The addict's reliance on the drug to reawaken her dulled feelings is no adolescent caprice. The dullness is itself a consequence of an emotional malfunction not of her making; the internal shutdown of vulnerability. Vulnerability is our susceptibility to be wounded. This fragility is part of our nature and cannot be escaped. The best the brain can do is to shut down conscious awareness of it when pain becomes so vast or unbearable that it threatens our ability to function. The automatic repression of painful emotion is a helpful child's prime defence mechanism and can enable the child to endure trauma otherwise be catastrophic. The unfortunate consequence is a wholesale dulling of emotional awareness.

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All of the diagnoses that you deal with - depression, anxiety, ADHD, bipolar illness, post traumatic stress disorder, even psychosis, are significantly rooted in trauma. They are manifestations of trauma. Therefore the diagnoses don't explain anything. The problem in the medical world is that we diagnose somebody and we think that is the explanation. He's behaving that way because he is psychotic. She's behaving that way because she has ADHD. Nobody has ADHD, nobody has psychosis - these are processes within the individual. It's not a thing that you have. This is a process that expresses your life experience. It has meaning in every single case.

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It is worth recalling here that the injudicious use of rewards and praise can be pressure tactics no less than verbal or physical coercion. As we have seen, there are three dangers with motivating by means of reward and praise. First, they feed the anxiety that not the person but the desired achievement is what is valued by the parent. They directly reinforce the insecurity of the ADD child. Second, since children can sense the parents’ will pushing them, even if under benign disguises such as gifts or warm words, counterwill will be strengthened. Third, praise and reward will themselves become the goal, at the expense of the child’s interest in the actual process of what he is doing. Children thus motivated will sooner or later learn to get by with the least amount of effort necessary to earn the praise or the reward. Short cuts and cheating often follow.

Emotions interpret the world for us. They have a signal function, telling us about our internal states as they are affected by input from the outside. Emotions are responses to present stimuli as filtered through the memory of past experience, and they anticipate the future based on our perception of the past.

Freedom in society is gauged by our success in getting what we want and conditioned by status and power, by race, class and gender. In the internal world of the psyche, however, freedom means something very different. It is the ability to opt for our long-term physical and spiritual well-being as opposed to our immediate urges. Absent that ability, any talk of ‘free will’ or ‘choice’ becomes nearly meaningless.

The family therapist David Freeman once concluded a public lecture on intimacy and relationships by saying that if there was any one thing he hoped his audience would remember from his talk, it was the awareness that one does not know his or her spouse, his or her children. We may believe we have a perfect idea of why they act as they do, when in reality our beliefs reflect no more than our own anxieties.

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