those who have experienced positive disintegration. The gifted child, the suicidal teen, or the troubled artist is often experiencing the features of TPD, and if they accept and understand the meaning of their intense feelings and crises, they can move ahead, not fall apart. The completion of an extensive autobiography to help the individual gain perspective on their past and present is an important component in the autopsychotherapy process. In this process, the therapist plays a very small role and acts more as an initial stimulus than an ongoing therapist. Dąbrowski asked clients to read his books and to see how his ideas might relate to their lives.

Autopsychotherapy

For Dąbrowski, the goal of therapy is to eliminate the therapist by providing a context within which a person can understand and help themself – an approach to therapy that he called autopsychotherapy. The client is encouraged to embark on a journey of self-discovery, with an emphasis on looking for the contrast between what is higher versus what is lower within their personality and value structure. They are encouraged to further explore their value structure, especially as it relates to the rationale and justification of their positions; discrepancies between values and behaviour are highlighted. The approach is called autopsychotherapy to emphasize the important role that the individual must play in their own therapy process and in the larger process of personality development. The individual must come to see themselves as being in charge of determining or creating their own unique personality ideal and value structure. This includes a critical review of the social mores and values they have learned.

Dąbrowski was very concerned about what he called one-sided development, in which people display significant advanced development in only one aspect of life, usually intellectual. He believed that it is crucial to balance one’s development.

Overexcitability

In describing overexcitability (OE), Dąbrowski emphasized two main aspects: higher-than-average sensitivity, and higher-than-average responsiveness, of the nerves to stimuli. Dąbrowski explained, “The prefix ‘over’ attached to ‘excitability’ serves to indicate that the reactions of excitation are over and above average in intensity, duration and frequency.” If someone has strong OE, they will need less stimuli to cause a reaction and the reaction will be stronger than an individual who does not demonstrate overexcitability.

Dąbrowski reminded clients that without internal unease there is little stimulus for change or growth. Rather than trying to rapidly ameliorate symptoms, this approach encourages individuals to fully experience their feelings and to try to maintain a positive and developmental outlook regarding what they may perceive as strong depression or anxiety. An emphasis is placed on the client becoming aware that they can consciously control the direction of their life and apply what Dabrowski called autopsychotherapy.

Key Ideas

Dąbrowski based his theory on certain key ideas:

  • Lower animal instincts (first factor) must be inhibited and transformed into “higher” forces for people to be truly human as this ability to transform instincts is what separates people from other animals.
  • The common initial personality integration, based upon socialization (second factor), does not reflect true personality.
  • At the initial level of integration, there is little internal conflict as when one “goes along with the group”, there is little sense of individual wrongdoing. External conflicts often relate to the blockage of social goals—career frustrations for example. The social mores and values prevail with little question or conscious examination.
  • True personality must be based upon a system of values that are consciously and volitionally chosen by the person to reflect their own individual sense of “how life ought to be” and their “personality ideal” – the ideal person they feel they “ought to be”.
  • The lower animal instincts, the forces of peer groups, and socialisation are inferior to the autonomous self (personality) consciously constructed by the person.
  • To break down the initial integration, crises and disintegrations are needed, usually provided by life experience.
  • These disintegrations are positive if the person can achieve positive and developmental solutions to the situation.
  • “Unilevel crises” are not developmental as the person can only choose between equal alternatives, such as whether to go left or right.
  • A new type of perception involves “multilevelness”, a vertical view of life that compares lower versus higher alternatives and now allows the individual to choose a higher resolution to a crisis over other available, but lower, alternatives—the developmental solution.
  • “Positive disintegration” is a vital developmental process.
  • Developmental potential describes the forces needed to achieve autonomous personality development.
  • Developmental potential includes several factors including innate abilities and talents, “overexcitability” and the “third factor”.
  • Overexcitability is a measure of an individual’s nervous system’s level of response.
  • Overexcitability, or an overly sensitive nervous system, makes one prone to angst, depression and anxiety. Dąbrowski’s calls these psychoneuroses—a very positive and developmental feature.
  • The third factor is a measure of an individual’s drive toward autonomy.
  • When multilevel and autonomous development is achieved, a secondary integration is seen reflecting one’s mature personality. The individual has no inner conflict; they are in internal harmony as their actions reflect their deeply felt hierarchy of values.

Dąbrowski’s approach is of interest philosophically as it is Platonic, reflecting the bias of Plato toward seeing an individual’s essence as a critical determinant of their developmental course in life. However, Dąbrowski also added a major existential aspect as well, one that depends upon the anxieties a person feels and on how they resolve the day-to-day challenges they face. According to Dąbrowski’s theory, essence must be realised through an existential and experiential process of development. The characterisation advanced by Kierkegaard of “Knights of faith” may be compared to Dąbrowski’s autonomous individual.

Dąbrowski also reviewed the role of logic and reasoning in personal development and concluded that intellect alone does not fully help people know what to do in life. His theory incorporates Jean Piaget’s views of development into a broader scheme guided by emotion, as the emotions one feels about something are the more accurate guide to life’s major decisions.

Secondary Integration versus Self-Actualisation

People[example needed] have often equated Maslow’s concept of self-actualisation with Dąbrowski’s idea of secondary integration, despite there being some major differences between the two ideas. Dąbrowski, a personal friend and correspondent of Maslow, rejected Abraham Maslow’s description of self-actualisation. Actualisation of an undifferentiated self is not a developmental outcome in Dąbrowski’s theory, whereas Maslow described self-actualisation as a process where the self is accepted “as is”, with both higher and lower aspects of the self being actualised. For Maslow, self-actualisation involved “being all that one can be and accepting one’s deeper self in all its aspects”.

Dąbrowski instead applied a multilevel (vertical) approach to self. He spoke of the need to become aware of and inhibit and reject the lower instinctual aspects of the intrinsic human self, and to actively choose and assemble higher elements into a new unique self. Dąbrowski would have people differentiate the initial self into higher and lower aspects, and reject the lower and actualise the higher aspects to create their unique personality; Maslow would have people “embrace without guilt” all aspects.

Dąbrowski introduces the notion that although the lower aspects may initially be intrinsic to the self, people can develop a self-awareness of their lower nature and discover how they feel about these low levels. If they feel badly about behaving in these ways, they can cognitively and volitionally decide to inhibit and eliminate these behaviours; Dąbrowski called this personality shaping. In this way, the higher aspects of the self are actualised while the lower aspects are inhibited. For Dąbrowski, this inhibition is the unique aspect of humans sets people apart from other animals – no other animal is able to differentiate their lower instincts and inhibit their animalistic impulses, an idea also expressed in Plessner’s eccentricity.

Dąbrowski and the Gifted Individual

An appendix to Dąbrowski (1967) reports the results of investigations done in 1962 where “a group of [Polish] gifted children and young people aged 8 to 23” were examined.  Of the 80 youth studied, 30 were “intellectually gifted” and 50 were from “drama, ballet, and plastic art schools”. 

Dąbrowski found that every one of the children displayed overexcitability

Which constituted the foundation for the emergence of neurotic and psychoneurotic sets. Moreover it turned out that these children also showed sets of nervousness, neurosis, and psychoneurosis of various kinds and intensities, from light vegetative symptoms, or anxiety symptoms, to distinctly and highly intensive psychasthenic or hysterical sets.

Dąbrowski asked why these children would display such “states of nervousness or psychoneurosis” and suggested that it was due to the presence of OE. 

Probably the cause is more than average sensitivity which not only permits one to achieve outstanding results in learning and work, but at the same time increases the number of points sensitive to all experiences that may accelerate anomalous reactions revealing themselves in psychoneurotic sets.

The association between OE and giftedness has been the topic of extensive research done by Michael Piechowski and colleagues Lysy and Miller. It appears that intellectual OE is a marker of potential for giftedness/creativity, and that other types of OE may be as well. Dąbrowski’s thesis is that the gifted will disproportionately display this process of positive disintegration and personality growth.

Criticism

For the last 40 years, efforts to measure Dabrowskian constructs have been limited to looking at overexcitability. The most widely known instrument is the Overexcitability Questionnaire-Two.

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What is Flourishing?

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Introduction

Flourishing, or human flourishing, is the complete goodness of humans in a developmental life-span, that somehow includes positive psychological functioning and positive social functioning, along with other basic goods.

The term has gained more usage and interest in recent times, but is rooted in ancient philosophical and theological usages. Aristotle’s term eudaimonia is one source for understanding human flourishing. The Hebrew Scriptures, or the Old Testament, also speak of flourishing, as they compare the just person to a growing tree. Christian Scriptures, or the New Testament, build upon Jewish usage and speak of flourishing as it can exist in heaven. The medieval theologian Thomas Aquinas drew from Aristotle as well as the Bible, and utilised the notion of flourishing in his philosophical theology. More recently, the Positive Psychology of Martin Seligman, Corey Keyes, Barbara Fredrickson, and others, have expanded and developed the notion of human flourishing.

Empirical studies, such as those of the Harvard Human Flourishing Program, and practical applications, indicate the importance of the concept and the increasingly widespread use of the term in business, economics, and politics. In positive psychology, flourishing is “when people experience positive emotions, positive psychological functioning and positive social functioning, most of the time,” living “within an optimal range of human functioning.” It is a descriptor and measure of positive mental health and overall life well-being, and includes multiple components and concepts, such as cultivating strengths, subjective well-being, “goodness, generativity, growth, and resilience.” In this view, flourishing is the opposite of both pathology and languishing, which are described as living a life that feels hollow and empty.

Etymology and Definition

Although “flourishing” could refer to the general healthy state of a plant as it grows, properly speaking it is the stage in a vascular plant’s morphogenesis, specifically the stage of growth when it develops flowers.

Etymology

The English term “flourish” comes from the Latin florere, “to bloom, blossom, flower,” from the Latin flos, “a flower.” To contrast the term with a plant’s lack of full development, “flourish” came to indicate growth or development with vigour. Around 1597, the term came to include the notion of prosperity, insofar as a to bear flowers is an indication of the fullness of life and productivity.

Definitions

As an obvious consequence of the widespread use of the term “flourishing” in different fields and by different authors, there is not a general consensus about a definition of flourishing.

For instance, there is also a lot of debate about the mutual relations between flourishing and some related concepts, as the Aristotelian concept of eudaimonia, and the concepts of happiness and well-being. According to a Neo-Aristotelian view, the concept of human flourishing offers an explanation of the human good that is objective, inclusive, individualized, agent-relative, self-directed and social. It views human flourishing objectively because it is desirable and appealing. Flourishing is a state of being rather than a feeling or experience. It comes from engaging in activities that both express and produce the actualization of one’s potential.

According to some voices in Positive Psychology, flourishing is a “descriptor of positive mental health.” According to Fredrickson and Losada, flourishing is living:”

…within an optimal range of human functioning, one that connotes goodness, generativity, growth, and resilience.”

According to the Mental Health Foundation of New Zealand (Fredrickson & Lahoda, 2005), flourishing:”

…is a state where people experience positive emotions, positive psychological functioning and positive social functioning, most of the time. In more philosophical terms this means access to the pleasant life, the engaged or good life and the meaningful life […] It requires the development of attributes and social and personal levels that exhibit character strengths and virtues that are commonly agreed across different cultures (Seligman, Steen, Park and Peterson, 2005). On the other hand languishing includes states of experience where people describe their lives as “hollow” or “empty”.“

According to Keyes, mental health does not imply an absence of mental illness. Rather, mental health is a “separate dimension of positive feelings and functioning.” Individuals described as flourishing have a combination of high levels of emotional well-being, psychological well-being, and social well-being. Flourishing people are happy and satisfied; they tend to see their lives as having a purpose; they feel some degree of mastery and accept all parts of themselves; they have a sense of personal growth in the sense that they are always growing, evolving, and changing; finally, they have a sense of autonomy and an internal locus of control, they chose their fate in life instead of being victims of fate.

Psychologist Martin Seligman, one of the founding fathers of happiness research, wrote in his book, Flourish, a new model for happiness and well-being based on positive psychology. This book expounds on simple exercises that anyone can do to create a happier life and to flourish. Flourish, is a tool to understand happiness by emphasizing how the five pillars of Positive Psychology, also known as PERMA, increase the quality of life for people who apply it to their lives.

According to Fredrickson and Losada (2005), flourishing is characterised by four main components: goodness, generative, growth, and resilience.

According to Keyes, only 18.1% of Americans are actually flourishing. The majority of Americans can be classified as mentally unhealthy (depressed) or not mentally healthy or flourishing (moderately mentally healthy/languishing).

Tyler J. VanderWeele, a prominent epidemiologist and expert in biostatistics who has extensively studied human flourishing, has proposed the following, quite different, definition:

Flourishing itself might be understood as a state in which all aspects of a person’s life are good. We might also refer to such a state as complete human well-being, which is again arguably a broader concept than psychological well-being. Conceptions of what constitutes flourishing will be numerous and views on the concept will differ. However, I would argue that, regardless of the particulars of different understandings, most would concur that flourishing, however conceived, would, at the very least, require doing or being well in the following five broad domains of human life: (i) happiness and life satisfaction; (ii) health, both mental and physical; (iii) meaning and purpose; (iv) character and virtue; and (v) close social relationships. All are arguably at least a part of what we mean by flourishing. […]If, however, we think about flourishing not only as a momentary state but also as something that is sustained over time, then one might also argue that a state of flourishing should be such that resources, financial and otherwise, are sufficiently stable so that what is going well in each of these five domains is likely to continue into the future for some time to come.[…] I would in no way claim that these domains above entirely characterize flourishing. […] I would only argue here that, whatever else flourishing might consist in, these five domains above would also be included, and thus these five domains above may provide some common ground for discussion.

Summary

To summarise the definitions above: Human flourishing is the ongoing fulfilment of human capacities within given contexts by advancing one’s own good and the common good.

In order to better understand this synthesis, one has to keep in mind that, in the view of Aristotle and Thomas Aquinas, a capacity of a being is a potential stemming from its nature to perform certain kinds of activities, or to undergo certain kinds of changes in accordance with its inner dynamism. For instance, the capacity to bear fruit or the capacity to grow are within a tree’s natural potential. On the other hand, the common good is some good—whether material or non-material—that has four characteristics: it is specific, in the sense that it is not general good-in-itself; it is objective, that is, it exists outside of the individual and is independent from the existence of any particular person; it is collective, for it exists only within some community; it is shareable, that is, many people can participate, enjoy, or use it simultaneously.

Aristotle and Flourishing

Aristotle and Biology

The Greek philosopher, Aristotle, contributed greatly to a deeper understanding of flourishing as a model for human life. Better-known for his work in metaphysics and logic, he was nevertheless a biologist first and foremost. His understanding of the development of flora and fauna, seen especially in his work Generation of Animals, provided a scientific background for recognising a similar development in the human being.

Eudaimonia

Aristotle’s term for the optimal state of the human being is eudaimonia (Greek: εὐδαίμονία). He gives various definitions and descriptions of eudaimonia, in the Nicomachean Ethics, the Eudemian Ethics, and in his Politics, among which:

  • “The active exercise of his soul’s faculties in conformity with excellence or virtue, or if there be several human excellences or virtues, in conformity with the best and most perfect among them. Moreover this activity must occupy a complete lifetime; for one swallow does not make spring, nor does one fine day; and similarly one day or a brief period of happiness does not make a man supremely blessed and happy.”
  • “Happiness therefore is co-extensive in its range with contemplation: the more a class of beings possesses the faculty of contemplation, the more it enjoys happiness, not as an accidental concomitant of contemplation but as inherent in it, since contemplation is valuable in itself. It follows that happiness is some form of contemplation.”
  • “So, as the function of the soul and of its excellence must be one and the same, the function of its excellence is a good life. This, then, is the final good, that we agreed to be happiness. It is evident from our assumptions (happiness was assumed to be the best thing, and ends-the best among goods-are in the soul; but things in the soul are states or activities), since the activity is better than the disposition, and the best activity is of the best state, and virtue is the best state, that the activity of the virtue of the soul must be the best thing. But happiness too was said to be the best thing: so happiness is the activity of a good soul. Now as happiness was agreed to be something complete, and life may be complete or incomplete-and this holds with excellence also (in the one case it is total, in the other partial)-and the activity of what is incomplete is itself incomplete, happiness must be activity of a complete life in accordance with complete virtue.”
  • “Happiness is the complete activity and employment of virtue, and this not conditionally but absolutely. When I say ‘conditionally’ I refer to things necessary, by ‘absolutely’ I mean ‘nobly: for instance, to take the case of just actions, just acts of vengeance and of punishment spring it is true from virtue, but are necessary, and have the quality of nobility only in a limited manner (since it would be preferable that neither individual nor state should have any need of such things), whereas actions aiming at honours and resources are the noblest actions absolutely; for the former class of acts consist in the removal of something evil, but actions of the latter kind are the opposite – they are the foundation and the generation of things good.”

Sometimes eudaimonia is translated as “happiness”; other times, as “welfare” or “well-being,” showing that no translation is fully adequate to capture its meaning in Greek.

Philosopher Joe Sachs emphasizes the importance of the activity of eudaimonia, a “being-at-work” of the human soul. This indicates that “flourishing” can adequately translate eudaimonia, insofar as the term signifies the dynamism of the principle of life and growth within a human.

Positive Psychology and Flourishing

Brief History

“Flourishing” as a psychological concept has been developed by Corey Keyes and Barbara Fredrickson.

Keyes collaborated with Carol Ryff in testing her Six-factor Model of Psychological Well-being, and in 2002 published his theoretical considerations in an article on The Mental Health Continuum: From Languishing to Flourishing. qualified by Fredrickson as “path-breaking work that measures mental health in positive terms rather than by the absence of mental illness.”

Barbara Fredrickson developed the broaden-and-build theory of positive emotions. According to Fredrickson there is a wide variety of positive effects that positive emotions and experiences have on human lives. Fredrickson notes two characteristics of positive emotions that differ from negative emotions:

  1. Positive emotions do not seem to elicit specific action tendencies the same way that negative emotions do. Instead, they seem to cause some general, non-direction oriented activation.
  2. Positive emotions do not necessarily facilitate physical action, but do spark significant cognitive action. For this reason, Fredrickson conceptualises two new concepts: thought-action tendencies, or what a person normally does in a particular situation, and thought-action repertoires, rather an inventory of skills of what a person is able to do.

Previous theories of emotion stated that all emotions are associated with urges to act in particular ways, called action-tendencies. According to Fredrickson, most positive emotions do not follow this model of action-tendencies, since they do not usually occur in life-threatening circumstances and thus do not generally elicit specific urges. Fredrickson proposes that instead of one general theory of emotions, psychologists should develop theories for each emotion or for subsets of emotions.

The broaden-and-build theory of positive emotions proposed by Fredrickson states that while negative emotions narrow thought-action tendencies to time tested strategies as handed down by evolution, positive emotions broaden thought-action repertoires. Positive emotions often cause people to discard time-tested or automatic action tendencies and pursue novel, creative, and often unscripted courses of thought and action. These positive emotions and thought-action repertoires can be seen as applicable to the concept of flourishing because flourishing children and adults have a much wider array of cognitive, physical, and social possibilities, which results in the empirical and actual successes of a flourishing life.

The concept has also been used by Martin E.P. Seligman, the founder of positive psychology, in his 2011 publication Flourish. Seligman, usually considered the father of positive psychology, characterizes human flourishing as excellence in 5 fields: positive emotion, engagement, relationships, meaning, and achievement. Consequently, his model of human flourishing is usually called the PERMA model. He claims also that health is an essential element of flourishing, but he presents a quite vast notion of health, including biological assets (e.g. the hormone oxytocin, longer DNA telomeres), subjective assets (e.g. optimism, vitality), and functional assets (good marriage, rich friendships, engaging work). Although Seligman’s PERMA model is certainly useful for psychological studies on flourishing, it doesn’t capture the essence of human flourishing, since it may allow us to consider as flourishing evidently evil people, as brutal dictators, if they test good in these five fields. To avoid this misunderstanding of human flourishing, Seligman himself, and also other thinkers as Christopher Peterson, have also discussed what they call “character strengths” or “virtues.”. Seligman gives the following definition of flourishing:

To flourish is to find fulfilment in our lives, accomplishing meaningful and worthwhile tasks, and connecting with others at a deeper level—in essence, living the “good life”.

Measurement and Diagnostic Criteria

With the concept of flourishing, psychologists can study and measure fulfilment, purpose, meaning, and happiness. Flourishing can be measured through self-report measures. Individuals are asked to respond to structured scales measuring the presence of positive affect, absence of negative affect, and perceived satisfaction with life. Participants are specifically asked about their emotions and feelings because scientists theorize that flourishing is something that manifests itself internally rather than externally.

Keyes has operationalized symptoms of positive feelings and positive functioning in life by reviewing dimensions and scales of subjective well-being and, therefore, creating a definition of flourishing. To complete, or “operationalize”, the definition of what it means to be functioning optimally, or flourishing, diagnostic criteria have been developed for a flourishing life:

  1. Individual must have had no episodes of major depression in the past year
  2. Individual must possess a high level of well-being as indicated by the individuals meeting all three of the following criteria
    • High emotional well-being, defined by 2 of 3 scale scores on appropriate measures falling in the upper tertile.
      • Positive affect
      • Negative affect (low)
      • Life satisfaction
    • High psychological well-being, defined by 4 of 6 scale scores on appropriate measures falling in the upper tertile.
      • Self-acceptance
      • Personal growth
      • Purpose in life
      • Environmental mastery
      • Autonomy
      • Positive relations with others
    • High social well-being, defined by 3 of 5 scale scores on appropriate measures falling in the upper tertile.
      • Social acceptance
      • Social actualisation
      • Social contribution
      • Social coherence
      • Social integration

Major Empirical Findings

Positive emotional feelings such as moods, and sentiments such as happiness, carry more personal and psychological benefits than just a pleasant, personal subjective experience. Flourishing widens attention, broaden behavioural repertoires, which means to broaden one’s skills or regularly performed actions, increase intuition, and increase creativity. Secondly, good feelings can have physiological manifestations, such as significant and positive cardiovascular effects, such as a reduction in blood pressure. Third, good feelings predict healthy mental and physical outcomes. Also, positive affect and flourishing is related to longevity. In a 2022 study of intrusive thoughts and flourishing, Jesse Omoregie and Jerome Carson found that people who experience flourishing would usually experience minimal intrusive thoughts. Omoregie and Carson further concluded that flourishing is a variable that helps in the reduction of psychological problems such as anxiety, depression, and intrusive thoughts.

The many components of flourishing elicit more tangible outcomes than simply mental or physiological results. For example, components such as self-efficacy, likability, and prosocial behaviour encourage active involvement with goal pursuits and with the environment. This promotes people to pursue and approach new and different situations. Therefore, flourishing adults have higher levels of motivation to work actively to pursue new goals and are in possession of more past skills and resources. This helps people to satisfy life and societal goals, such as creating opportunities, performing well in the workplace, and producing goods, work and careers that are highly valued in American society. Authors, Robert Kegan and Lisa Laskow Lahey, in their book, An Everyone Culture, “argues that organizations do best when they build an environment that encourages constant personal development among their employees.” This success results in higher satisfaction and reinforces Frederickson’s Broaden and Build model, for more positive adults reap more benefits and, are more positive, which creates an upward spiral.

Studies have shown that people who are flourishing are more likely to graduate from college, secure “better” jobs, and are more likely to succeed in that job. One reason for this success can be seen in the evidence offered above when discussing languishing: those that flourish have less work absenteeism, cited by Lyubomirsky as “job withdrawal.” Finally, those that are flourishing have more support and assistance from co-workers and supervisors in their workplace.

Flourishing has been found to impact more areas than simply the workplace. In particular community involvement and social relationships have been cited as something that flourishing influences directly. For example, those that flourish have been found to volunteer at higher levels across cultures. Moreover, in terms of social support and relationships, studies have shown that there is an association between flourishing and actual number of friends, overall social support, and perceived companionship.

Applications

The definition or conceptualisation of mental health under the framework of flourishing and languishing describes symptoms that can cooperate with intervention techniques aimed at increasing levels of emotional, social, and psychological well-being. Furthermore, as Keyes implies, in a world full of flourishing people, all would be able to reap the benefits that this positive mental state and life condition offers.

Education

Keyes mentions children as well as adults. He says that children are directly affected by maternal depression, and points out that the flourishing or languishing of teachers and the effect on students have not been studied. Keyes also speculates that teacher retention may be associated with the students’ frames of mind. Furthermore, if students can be made to flourish, the benefits to the education process are greater, as flourishing can increase attention and thought-action repertoires.

Engagement

Flourishing also has many applications to civic duty and social engagement. Keyes believes that most people do not focus enough on those aspects of life and focus instead on personal achievement. Keyes suggests that people should provide encouragement to children, and adults, to participate socially. People that exhibit flourishing are engaged in social participation and people that are engaged in social participation exhibit flourishing. Therefore, he suggests that people should give their kids a purpose, which creates a sense of contribution and environmental mastery that enhances feelings of well-being and fulfilment.

Criticisms

This psychological concept of flourishing is built on Fredrickson’s broaden-and-build theory of positive emotions, but some researchers have suggested that there are other functions of positive emotions. Mackie and Worth propose that positive emotions diminish cognitive capabilities. They showed that when exposed to a persuasive message for a limited amount of time, subjects experiencing a positive mood showed reduced processing as compared with subjects in a neutral mood. Others have suggested that positive emotions diminish the motivation but not the capacity for cognitive processing. Flourishing is still a newly developing subject of study and, more tests need to be done to fully define, operationalise, and apply the concept of flourishing; this lack of research is also one criticism of the concept of flourishing.

Contemporary Flourishing Research

Global Flourishing Study

It is a longitudinal study about human flourishing, involving data collection of individuals of 22 countries all around the world. It is carried out by scholars at the Human Flourishing Program at Harvard and Baylor’s Institute for Studies of Religion, in partnership with Gallup and the Centre for Open Science. Its preparation began in 2018 and its first data are expected by the summer of 2023.

Johns Hopkins: Paul McHugh Programme for Human Flourishing

This programme based at Johns Hopkins University, founded in 2015, and directed by Margaret S. Chisolm, aims at bringing the results of interdisciplinary research on health and human flourishing to an audience of both clinicians and clinicians-in-training.

Harvard Human Flourishing Programme

This programme was founded in 2016 at Harvard’s Institute for Quantitative Social Science and directed by Tyler J. VanderWeele. Its aim is to study and promote human flourishing.

University of Pennsylvania: Positive Psychology Centre and Flourishing and Humanities Project

This interdisciplinary research project, based at the University of Pennsylvania’s Positive Psychology Centre, directed by James Pawelski and founded in 2014, studies the relations of the arts and humanities with human flourishing.

Humanity 2.0

The Humanity 2.0 Foundation mission is to identify impediments to human flourishing and then work collaboratively across sectors to remove them by sourcing and scaling bold and innovative solutions. To support this mission, the Humanity 2.0 Institute integrates global research on key questions: What is human flourishing? What are the pathways to achieve human flourishing? What obstacles block these pathways? What are practical solutions to remove these obstacles? Research partners include the Human Flourishing Programme at Harvard University, the Pontifical Gregorian University and the University of Pennsylvania Positive Psychology Centre and Flourishing Humanities Project.

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What are Drug Addiction Recovery Groups?

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Introduction

Drug addiction recovery groups are voluntary associations of people who share a common desire to overcome their drug addiction.

Outline

Different groups use different methods, ranging from completely secular to explicitly spiritual. Some programmes may advocate a reduction in the use of drugs rather than outright abstention. One survey of members who found active involvement in any addiction recovery group correlates with higher chances of maintaining sobriety. Although there is not a difference in whether group or individual therapy is better for the patient, studies show that any therapy increases positive outcomes for patients with substance use disorder. The survey found group participation increased when the individual members’ beliefs matched those of their primary support group (many addicts are members of multiple addiction recovery groups). Analysis of the survey results found a significant positive correlation between the religiosity of members and their participation in twelve-step programs (these programs describe themselves as spiritual rather than religious) and to a lesser level in non-religious SMART Recovery groups, the correlation factor being three times smaller for SMART Recovery than for the twelve-step addiction recovery groups. Religiosity was inversely related to participation in Secular Organisations for Sobriety.

A survey of a cross-sectional sample of clinicians working in outpatient facilities (selected from the SAMHSA On-line Treatment Facility Locator) found that clinicians only referring clients to twelve-step groups were more likely than those referring their clients to twelve-step groups and “twelve-step alternatives” to believe less strongly in the effectiveness of Cognitive Behavioural and psychodynamic-oriented therapy, and were likely to be unfamiliar with twelve-step alternatives. A logistic regression of clinician’s knowledge and awareness of Cognitive Behavioural Therapy effectiveness and preference for the twelve-step model was correlated with referring exclusively to twelve-step groups.

Twelve-Step Recovery Groups

Twelve-step programs are mutual aid organizations for the purpose of recovery from substance addictions, behavioural addictions and compulsions. Developed in the 1930s by alcoholics, the first twelve-step programme, Alcoholics Anonymous (AA), aided its membership to overcome alcoholism. Since that time, dozens of other organisations have been derived from AA’s approach to address problems as varied as drug addiction, compulsive gambling, sex and overeating. All twelve-step programmes utilise a version of AA’s suggested twelve steps first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.

As summarised by the American Psychological Association (APA), the process involves the following:

  • Admitting that one cannot control one’s alcoholism, addiction, or compulsion;
  • Coming to believe in a Higher Power that can give strength;
  • Examining past errors with the help of a sponsor (experienced member);
  • Making amends for these errors;
  • Learning to live a new life with a new code of behaviour; and
  • Helping others who suffer from the same alcoholism, addictions, or compulsions.

Participants attend meetings and are able to make new connections with other members who are striving towards a similar goal. If a person is unable to attend a meeting face-to-face, many of the groups have meetings by phone or online as another option. Each group has its own textbook, workbooks or both, which provide information about their program of recovery and suggestions on how to “work the steps”. Often, free literature is available for anyone who asks for it at a meeting. This provides potential new members or family members with relevant information about both the addiction and that specific groups’ version of the twelve-step process of recovery. New members are invited to work with another member who has already been through the twelve-steps at least once. That person serves as a guide to the new member, answers questions and provides feedback as the new member goes through the steps. These groups are spiritually based and encourage a belief in a power greater than the members. Most do not have one specific conception of what that means and allow the member to decide what spirituality means to them as it applies to their recovery. The groups emphasize living on a spiritual yet not necessarily religious basis. Groups typically advocate for complete abstinence, usually from all drugs including alcohol. This is because of the perceived potential for cross-addiction, the idea that there is a tendency to trade one addiction for another. Despite the idea of cross-addiction being accepted as real in many addiction recovery groups, there is said to be little empirical evidence to support it and recent research suggests that the opposite is more likely to be true.

The following is a list of twelve-step drug addiction recovery groups. Twelve-step programmes for problems other than drug addiction also exist.

  • Alcoholics Anonymous (AA) – This group gave birth to the twelve-step programme of recovery. Meetings are focused on alcoholism only and advocate complete abstinence. Meetings are held all over the world.
  • Cocaine Anonymous (CA) – This group is focused on cessation of cocaine and all other mind-altering substances. The programme advocates complete abstinence from all mind-altering substances in order to recover from the disease of addiction. Meetings are held all over the world.
  • Celebrate Recovery (CR) – Celebrate recovery is a recovery programme for any life problem, including addiction to alcohol and other drugs. In contrast to most 12-step programmes, the group recognises Jesus Christ as their higher power. Their groups are located in the United States.
  • Crystal Meth Anonymous (CMA) – This group focuses on abstinence from crystal meth although it does recognise the potential for cross-addiction, the tendency for an addict to substitute one addiction for another. Meetings are currently available in eight countries.
  • Heroin Anonymous (HA) – This group is focused on abstinence from heroin along with all other drugs including alcohol. Meetings are held in England and the United States.
  • Marijuana Anonymous (MA) – This group focuses of recovery from marijuana addiction. Groups meet in eleven countries.
  • Nicotine Anonymous (NicA) – This group is for those desiring to stop the use of nicotine in all forms. Groups are available in many countries.
  • Narcotics Anonymous (NA) – This group has meetings in 139 countries and focuses on recovery from the use of all drugs and alcohol. The group makes no distinction between any mood or mind-altering substance and encourages members to look for similarities the common problem they all share, rather than focusing on the differences.
  • Pagans in Recovery (PIR) – Pagans in recovery have adapted the twelve-step programme of recovery into language that is not overtly Christian as it was originally written so that those with other belief systems can more comfortably work the programme. They have their own literature but do not currently have an official site for meeting availability.
  • Pills Anonymous (PA) – This group is focused on addiction to pills and all other mind-altering substances. Groups are available in seven countries.

Non-Twelve-Step Recovery Groups

These groups do not follow the twelve-step recovery method, although their members may also attend twelve-step meetings. It is common for individuals to try many different meetings and groups while in recovery. What works for one may not work for another, so trying different types of meetings can be helpful to someone seeking recovery from drugs and alcohol.

  • The Washingtonians – A defunct 19th Century mutual aid society founded by alcoholics with a desire to maintain sobriety
  • Association of Recovering Motorcyclists (ARM) – This association of recovering motorcyclists is a brotherhood of men recovering from alcohol and/or drug addiction. They support one another in remaining abstinent from drugs and alcohol while continuing to ride motorcycles together regularly.
  • Recovering Women Riders (RWR) – Recovering women riders is a sisterhood of recovering women motorcyclists. Affiliated with the association of recovering motorcyclists, they also seek to support one another in remaining abstinent from drugs and alcohol while continuing to enjoy the lifestyle of riding bikes together.
  • LifeRing Secular Recovery (LSR)
  • Moderation Management (MM)
  • Rational Recovery (largely defunct)
  • Recovery Dharma (RD)
  • Refuge Recovery (RR)
  • Secular Organizations for Sobriety (SOS)
  • SMART Recovery
  • Women for Sobriety (WFS)

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What is 8-OH-DPAT?

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Introduction

8-OH-DPAT is a research chemical of the aminotetralin chemical class which was developed in the 1980s and has been widely used to study the function of the 5-HT1A receptor. It was one of the first major 5-HT1A receptor full agonists to be discovered.

Refer to Azapirone.

Originally believed to be selective for the 5-HT1A receptor, 8-OH-DPAT was later found to act as a 5-HT7 receptor agonist and serotonin reuptake inhibitor/releasing agent as well.

In animal studies, 8-OH-DPAT has been shown to possess antidepressant, anxiolytic, serenic, anorectic, antiemetic, hypothermic, hypotensive, bradycardic, hyperventilative, and analgesic effects.

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What is Tandospirone?

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Introduction

Tandospirone, sold under the brand name Sediel, is an anxiolytic and antidepressant medication used in Japan and China, where it is marketed by Dainippon Sumitomo Pharma. It is a member of the azapirone class of drugs and is closely related to other azapirones like buspirone and gepirone.

Tandospirone was introduced for medical use in Japan in 1996 and in China in 2004.

Medical Uses

Anxiety and Depression

Tandospirone is most commonly used as a treatment for anxiety and depressive disorders, such as generalised anxiety disorder and dysthymia respectively. For both indications it usually takes a couple of weeks for therapeutic effects to begin to be seen, although at higher doses more rapid anxiolytic responses have been seen. It has also been used successfully as a treatment for bruxism.

Augmentation for Depression

Tandospirone can be used as an effective augmentation, especially when coupled with fluoxetine or clomipramine.

Other Uses

Tandospirone has been tried successfully as an adjunctive treatment for cognitive symptoms in schizophrenic individuals.

Side Effects

Common adverse effects include:

  • Dizziness
  • Drowsiness
  • Insomnia
  • Headache
  • Gastrointestinal disorders
  • Dry mouth
  • Negative influence on explicit memory function
  • Nausea

Adverse effects with unknown frequency include:

  • Hypotension (low blood pressure)
  • Dysphoria
  • Tachycardia
  • Malaise
  • Psychomotor impairment

It is not believed to be addictive but is known to produce mild withdrawal effects (e.g. anorexia) after abrupt discontinuation.

Pharmacology

Pharmacodynamics

Tandospirone acts as a potent and selective 5-HT1A receptor partial agonist, with a Ki affinity value of 27 ± 5 nM and approximately 55 to 85% intrinsic activity. It has relatively weak affinity for the 5-HT2A (1,300 ± 200), 5-HT2C (2,600 ± 60), α1-adrenergic (1,600 ± 80), α2-adrenergic (1,900 ± 400), D1 (41,000 ± 10,000), and D2 (1,700 ± 300) receptors, and is essentially inactive at the 5-HT1B, 5-HT1D, β-adrenergic, and muscarinic acetylcholine receptors, serotonin transporter, and benzodiazepine allosteric site of the GABAA receptor (all of which are > 100,000). There is evidence of tandospirone having low but significant antagonistic activity at the α2-adrenergic receptor through its active metabolite 1-(2-pyrimidinyl)piperazine (1-PP).

Society and Culture

Name

Tandospirone is also known as metanopirone and by the developmental code name SM-3997. It is marketed in Japan under the brand name Sediel.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Tandospirone >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Perospirone?

Published on by Andrew Marshall1 Comment

Introduction

Perospirone (Lullan) is an atypical antipsychotic of the azapirone family. It was introduced in Japan by Dainippon Sumitomo Pharma in 2001 for the treatment of schizophrenia and acute cases of bipolar mania.

Medical Uses

Its primary uses are in the treatment of schizophrenia and bipolar mania.

Schizophrenia

In a clinical trial that compared it to haloperidol in the treatment of schizophrenia it was found to produce significantly superior overall symptom control. In another clinical trial perospirone was compared with mosapramine and produced a similar reduction in total PANSS score, except with respect to the blunted affect part of the PANSS negative score, in which perospirone produced a significantly greater improvement. In an open-label clinical trial comparing aripiprazole with perospirone there was no significant difference between the two treatments discovered in terms of both efficacy and tolerability. In 2009 a clinical trial found that perospirone produced a similar reduction of PANSS score than risperidone and the extrapyramidal side effects was similar in both frequency and severity between groups.

A meta-analysis published in 2013 found that it is statistically significantly less efficacious than other second-generation antipsychotics.

Adverse Effects

Has a higher incidence of extrapyramidal side effects than the other atypical antipsychotics, but still less than that seen with typical antipsychotics. A trend was observed in a clinical trial comparing mosapramine with perospirone that favoured perospirone for producing less prominent extrapyramidal side effects than mosapramine although statistical significant was not reached. It may produce less QT interval (measurement made on an electrocardiogram used to assess some of the electrical properties of the heart) prolongation than zotepine, as in one patient who had previously been on zotepine switching to perospirone corrected their prolonged QT interval. It also tended to produce less severe extrapyramidal side effects than haloperidol in a clinical trial comparing the two (although statistical significance was not reached).

Discontinuation

The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotics to avoid acute withdrawal syndrome or rapid relapse. Symptoms of withdrawal commonly include nausea, vomiting, and loss of appetite. Other symptoms may include restlessness, increased sweating, and trouble sleeping. Less commonly there may be a felling of the world spinning, numbness, or muscle pains. Symptoms generally resolve after a short period of time.

There is tentative evidence that discontinuation of antipsychotics can result in psychosis. It may also result in reoccurrence of the condition that is being treated. Rarely tardive dyskinesia can occur when the medication is stopped.

Pharmacology

Perospirone binds to the following receptors with very high affinity (as an antagonist unless otherwise specified):

  • 5-HT1A (partial agonist; Ki=2.9 nM)
  • 5-HT2A (inverse agonist; Ki=1.3 nM)
  • D2 (Ki = 0.6 nM)

And the following receptor with high affinity:

  • H1 (inverse agonist)

And the following with moderate affinity:

  • D4
  • α1 adrenoceptor

And with low affinity for the following receptor:

  • D1

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What is Umespirone?

Published on by Andrew Marshall1 Comment

Introduction

Umespirone (KC-9172) is a drug of the azapirone class which possesses anxiolytic and antipsychotic properties.

Outline

It behaves as a 5-HT1A receptor partial agonist (Ki = 15 nM), D2 receptor partial agonist (Ki = 23 nM), and α1-adrenoceptor receptor antagonist (Ki = 14 nM), and also has weak affinity for the sigma receptor (Ki = 558 nM).

Unlike many other anxiolytics and antipsychotics, umespirone produces minimal sedation, cognitive/memory impairment, catalepsy, and extrapyramidal symptoms.

Synthesis

The condensation between ethyl cyanoacetate and acetone gives ethylisopropylidenecyanoacetate 759-58-0. This product is reacted with N-butylcyanoacetamide 39581-21-0 in sodium methoxide solution to give N-butyl-2,4-dicyano-3,3-dimethylglutarimide, CID:10681941. The glutarimide is cyclized with phosphoric acid to yield 3-butyl-9,9-dimethyl-3,7-diazabicyclo[3.3.1]nonane-2,4,6,8-tetraone, https://pubchem.ncbi.nlm.nih.gov/compound/10825633 CID:10825633.

The reaction between 1-(o-anisyl)piperazine 35386-24-4 and 1,4-dibromobutane 110-52-1 gives the Quat salt CID:15895413.

Convergent synthesis (in the presence of potassium carbonate) affords Umespirone (KC-9172).

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What is Tiospirone?

Published on by Andrew Marshall1 Comment

Introduction

Tiospirone (BMY-13,859), also sometimes called tiaspirone or tiosperone, is an atypical antipsychotic of the azapirone class.

Outline

It was investigated as a treatment for schizophrenia in the late 1980s and was found to have an effectiveness equivalent to those of typical antipsychotics in clinical trials but without causing extrapyramidal side effects.

However, development was halted and it was not marketed.

Perospirone, another azapirone derivative with antipsychotic properties, was synthesized and assayed several years after tiospirone.

It was found to be both more potent and more selective in comparison and was commercialised instead.

Pharmacology

Pharmacodynamics

Tiospirone acts as a 5-HT1A receptor partial agonist, 5-HT2A, 5-HT2C, and 5-HT7 receptor inverse agonist, and D2, D4, and α1-adrenergic receptor antagonist.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Tiospirone >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Zalospirone?

Published on by Andrew Marshall1 Comment

Introduction

Zalospirone (WY-47,846) is a selective 5-HT1A partial agonist of the azapirone chemical class.

It was found to be effective in the treatment of anxiety and depression in clinical trials, but a high proportion of subjects dropped out due to side effects and development was subsequently never completed.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Zalospirone >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Revospirone?

Published on by Andrew Marshall1 Comment

Introduction

Revospirone (Bay Vq 7813) is an azapirone drug which was patented as a veterinary tranquiliser but was never marketed.

It acts as a selective 5-HT1A receptor partial agonist.

Similarly to other azapirones such as buspirone, revospirone produces 1-(2-pyrimidinyl)piperazine (1-PP) as an active metabolite.

As a result, it also acts as an α2-adrenergic receptor antagonist to an extent.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Revospirone >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.