All Posts By

Andrew Dettman


By | The Authors Pen

This extract is from the book ‘Management of the Addicted Patient in Primary Care’ Pomm & Pomm, published by Springer in 2007:

Spectrum of Addiction

“One of the most difficult concepts for many primary care physicians to accept is that addiction is a disease. This thought naturally dispels the idea that people who experience the diagnosed disorder of substance dependence have a choice.

Actually once addiction is manifest in an individual, willpower is no longer a viable hypothesis. At this point, “saying no” does not work (although people diagnosed with substance abuse might still have the ability to choose). Basically, there comes a time when the psychosocial, genetic, biophysiologic and the individual’s coping mechanisms have set the stage for a switch to be turned on that starts the disease process, a process that cannot be cured but that can definitely be arrested and brought into remission. When the disease of addiction manifests in the body, it is no different from any other disease:

  1. The illness can be described;
  2. The course of the illness is predictable and progressive;
  3. The disease is primary; that is, it is not just a symptom of an underlying disorder;
  4. It is permanent; and
  5. It is terminal. If left untreated, it results in premature death.

In fact, the American Psychiatric Association began in 1965 to use the term disease to describe alcoholism, and the American Medical Association followed suit in i966. In 1983, the American Society of Addiction Medicine published a policy statement relating to alcoholism being a primary disease. Essentially, all major specialty organizations that work with the drug/alcohol-addicted population are now in agreement about the disease model of addiction.

We might not know the etiology, but science has not determined the exact etiology of most diseases, including the more common ones, such as hypertension and diabetes mellitus. Yet we do not blame hypertensive or diabetic patients for their diseases in the way that we blame alcoholics/addicts for their illnesses, it seems so much easier to be less judgmental when treating the other types of patients.

Until you accept the disease model of addiction, it is much more difficult to see your patients who are suffering with chemical dependency through objective eyes. As a primary care physician, especially because you are on the front line, you may be more prone to feelings of frustration and anger when confronted with an individual you believe can just “put the substance down.” Thoughts such as “why doesn‘t he or she just stop” or “l can’t believe he or she continues using drugs despite all he or she has been through” can interfere with appropriate intervention and treatment planning. Although many professionals are susceptible to the same feelings, the primary care physician often sees this type of patient much earlier in the course of the illness, and a significant relationship may have already been developed (unless a drug seeker has just dropped by for your professional services). In addition, beyond the rela- tionship with your patient, you often have a relationship with the family and have also been influenced by their denial system.”

There’s no you in American behavior

By | The Authors Pen

There’s no you in American behavior ….

Be-hav(e)-i- >>>> our©

The 4, 3, 2, 1 of behaviour change
1 – is our, the collective
2 – the person, ego portal, i
expanding and contracting
3 – is mental/time axis of inner space, hav(e)
4 – (1+3) is the now Singularity, be*

Three parts inside, one outside
Nine tenths hidden
One tenth seen
All matter like an iceberg

Behaviour change is from the inner ‘be’ >>>>
Flowing out >>>>
Constant change >>>>
Kun faya kun, “Be”, and it is.

||Be||hav(e)i <<< our
That is told to change from the ‘outside in’
Is not permanent
A revolving door of command
Lost in have’s maze
A hoopla parody
Whacked with the stick of money
The BE closed down
Overgrown castle of our Sleeping Beauty.

Then Life sends a Majesty
A sublimity
A mighty Word
A drawn again Excalibur
Exposing the labyrinth of the lost
haves and have nots,
Jailers and jailed.
Pieces are returned to
All praise belongs to The One

Be well
Be healed
Be loved
Be sure
Be happy

The missing u …. waw
To Love’s behaviour

*Mandukya Upanishad
The Mandukya Upanishad reveals the mystery of manifest existence through the word AUM, which embodies the three principles represented by the three letters, and is beyond time and space, with the fourth principle indicating the surrounding silence of the unmanifest.

©2013 Andrew Dettman

Universal Application

By | The Authors Pen

Universal Application ….

Over the last nearly 80 years, there has been a collective beachhead of sanity and practical mindful calm established by individual people within the ferocious storms of their disease of addiction, a disease that has now become such a global pandemic.

This Programme of recovery has proved itself on the inner battlefields of countless millions of sensitive men and women as they have bequeathed to mankind the only effective remedy for the catastrophe that now threatens to erupt upon the exterior battlefields of our global culture.

“In as much as collectives are mere accumulations of individuals, their problems are also accumulations of individual problems … Such problems are never solved by legislation or tricks. They are only solved by a general change of attitude. And the change does not begin with propaganda and mass meetings, or with violence. It begins with a change in individuals. It will continue as a transformation of their personal likes and dislikes, of their outlook on life and of their values, and only the accumulation of such individual changes will produce a collective solution.” (C. G. Jung, Psychology & Religion (New Haven and London: Yale University Press, 1938) 95.)

Offered is a simple rendition of the principles of recovery that the 12 Step Programme contains as an introduction for you as individuals or collectives, to further investigate and adapt for yourselves. The rendition is from a book that I wrote in 1997.

For any particular personal problem, I would strongly advise that whatever problem appears appropriate to you can be inserted into Step One, then an Internet Search should be done on that word plus ‘addiction’ to find information on the specific 12 Step Fellowship that can help and support you.

12 Step Pyramid Building (©AJDettman 1997)

  1. We admitted we were powerless over ***********—that our lives had become unmanageable.
  2. Came to believe that a power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory, and when we were wrong, promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message appropriately, and to practice these principles in all our affairs. (Modified – Originally from AA)

Fig 1





The words allow an exploration of the symbol in Fig 1 and to see the three dimensional structure of the pyramid as one comprised of four triangles upon a square base. The above key words can each be placed around the points of four triangles and as these triangles come together in our erected structure the relationship between these words and the 12 Steps of the Programme can be explained: the inner map for personal change and continued development can be charted and internalised.
            Spiritual                                               Hope
                  1                                                        2
Mental             Physical                       Strength          Experience
            Fig. 2                                                   Fig. 3
            Unity                                                   Physical
               3                                                             4
Service.           CHANGE                         Mental             Spiritual
            Fig. 4                                                   Fig. 5

As these triangles come together upon the square base to form a pyramid, the key words also quite naturally come together to form their therapeutic identifications for the Steps themselves and their inter-relationships. If one takes a bird’s-eye view of the pyramid the following relationships transpire, with four words meeting at the apex and two words meeting at the four corners of the pyramid’s base.

            5. Strength                              4. Experience
            6. Mental                                 9. Service
                                                                                      3. Physical
                                                                                    10. Hope
                                                ………………………….>> 11. Spiritual
                                                                                     12. Unity
            1. Physical                               7. Mental
            2. Spiritual                               8. CHANGE
                                    Fig. 6
So, in this simple structure there can be seen the mandala that Jung talked about. The whole contained in a sphere, the straight lines of the base and sides all cohering to aid and protect the inner work and transmutation of awareness.
The first two Steps are vital as foundations for the work to come, but we can see here how the progress can be mapped. From the first two Steps, the adherent is taken up to Step three even though our structure is not built as yet, then down to Step four and then across to Step five. Steps six and seven are only completed by going inside the square and diagonally transverse the inner foundations to reach Step seven. Then Steps eight and nine are completed and the final erection of the pyramid is possible with assimilation of the meaning of Steps ten, eleven and twelve.
It may be seen that all the main work is done around the base of the pyramid with the vital bridging Steps being of an internal nature and then up to the apex for the maintenance Steps after a CHANGE has been achieved in Step eight. If this seems a little arcane to you upon first reading, then this is quite normal, the importance of this ancient symbol will become clearer and clearer to you as you make progress.
By referring to the Steps themselves, they can be listed according to the manner in which the principle descriptive words meet around the pyramid structure.
Step 1. PHYSICAL. This Step is a physical Step. The only place that a person can start is in their physical body with an awareness of life up to this point when ‘the journey of a thousand miles’ is to start with the first step – or in this case the first of twelve Steps.
Step 2. SPIRITUAL. Wherever the word spiritual is employed in this work, it is the term to denote ‘power’. The power of Faith which can move mountains, the power of Love which can melt the hardest of hearts and the power of  Hope which encourages the effort to achieve the transformation and then to sustain the change on a daily basis and beyond.
Step 3. PHYSICAL. Paradoxically, this Step is physical because the decision taking process is grounded in our experiential realm and the process of deciding is constant whether a person is deciding to buy a new washing machine or deciding to trust their future existence to a life based on spiritual principles.
Step 4. EXPERIENCE. This Step renders our past experience into a useful and living entity by stripping away elements that are ‘past their sell buy date’ and cherishing and collating inner goods which can be rearranged to provide a realistic view of just what there is that is worth setting our future store by.
Step 5. STRENGTH. To share matters that arise in our simple analysis of our basic sex, social and security instincts can require strength and courage.
Step 6. MENTAL. To be willing to change is a decision that is reaffirmed after the preparatory work is completed.
Step 7. MENTAL. This is the ‘marriage’ step when the Faith healing brings the inner animosity to an end. God responds to the inner leadership of an individual’s desire and the inner opposites are again repaired to a healthy psychic creativity which is both practical and mysterious.
Step 8. CHANGE. This is the point at which the real beginning is made and the way is opened for the nurturing of inner change to become a realised way of life with practise and being led by intuition and logic working in a harmony of inspiration.
Step 9. SERVICE. This Step starts to polish the principle of ‘due proportion’ as the primary focus of our personal and public application of our new insights.
Step 10. HOPE. The living Steps are now attainable at the apex of our inner pyramid with the appreciation of the very real hope of sustaining personal and interactive change on a daily basis.
Step 11. SPIRITUAL. This is the Step which guarantees the power to energise the whole work once it has been completed. It is linked to Step two and it is to Step eleven that Step two looked in the depth of its affirmation to try to progress through uncertainty. It is the Step of real achievement and the realisation of a return to purpose, dignity and inner intimacy with the ennobling grandeur of a personal relationship with the Higher Power experienced as a growing personal and practical concord.
Step 12. UNITY. In this Step there is the beginning of cohesion and an awareness of the sheer Unity of Existence and the practise of flying in the teeth of turbulence to share a personal witness wherever appropriate.
1. Physical
2. Spiritual
3. Physical
4. Experience
5. Strength
6. Mental
————— (Thorns mentioned by& Sleeping Beauty)
7. Mental
9. Service
10. Hope
11. Spiritual
12. Unity
As the 12 STEP Programme is worked, the animosity of left right brain is overcome by the integration of the hemispheres as is shown in the listing. The mental realms are united and change occurs.

A view from 1987

By | The Authors Pen

A view from 1987 …

Written in 1987 by Anne Wilson Schaef in “When Society Becomes an Addict”.

“Our society is deteriorating at an alarming rate. As we watch the news and read the newspapers, we are increasingly made aware of corruption in high places, financial collapse, and a lack of morality in settings ranging from preschools to meat packing plants. We fear that our children will be stolen by child pornography rings, and we hear of our “healers” taking sexual advantage of their clients. Our planet is being destroyed by acid rain and pollution, and nuclear holocaust is a very real possibility. Hunger and wars rage over the planet.
…. Those few individuals who notice and draw attention to these growing problems are met with massive denial.
…. Much of what we know about our society can be compared to what the blind persons knew about the elephant. As that old story teaches us, an elephant is more than just ears, a tail, or a trunk, it is more, even, than just an animal. It is also a process within a context. It is born, it lives, and it dies. This is a process.
The context of our elephant – our society – is the fact that the system in which we live is an addictive system. It has all the characteristics and exhibits all the processes of the individual alcoholic or addict. It functions in precisely the same ways.
…. This awareness that society has an addictive disease is what is missing from other explanations and treatments of the problems we are having today.
…. In addition, most people who look at the system are too close to it and too involved in it to see it clearly.
…. In order to perceive the Addictive System for what it is, one must be in it but not of it. In other words, must be recovering from its effects. There are people who fit this criterion. Historically, however, the main curing agent for addictions has been anonymous – Alcoholics Anonymous, Al Anon, Overeaters Anonymous, Gamblers Anonymous, and so on. As a result, the people who have the most accurate perceptions of our system have often hidden this knowledge in anonymity….”

The Word, Its Diction Chamber and Its Prince’s Kiss

A New Articulation

By | The Authors Pen

A New Articulation ….

“In as much as collectives are mere accumulations of individuals, their problems are also accumulations of individual problems … Such problems are never solved by legislation or tricks. They are only solved by a general change of attitude. And the change does not begin with propaganda and mass meetings, or with violence. It begins with a change in individuals. It will continue as a transformation of their personal likes and dislikes, of their outlook on life and of their values, and only the accumulation of such individual changes will produce a collective solution.” (C. G. Jung, Psychology & Religion (New Haven and London: Yale University Press, 1938) 95.)

What Carl Jung saw 78 years ago is now fully landed in the global culture of Mankind. What this description identifies is the insanity of the partisan political system that keeps promising a central articulation that it says can deliver for the electorates that vote for governance to be enacted upon themselves from within such a system. In fact there is no further legislation, threat of violence be it financial or physical, propaganda or mass movement party that can lead anybody, anywhere, anymore. That is what Jung said. That is what he meant to say. That is what was true then. That is what is true now.

Articulation is the key to the future forms of leadership that will evolve out of the recovery processes soon to be embarked upon by the executive functions of Mankind.

An articulated lorry gives the clue.

An articulated lorry is supremely versatile, can pull very heavy loads with great manoeuvrability, can unhitch the power source quickly from one project and hitch it onto another very easily. The tractor units can work together to clear many trailers, but they are autonomous. The trailers can be full of issues that where hitherto the property of only one side of the old political divide, but in the future such divisions will be seen to be secondary to the primary ability of actually having the traction to move the trailers to a required destination.

Quite simply, the Era Change is one of Leadership Change, the way that Leadership is articulated to the led, the way that problems are articulated to the solution mechanisms of Mankind, the way that power is articulated through material forms for The Human as beings.