Addiction treatment homework planner practiceplanners

Addiction Treatment Homework Planner (PracticePlanners) Visit to download the full and correct content document: https://ebookmass.com/product/addiction-treatment-homework-planner-practiceplann ers/

Cover image: © Ryan McVay/Getty Images Cover design: Wiley This book is printed on acid-free paper.

Copyright © 2014 by James R. Finley and Brenda S. Lenz. All rights reserved.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey Published simultaneously in Canada No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008, or online at www.wiley.com/go/permissions.

Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with the respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor the author shall be liable for damages arising here from.

For general information about our other products and services, please contact our Customer Care Department within the United States at (800) 762-2974, outside the United States at (317) 572-3993 or fax (317) 572-4002.

Wiley publishes in a variety of print and electronic formats and by print-on-demand. Some material included with standard print versions of this book may not be included in e-books or in print-on-demand. If this book refers to media such as a CD or DVD that is not included in the version you purchased, you may download this material at http://booksupport.wiley.com. For more information about Wiley products, visit www.wiley.com.

Library of Congress Cataloging-in-Publication Data: Finley, James R., 1948 – author.

Addiction treatment homework planner/James R. Finley and Brenda S. Lenz.–Fifth edition.

1 online resource.–(PracticePlanners series) Includes bibliographical references.

Description based on print version record and CIP data provided by publisher; resource not viewed.

ISBN 978-1-118-83651-4 (ebk)–ISBN 978-1-118-83627-9 (ebk)–ISBN 978-1-118-56059-4 (pbk) 1. Substance abuse–Treatment–Handbooks, manuals, etc. 2. Substance abuse–Treatment–Planning. I. Lenz, Brenda S., author. II. Title.

RC564.15 616.86'06–dc23 2013039176

Printed in the United States of America 10 9 8 7 6 5 4 3 2 1

For Matthew Raymond Hernandez—budding artist, dreamer, beloved grandson—you did more living in nine years than some do in decades, and you’ll always live in our hearts.

Love, Grandpa Jim —JRF To my family, who supports me so that I am able to do the work I love.

—BSL

CONTENTS

PracticePlanners® Series Preface

xv

Preface

xvii

SECTION 1: Adult-Child-of-an-Alcoholic (ACA) Traits

1

Exercise 1.A

Addressing ACA Traits in Recovery

2

Exercise 1.B

Understanding Family History

6

SECTION 2: Anger

8

Exercise 2.A

Is My Anger Due to Feeling Threatened?

9

Exercise 2.B

Is My Anger Due to Unmet Expectations?

14

SECTION 3: Antisocial Behavior

17

Exercise 3.A

Benefits of Helping Others

18

Exercise 3.B

Taking Inventory of Destructive Behaviors

22

SECTION 4: Anxiety

24

Exercise 4.A

Anxiety Triggers and Warning Signs

25

Exercise 4.B

Coping With Stress

29

SECTION 5: Attention-Deficit/Hyperactivity Disorder (ADHD)—Adolescent

32

Exercise 5.A

Developing a Recovery Program

33

Exercise 5.B

Staying Attentive and Other Negotiating Skills

37

SECTION 6: Attention-Deficit/Hyperactivity Disorder (ADHD)—Adult

40

Exercise 6.A

From Recklessness to Calculated Risks

41

Exercise 6.B

Getting Organized

44

Exercise 6.C

Self-Soothing: Calm Down, Slow Down

47

SECTION 7: Bipolar Disorder

49

Exercise 7.A

Early Warning Signs of Mania/Hypomania

50

Exercise 7.B

Mania, Addiction, and Recovery

53

ix

SECTION 8: Borderline Traits

55

Exercise 8.A

Forming Stable Relationships

56

Exercise 8.B

Seeing That We’re All Just Human

60

SECTION 9: Childhood Trauma

62

Exercise 9.A

Corresponding With My Childhood Self

63

Exercise 9.B

Setting and Maintaining Boundaries

66

SECTION 10: Chronic Pain

68

Exercise 10.A

Coping With Addiction and Chronic Pain

69

Exercise 10.B

Managing Pain Without Addictive Drugs

72

SECTION 11: Conduct Disorder/Delinquency

75

Exercise 11.A

How Do You Do That?

76

Exercise 11.B

Trading Places

80

SECTION 12: Dangerousness/Lethality

83

Exercise 12.A

Anger as a Drug

84

Exercise 12.B

Managing Risk

87

SECTION 13: Dependent Traits

89

Exercise 13.A

Building My Support Network

90

Exercise 13.B

How Interdependent Am I?

94

SECTION 14: Eating Disorders and Obesity Exercise 14.A Exercise 14.B

97

Creating a Preliminary Eating and Health Plan

98

Eating Patterns Self-Assessment

102

SECTION 15: Family Conflicts

104

Exercise 15.A

Creating Positive Family Rituals

105

Exercise 15.B

Identifying Conflict Themes

108

SECTION 16: Gambling

110

Exercise 16.A

Consequences and Benefits

111

Exercise 16.B

Understanding Nonchemical Addictions

114

x

CONTENTS

SECTION 17: Grief/Loss Unresolved

116

Exercise 17.A

Am I Having Difficulty Letting Go?

117

Exercise 17.B

Moving on After Loss

120

Exercise 17.C

What Would They Want for Me?

124

SECTION 18: Impulsivity

126

Exercise 18.A

Handling Crisis Without Impulsivity

127

Exercise 18.B

Learning to Think Things Through

130

SECTION 19: Legal Problems

132

Exercise 19.A

Handling Tough Situations in a Healthy Way

133

Exercise 19.B

What’s Addiction Got to Do With My Problems?

137

SECTION 20: Living Environment Deficiency

140

Exercise 20.A

Assessing My Environment

141

Exercise 20.B

What Would My Ideal Life Look Like?

144

SECTION 21: Medical Issues

147

Exercise 21.A

Coping With Addiction and Other Medical Problems

148

Exercise 21.B

Physical and Emotional Self-Care

152

SECTION 22: Narcissistic Traits

154

Exercise 22.A

Being Genuinely Unselfish

155

Exercise 22.B

Getting Out of Myself

158

SECTION 23: Nicotine Use/Dependence

160

Exercise 23.A

Assessing Readiness and Preparing to Quit

161

Exercise 23.B

Addressing Relapse Triggers

164

Exercise 23.C

Use of Affirmations for Change

167

SECTION 24: Obsessive-Compulsive Disorder (OCD)

170

Exercise 24.A

Interrupting Compulsive Thoughts and Urges

172

Exercise 24.B

Reducing Compulsive Behaviors

177

SECTION 25: Occupational Problems

180

Exercise 25.A

Interest and Skill Self-Assessment

181

Exercise 25.B

Workplace Problems and Solutions

185

CONTENTS

xi

SECTION 26: Oppositional Defiant Behavior

187

Exercise 26.A

Analyzing Acting-Out Behavior

188

Exercise 26.B

Learning to Ask Instead of Demand

191

SECTION 27: Parent–Child Relational Problem

194

Exercise 27.A

Am I Teaching My Child Addictive Patterns?

195

Exercise 27.B

What Do I Want for My Children?

198

SECTION 28: Partner Relational Conflicts

201

Exercise 28.A

Communication Skills

202

Exercise 28.B

Relationship Assessment

207

SECTION 29: Peer Group Negativity

209

Exercise 29.A

Creating Recovery Peer Support

210

Exercise 29.B

What Do I Need and How Do I Get It?

213

SECTION 30: Posttraumatic Stress Disorder (PTSD) Exercise 30.A Exercise 30.B

Coping With Addiction and PTSD or Other Anxiety Disorders

216

Safe and Peaceful Place Meditation

220

SECTION 31: Psychosis Exercise 31.A Exercise 31.B

215

222

Coping With Addiction and Schizophrenia Spectrum Disorders

223

Planning a Stable Life

227

SECTION 32: Relapse Proneness

229

Exercise 32.A

Early Warning Signs of Relapse

230

Exercise 32.B

Identifying Relapse Triggers and Cues

233

Exercise 32.C

Relapse Prevention Planning

237

SECTION 33: Self-Care Deficit as a Primary Problem

240

Exercise 33.A

Assessing Self-Care Deficits

241

Exercise 33.B

Relating Self-Care Deficits to My Addiction

245

SECTION 34: Self-Care Deficit as a Secondary Problem

xii

247

Exercise 34.A

Filling in Self-Care Gaps

248

Exercise 34.B

Working Toward Interdependence

251

CONTENTS

SECTION 35: Self-Harm

253

Exercise 35.A

Understanding Self-Harm and Addiction

254

Exercise 35.B

Self-Harm Risk Factors, Triggers, and Early Warning Signs

257

SECTION 36: Sexual Abuse

259

Exercise 36.A

It Wasn’t My Fault

261

Exercise 36.B

Internal and External Resources for Safety

265

SECTION 37: Sexual Promiscuity

267

Exercise 37.A

Is It Romance or Is It Fear?

268

Exercise 37.B

Working Through Shame

272

SECTION 38: Sleep Disturbance

274

Exercise 38.A

Assessing Sleep Problems

275

Exercise 38.B

Improving Sleep Hygiene

278

SECTION 39: Social Anxiety

279

Exercise 39.A

Understanding Thoughts, Worries, and Fears

281

Exercise 39.B

Action Plan to Address Social Anxiety

285

SECTION 40: Spiritual Confusion

288

Exercise 40.A

Understanding Spirituality

289

Exercise 40.B

Finding a Higher Power That Makes Sense

292

SECTION 41: Substance-Induced Disorders

294

Exercise 41.A

Using My Support Network

296

Exercise 41.B

Exploring Treatment and Recovery Options

299

SECTION 42: Substance Intoxication/Withdrawal

301

Exercise 42.A

Coping With Post-Acute Withdrawal (PAW)

302

Exercise 42.B

Using Books and Other Media Resources

305

SECTION 43: Substance Use Disorders

307

Exercise 43.A

Consequences of Continuing Addictive Lifestyles

308

Exercise 43.B

Alternatives to Addictive Behavior

311

Exercise 43.C

Personal Recovery Planning

314

Exercise 43.D

Taking Daily Inventory

319

CONTENTS

xiii

Exercise 43.E

Making Change Happen

322

Exercise 43.F

Balancing Recovery, Family, and Work

326

SECTION 44: Suicidal Ideation Exercise 44.A

Problem Solving and Safety Planning

330

Exercise 44.B

Why Do I Matter and Who Cares?

334

SECTION 45: Treatment Resistance

336

Exercise 45.A

Addressing Readiness and Motivation

337

Exercise 45.B

Problem Identification: Is It Addiction?

340

SECTION 46: Unipolar Depression

xiv

329

343

Exercise 46.A

Correcting Distorted Thinking

344

Exercise 46.B

Gratitude

348

APPENDIX A: Alternate Assignments for Presenting Problems

350

APPENDIX B: Suggested Bibliotherapy

371

APPENDIX C: Alphabetical Index of Exercises

384

About the Authors

387

About the CD-ROM

388

Downloadable CD material at http://booksupport.wiley.com

388

CONTENTS

PRACTICEPLANNERS® SERIES PREFACE

Accountability is an important dimension of the practice of psychotherapy. Treatment programs, public agencies, clinics, and practitioners must justify and document their treatment plans to outside review entities in order to be reimbursed for services. The books and software in the PracticePlanners® series are designed to help practitioners fulfill these documentation requirements efficiently and professionally.

The PracticePlanners® series includes a wide array of treatment planning books including not only the original Complete Adult Psychotherapy Treatment Planner, Child Psychotherapy Treatment Planner, and Adolescent Psychotherapy Treatment Planner, all now in their fifth editions, but also Treatment Planners targeted to specialty areas of practice, including: • • • • • • • • • • • • • • • • • • • • • • • • • •

Addictions Co-occurring disorders Behavioral medicine College students Couples therapy Crisis counseling Early childhood education Employee assistance Family therapy Gays and lesbians Group therapy Juvenile justice and residential care Mental retardation and developmental disability Neuropsychology Older adults Parenting skills Pastoral counseling Personality disorders Probation and parole Psychopharmacology Rehabilitation psychology School counseling and school social work Severe and persistent mental illness Sexual abuse victims and offenders Social work and human services Special education

xv

• • • •

Speech-language pathology Suicide and homicide risk assessment Veterans and active military duty Women’s issues

In addition, three branches of companion books can be used in conjunction with the Treatment Planners, or on their own: •

Progress Notes Planners provide a menu of progress statements that elaborate on the client’s symptom presentation and the provider’s therapeutic intervention.

Each Progress Notes Planner statement is directly integrated with the behavioral definitions and therapeutic interventions from its companion Treatment Planner.

•

Homework Planners include homework assignments designed around each presenting problem (such as anxiety, depression, chemical dependence, anger management, eating disorders, or panic disorder), which is the focus of a chapter in its corresponding Treatment Planner.

•

Client Education Handout Planners provide brochures and handouts to help educate and inform clients on presenting problems and mental health issues, as well as life skills techniques. The handouts are included on CD-ROMs for easy printing from your computer and are ideal for use in waiting rooms, at presentations, as newsletters, or as information for clients struggling with mental illness issues. The topics covered by these handouts correspond to the presenting problems in the Treatment Planners.

Adjunctive books, such as The Psychotherapy Documentation Primer and The Clinical Documentation Sourcebook, contain forms and resources to aid the clinician in mental health practice management.

The goal of our series is to provide practitioners with the resources they need in order to provide high-quality care in the era of accountability. To put it simply: We seek to help you spend more time on patients and less time on paperwork.

ARTHUR E. JONGSMA, JR. Grand Rapids, Michigan

xvi

PRACTICEPLANNERS® SERIES PREFACE

PREFACE

The long-awaited and recently published fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the first major change in the DSM since DSM-IV was published in 1994 and slightly amended with the text revision to the DSM-IV (DSM-IV-TR) in 2000. The DSM-5 includes changes in the diagnostic criteria and organization of disorders in several categories related to substance dependence and/or abuse.

This edition of the Addiction Homework Planner, in turn, reflects both the changes in the DSM and the continued emphasis on consumer-centered, assessment-driven, evidence-based treatment in the field of psychotherapy. We have continued to emphasize the importance of client motivation and shaped the content of this planner to help people in treatment move ahead in their readiness to work for positive change.

Each exercise was designed to address motivation, with some educational content to increase knowledge and awareness of addiction and to include a skills component.

We are retaining the previous edition’s use of an Appendix A listing additional assignments for each problem area, essentially the counterpart to the lists of additional problems in the exercise overviews. Rather than listing exercises based on American Society of Addiction Medicine (ASAM) criteria, we have made Appendix B a bibliography listing books for assignment to clients as bibliotherapy, for reference by clinicians, or both; each book’s entry lists the problem areas for which it will be useful.

We have again updated and retained most of the exercises and problem areas from the fourth edition, and further condensed nearly all of the lengthier exercises to make them no longer than two pages. We have also replaced several homework assignments to bring this book’s content into closer alignment with the Addiction Treatment Planner and to address nine new or modified problem areas in response to new developments in the field and the DSM-5, to increase the 88 assignments in the fourth edition to a new total of 100 exercises in 46 problem areas.

At the same time, there is more demand for treatment strategies and interventions to be evidence-based, and we have sought to reflect this trend. We believe that clinicians need to include evidence-based therapeutic homework in treatment more each year for several reasons. Already-tight funding and other resources for treatment keep diminishing, while demand keeps growing. This is particularly true in the arena of substance abuse and the problems that come with it, as new synthetic drugs have made a dramatic impact, even in the short time since the fourth edition was published.

As always, homework between sessions helps clients keep their therapy in the forefront of their awareness and makes it easier to bring it into their daily lives at home, work, school, and social settings, so that they meet the inevitable questions and

xvii

challenges and bring them back to therapy quickly and solve these issues in a supported and collaborative way.

USING THIS BOOK This revision is a companion to the fifth edition of the Addiction Treatment Planner.

You can use the enclosed CD-ROM to install the assignments on your computer as Microsoft Word documents and print them as they are designed or customize them by rewording items, adding a logo or other art, or however else you choose. For further instructions, please see “About the CD-ROM.” As always, if you have suggestions, want to tell us which features you find especially useful, or would like to suggest topics to cover in future volumes, please contact us via this publisher. We are always eager for feedback we can use to make this a better resource with each edition. There is no work more important than helping people.

Thank you for serving the people with whom you work, and through them, your communities and the world.

xviii PREFACE

SECTION 1: ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS Therapist’s Overview

ADDRESSING ACA TRAITS IN RECOVERY

GOALS OF THE EXERCISE 1.

2.

3.

4.

5.

6.

Implement a plan for recovery from addiction that reduces the impact of adultchild-of-an-alcoholic (ACA) traits on sobriety.

Decrease dependence on relationships while beginning to meet one’s own needs.

Reduce the frequency of behaviors that are exclusively designed to please others.

Choose partners and friends who are responsible, respectful, and reliable.

Overcome fears of abandonment, loss, and neglect.

Understand the feelings that resulted from being raised in an addictive environment and reduce feelings of alienation by seeing similarities to others raised in non-addictive homes.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL • • • •

Borderline Traits Dependent Traits Partner Relationship Conflicts Sexual Promiscuity

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The “Addressing ACA Traits in Recovery” activity is for clients with patterns of codependent relationships, enmeshment, boundary issues, and burnout in love, friendship, and workplace relationships. It teaches clients about addictive relationship dynamics, then heightens motivation by focusing on the threat this poses to recovery, ending by directing clients to further exploration of issues of codependency. Follow-up may include discussing the issue with the therapist, group, and sponsor; support group referrals; bibliotherapy; and videotherapy (e.g., Rent Two Films and Let’s Talk in the Morning by John W. Hesley and Jan G. Hesley, also published by Wiley).

ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

1

EXERCISE 1.A

ADDRESSING ACA TRAITS IN RECOVERY

Adult children of alcoholics, or ACAs, are adults who grew up in families where one or both parents chronically abused alcohol and/or other drugs, suffered from other mental illness, or had other problems that made them unable to meet their children’s needs.

When those children become adults, they may have feelings and behavior patterns that resemble those of their parents, especially in relationships. This can happen whether or not they abuse alcohol or other drugs—ACAs often become “addicted” to unhealthy patterns and people in their love, friendship, and work relationships. They are drawn to situations that feel in some ways like their childhood family life, and to people who treat them in ways similar to the ways their parents treated them and others. ACAs often fall into the trap of trying to please, “fix,” or “save” others, and their own lives are left in turmoil. Their motives are caring, but their efforts to please or rescue others seldom work. The results cause these ACAs great emotional pain and may put them in dangerous situations or lead to a work-related cycle of starting new jobs with great hope and energy but ending up burning out on those jobs or careers. No one can really control anyone else; other people’s troubles are mostly caused by patterns only they can change, so trying to change them leads to one painful disappointment after another. As part of your recovery, this activity will help you learn to recognize and change these patterns, which are also often called codependency.

1.

There are reasons we’re drawn to relationships in which we try harder to solve other people’s problems than they do. If we are ACAs, these patterns often echo those we experienced in our families as children. It’s as if we’re trying to replay the same story and get it to have a happy ending. Have any of the feelings listed here drawn you into painful relationships or situations in love, friendship, and/or workplace situations?

You felt sure that if you tried hard enough, you could win approval.

You felt needed.

It was intense and exciting from the start.

You felt intensely and magnetically drawn to the other person.

They made you feel strong, smart, and capable.

The sex was incredible.

You identified with the hardships they’d suffered.

You felt that you could help them and change their lives.

2

ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

EXERCISE 1.A

2.

Here are signs of this kind of relationship. Please check off any you’ve experienced: Manipulation and mind games take up a lot of time and energy.

You’re held responsible (by others or yourself) for things you can’t control.

You see that you keep getting into high-risk or no-win situations, but you can’t help finding those are the only ones that attract you—safe people and jobs bore you.

You’re often worried that the relationship will fall apart, feeling you can keep the peace if you just say and do only the right things.

You keep your partner away from your other friends and family because they don’t get along, or you don’t think they would.

You spend a lot of time and energy solving other people’s problems, over and over, often with little or no appreciation or recognition.

You try hard to impress your partner and keep secrets; you fear that your partner would reject you if they knew about parts of your life or past.

You get in heated arguments that don’t make sense to either of you.

The relationship became very intense very fast when you first got together.

One or both of you feel a lot of jealousy and insecurity.

The relationship is never boring, but it’s usually stressful.

You go back and forth between feeling abandoned and feeling smothered.

3.

How does this relate to getting and staying clean and sober? Well, common sense tells us there’s a strong connection between stress and relapse, and research confirms that link. Looking at the items you checked for question 2, think about how stressful those relationships were or are. How could these stresses lead you to relapse, and how do you feel about that risk?

4.

Most people who get into addictive relationships don’t just do so once. What unhealthy patterns do you see in the people you find attractive?

ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

3

EXERCISE 1.A

5.

Consider participating in 12-step recovery programs specifically for ACAs. Identify three reasons this could be beneficial to you.

Be sure to bring this handout back to your next session with your therapist, and be prepared to talk about your thoughts and feelings about the exercise.

4

ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

Therapist’s Overview

UNDERSTANDING FAMILY HISTORY

GOALS OF THE EXERCISE 1.

2.

3.

4.

5.

6.

7.

Implement a plan for recovery from addiction that reduces the impact of adultchild-of-an-alcoholic (ACA) traits on sobriety.

Reduce the frequency of behaviors that are exclusively designed to please others.

Eliminate behaviors that are dangerous to self or others.

Eliminate self-defeating interpersonal patterns in occupational and social settings.

Choose partners and friends who are responsible, respectful, and reliable.

Understand the feelings that resulted from being raised in an addictive environment and reduce feelings of inferiority and/or alienation from others who were raised in nonaddictive homes.

Obtain emotional support for recovery from family members.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL • • • • •

Borderline Traits Childhood Trauma Family Conflicts Parent-Child Relational Problem Partner Relational Conflicts

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The “Understanding Family History” activity may be used effectively with clients who are experiencing shame, confusion, or anxiety as a result of seeing themselves repeat negative behaviors seen in childhood caretakers. It may be useful in couples therapy, because many ACA individuals form relationships with partners with similar backgrounds. For clients struggling with acceptance and forgiveness of their parents or of themselves, this activity may help in understanding the roles of addiction and powerlessness in distorting values and behaviors. It may also be useful for clients who have parenting issues in recovery to understand the roots of their children’s behaviors.

ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

5

EXERCISE 1.B

UNDERSTANDING FAMILY HISTORY

It’s important to understand the role of family history in addictions—not to blame those who raised us, but for our own recovery and our families’ futures. This exercise looks at how family history affects us.

1.

As a child, what did you learn about drinking, drug use, or other addictions in your family?

2.

What problems, if any, did your family have because of these behaviors (e.g., violence, divorce, financial problems, dangerous or illegal activities, or other worries)?

3.

Please describe the typical atmosphere in your family when someone was drinking, using drugs, or engaging in other addictive patterns, and its effects on you then and now.

4.

Below are some common patterns in families struggling with addictions, related to the unspoken rule “Don’t talk, don’t trust, don’t feel” that develops as other family members try to avoid confrontations or disappointment caused by the inability of addicted adults to be nurturing and dependable, or to cope with the emotional pain that is the result of that inability. For each pattern, give an example from your childhood and an example of how you can make healthy changes now. a.

Dishonesty/denial (1) Childhood example: (2) Working for healthy change:

b.

6

Breaking promises (1) Childhood example:

ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

EXERCISE 1.B

(2) Working for healthy change: c.

Isolating/withdrawing (1) Childhood example: (2) Working for healthy change:

d.

Emotional/physical/sexual abuse and neglect (1) Childhood example: (2) Working for healthy change:

e.

Influencing others to act in self-destructive ways (1) Childhood example: (2) Working for healthy change:

f.

Confused roles and responsibilities (e.g., children taking caring of adults, people blaming others for their own actions, etc.)

(1) Childhood example: (2) Working for healthy change:

5.

No family is completely dysfunctional, and nearly all of us remember our parents or other adults who raised us doing some good things we want to do for our children in turn. What good relationship patterns from your childhood do you want to continue and pass on?

6.

Consider the strengths you obtained from growing up in your house with your family. How can you use these strengths to facilitate your own recovery efforts?

Be sure to bring this handout back to your next session with your therapist, and be prepared to talk about your thoughts and feelings about the exercise.

ADULT-CHILD-OF-AN-ALCOHOLIC (ACA) TRAITS

7

SECTION 2: ANGER Therapist’s Overview

IS MY ANGER DUE TO FEELING THREATENED?

GOALS OF THE EXERCISE 1.

2.

3.

4.

5.

6.

7.

8.

9.

Develop a program of recovery that is free from substance abuse and violent behavior.

Terminate all behaviors that are dangerous to self or others.

Decrease the frequency of occurrence of angry thoughts, feelings, and behaviors.

Verbalize core conflicts that lead to dangerous/lethal behaviors.

Recognize the first signs of anger and use behavioral techniques to control it.

Think positively and realistically in anger-producing situations.

Learn that anger is a secondary emotion responding to fear or anxiety in response to a perceived threat.

Learn to self-monitor and shift into an introspective and cognitive problem-solving mode rather than an emotional reactive mode when anger is triggered.

Shift from a self-image as a helpless or passive victim of angry impulses to one of mastery and taking responsibility for responses to feelings.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL • • • •

Conduct Disorder/Delinquency Dangerousness/Lethality Oppositional Defiant Behavior Posttraumatic Stress Disorder (PTSD)

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The “Is My Anger Due to Feeling Threatened?” activity is suited for clients who are capable of introspection and who desire to change their reactive patterns of anger. It may be useful when clients describe perceptions of being unable to control their anger, have patterns of impulsive anger disproportionate to the triggering events or situations, or express regrets over their actions when angry. Follow-up can include keeping a journal documenting angry impulses and the client’s use of this process to manage their reactions. Teaching relaxation strategies, mindfulness strategies, and self-soothing strategies would be beneficial in conjunction with the client working on recognizing and managing their anger.

8

ANGER

EXERCISE 2.A

IS MY ANGER DUE TO FEELING THREATENED?

A wise person once said that every problem starts as a solution to another problem.

Once we see this, it’s easier to let go of the anger and find another solution for the original problem that works better. What kind of problem makes anger look like a solution? When is anger useful? It’s good for energizing and preparing us to fight. It’s the “fight” part of the fight-or-flight instinct that is any creature’s response to perceived (whether real or not) danger. When we feel angry, chances are that we feel threatened.

This instinct developed in prehistoric people over thousands of generations and is shared by many self-aware animal species as well. Nearly all of the threats they faced were physical (e.g., wild animals or hostile strangers), and in those situations anger served them well.

Some dangers are still physical, but more often we face threats we can’t fight physically. There are threats to our self-images and our beliefs about the world, which can feel just as dangerous as threats to our safety or health.

In this exercise, you’ll think about a situation that has triggered your anger and identify both the threat that the anger wants to fight and another solution that will work better.

1.

First, it’s important to recognize anger as soon as it starts to develop. To do this, you need to watch for the early warning signs of anger, both physical and mental. a.

b.

Here are some common physical effects of anger. Please check any you experience when you are starting to get angry: Muscle tension or shaking

Rapid heartbeat

Rapid, shallow breathing

“Butterflies in the stomach”

Reddening of the face

Agitation and restlessness

Our thinking changes with anger, often in these ways. Again, check any you experience: Impulsiveness and impatience

Feelings of power and certainty

All-or-nothing thinking

Taking things personally

Inability to see others’ perspectives

A sense of having been wronged

ANGER

9

EXERCISE 2.A

2.

Now think of a situation that has been an anger trigger for you over and over or that has led to serious consequences because of your angry actions. Briefly describe the situation and the consequences.

3.

Study the situation, and identify the threat that triggered your anger. Were you at risk of not getting something you wanted, or of losing something you already had and valued? Were you responding to “programmed” ways to react when situations feel similar? The item under threat could be physical well-being, a relationship, a career or life goal, your self-image, or even your values and beliefs about the way the world works. Explain how this situation threatens you.

4.

Think of a solution that will give you better results and cause fewer problems than acting in anger. Describe the solution and how you’d put it into action.

5.

After you’ve thought about triggers and solutions, what are your thoughts and feelings about the situation? Do you feel more in control?

6.

There are some situations in modern life where expressing anger is still appropriate, but not with physical violence. Please think of a way you can constructively express anger to be assertive and not submit to mistreatment, but do so without violence.

7.

When you feel your anger building, pause, take a breath and ask yourself, “Where’s the threat, and what else can I do about it?” This way, you can take control of your feelings and actions. This is difficult at first, but if you keep doing it, the pause and the question become automatic, just as the flash into rage was automatic. When you pause automatically and think this way, you control your anger, rather than it controlling you. At first, reminders help; think of someone you trust to help you with this. Explain what you’re doing, and ask them to watch

10 ANGER

EXERCISE 2.A

your mood and if you start looking angry, remind you to pause and find the threat.

Who is that person, and when will you talk with them about this?

Be sure to bring this handout back to your next therapy session, and be prepared to talk about your thoughts and feelings about the exercise.

ANGER 11

Therapist’s Overview

IS MY ANGER DUE TO UNMET EXPECTATIONS?

GOALS OF THE EXERCISE 1.

2.

3.

4.

5.

6.

7.

8.

9.

Develop a program of recovery free from substance abuse and dangerous/lethal behaviors.

Terminate all behaviors that are dangerous to self or others.

Decrease the frequency of occurrence of angry thoughts, feelings, and behaviors.

Verbalize the core conflicts that lead to dangerous/lethal behaviors.

Recognize the first signs of anger and use behavioral techniques to control it.

Think positively and realistically in anger-producing situations.

Learn and use stress-management skills to reduce stress and the irritability that accompanies it.

Learn to self-monitor and shift to a thinking and problem-solving mode rather than a reactive mode when anger is triggered.

Increase self-esteem and sense of purpose for living, and learn how to help others in recovery.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL • • • • • • • • •

Antisocial Behavior Attention-Deficit/Hyperactivity Disorder (ADHD)—Adolescent Attention-Deficit/Hyperactivity Disorder (ADHD)—Adult Borderline Traits Dangerousness/Lethality Family Conflicts Oppositional Defiant Behavior Parent-Child Relational Problem Partner Relational Conflicts

12 ANGER

EXERCISE 2.B

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT The “Is My Anger Due to Unmet Expectations?” activity is suited for clients who are capable of introspection and who desire to change their reactive patterns of anger. It may be useful when clients report feeling unable to control their anger, have patterns of impulsive anger disproportionate to triggering events or situations, or express regrets over their actions when angry. Follow-up can include keeping a journal documenting angry impulses and use of this process to identify trigger expectations and manage reactions.

ANGER 13

EXERCISE 2.B

IS MY ANGER DUE TO UNMET EXPECTATIONS?

People in treatment and recovery programs often say that anger always boils down to fear: That they’ll lose something they want to keep, or that they won’t get something they want. These aren’t usually life-and-death matters, but they often react as if they were.

When we look at this closely, we usually see that when possible losses or disappointments have triggered rage, we expected something different and are shocked and disappointed by what actually happened. Sometimes our expectations are based on what we feel is right and fair, what some call the “shoulda-woulda-couldas” (e.g., that the person in the next lane should let us merge instead of speeding up to crowd us out, or that people should be honest and considerate). Also, sometimes we just want something badly and convince ourselves that it should happen the way we want it to.

But our expectations are often unrealistic. That’s why many old-timers in Alcoholics Anonymous and other recovery programs define an expectation as “a premeditated resentment.” They mean that when we form expectations, we often set ourselves up for disappointment and the anger that follows.

Do you want to avoid getting angry unnecessarily? Anger interferes with our judgment, making us more likely to act impulsively and do things that damage relationships, undermine recovery, and weaken our immune systems. This exercise will help you avoid unrealistic expectations, to feel calm more of the time and angry less often.

1.

Please think back to the most recent time you got angry over an unrealistic expectation, a “shoulda-woulda-coulda” experience. Describe what happened.

2.

Was the event that triggered your anger something you felt should not have happened the way it did? If so, what was your expectation, and why did you have that expectation?

3.

We often expect things that aren’t likely (e.g., expecting someone who is usually late to be on time). If experience told you that what you expected was unlikely, what would have been a more reasonable expectation?

14 ANGER

EXERCISE 2.B

4.

Our expectations are often just mistakes in our thinking. If we learn not to make those mistakes, accepting what does happen is easier. Remember, accepting something doesn’t mean we like it or believe it’s right; it means admitting things are the way they are, and deciding to act on reality rather than our fantasies. If you run into the same situation again but expect what experience tells you is likely to happen, rather than what you hope for or feel should happen, how will you react differently?

5.

Here are some mistaken expectations we often get angry over. Please give your own examples: a. Expecting people to behave differently than the way they usually act (e.g., expecting love, warmth, and consideration from a person who is normally cold, selfish, and sarcastic) Example: b.

Taking things personally or expecting to be the center of someone else’s world Example:

c.

Perfectionism: Expecting ourselves or others to do things perfectly the first time, rather than accepting that we all make mistakes Example:

d.

Overoptimism (e.g., expecting everything to go the way we want, though it seldom does) Example:

6.

Other emotions that arise when we form unrealistic expectations are self-pity, discouragement, and anxiety. How have these been triggers for your past addictive behaviors?

7.

These emotions are setups for relapse. Recovery depends on managing them; it helps not to set ourselves up to get angry. The fewer expectations we have, especially unrealistic ones, the easier it is to stay in recovery. Please describe a

ANGER 15

Another random document with no related content on Scribd:

DANCE ON STILTS AT THE GIRLS’ UNYAGO, NIUCHI

Newala, too, suffers from the distance of its water-supply—at least the Newala of to-day does; there was once another Newala in a lovely valley at the foot of the plateau. I visited it and found scarcely a trace of houses, only a Christian cemetery, with the graves of several missionaries and their converts, remaining as a monument of its former glories. But the surroundings are wonderfully beautiful. A thick grove of splendid mango-trees closes in the weather-worn crosses and headstones; behind them, combining the useful and the agreeable, is a whole plantation of lemon-trees covered with ripe fruit; not the small African kind, but a much larger and also juicier imported variety, which drops into the hands of the passing traveller, without calling for any exertion on his part. Old Newala is now under the jurisdiction of the native pastor, Daudi, at Chingulungulu, who, as I am on very friendly terms with him, allows me, as a matter of course, the use of this lemon-grove during my stay at Newala.

FEET MUTILATED BY THE RAVAGES OF THE “JIGGER” (Sarcopsylla penetrans)

The water-supply of New Newala is in the bottom of the valley, some 1,600 feet lower down. The way is not only long and fatiguing, but the water, when we get it, is thoroughly bad. We are suffering not only from this, but from the fact that the arrangements at Newala are nothing short of luxurious. We have a separate kitchen—a hut built against the boma palisade on the right of the baraza, the interior of which is not visible from our usual position. Our two cooks were not long in finding this out, and they consequently do—or rather neglect to do—what they please. In any case they do not seem to be very particular about the boiling of our drinking-water—at least I can attribute to no other cause certain attacks of a dysenteric nature, from which both Knudsen and I have suffered for some time. If a man like Omari has to be left unwatched for a moment, he is capable of anything. Besides this complaint, we are inconvenienced by the state of our nails, which have become as hard as glass, and crack on the slightest provocation, and I have the additional infliction of pimples all over me. As if all this were not enough, we have also, for the last week been waging war against the jigger, who has found his Eldorado in the hot sand of the Makonde plateau. Our men are seen all day long—whenever their chronic colds and the dysentery likewise raging among them permit—occupied in removing this scourge of Africa from their feet and trying to prevent the disastrous consequences of its presence. It is quite common to see natives of this place with one or two toes missing; many have lost all their toes,

or even the whole front part of the foot, so that a well-formed leg ends in a shapeless stump. These ravages are caused by the female of Sarcopsylla penetrans, which bores its way under the skin and there develops an egg-sac the size of a pea. In all books on the subject, it is stated that one’s attention is called to the presence of this parasite by an intolerable itching. This agrees very well with my experience, so far as the softer parts of the sole, the spaces between and under the toes, and the side of the foot are concerned, but if the creature penetrates through the harder parts of the heel or ball of the foot, it may escape even the most careful search till it has reached maturity.

Then there is no time to be lost, if the horrible ulceration, of which we see cases by the dozen every day, is to be prevented. It is much easier, by the way, to discover the insect on the white skin of a European than on that of a native, on which the dark speck scarcely shows. The four or five jiggers which, in spite of the fact that I constantly wore high laced boots, chose my feet to settle in, were taken out for me by the all-accomplished Knudsen, after which I thought it advisable to wash out the cavities with corrosive sublimate. The natives have a different sort of disinfectant—they fill the hole with scraped roots. In a tiny Makua village on the slope of the plateau south of Newala, we saw an old woman who had filled all the spaces under her toe-nails with powdered roots by way of prophylactic treatment. What will be the result, if any, who can say?

The rest of the many trifling ills which trouble our existence are really more comic than serious. In the absence of anything else to smoke, Knudsen and I at last opened a box of cigars procured from the Indian store-keeper at Lindi, and tried them, with the most distressing results. Whether they contain opium or some other narcotic, neither of us can say, but after the tenth puff we were both “off,” three-quarters stupefied and unspeakably wretched. Slowly we recovered—and what happened next? Half-an-hour later we were once more smoking these poisonous concoctions—so insatiable is the craving for tobacco in the tropics.

Even my present attacks of fever scarcely deserve to be taken seriously. I have had no less than three here at Newala, all of which have run their course in an incredibly short time. In the early afternoon, I am busy with my old natives, asking questions and making notes. The strong midday coffee has stimulated my spirits to

an extraordinary degree, the brain is active and vigorous, and work progresses rapidly, while a pleasant warmth pervades the whole body. Suddenly this gives place to a violent chill, forcing me to put on my overcoat, though it is only half-past three and the afternoon sun is at its hottest. Now the brain no longer works with such acuteness and logical precision; more especially does it fail me in trying to establish the syntax of the difficult Makua language on which I have ventured, as if I had not enough to do without it. Under the circumstances it seems advisable to take my temperature, and I do so, to save trouble, without leaving my seat, and while going on with my work. On examination, I find it to be 101·48°. My tutors are abruptly dismissed and my bed set up in the baraza; a few minutes later I am in it and treating myself internally with hot water and lemon-juice.

Three hours later, the thermometer marks nearly 104°, and I make them carry me back into the tent, bed and all, as I am now perspiring heavily, and exposure to the cold wind just beginning to blow might mean a fatal chill. I lie still for a little while, and then find, to my great relief, that the temperature is not rising, but rather falling. This is about 7.30 p.m. At 8 p.m. I find, to my unbounded astonishment, that it has fallen below 98·6°, and I feel perfectly well. I read for an hour or two, and could very well enjoy a smoke, if I had the wherewithal—Indian cigars being out of the question.

Having no medical training, I am at a loss to account for this state of things. It is impossible that these transitory attacks of high fever should be malarial; it seems more probable that they are due to a kind of sunstroke. On consulting my note-book, I become more and more inclined to think this is the case, for these attacks regularly follow extreme fatigue and long exposure to strong sunshine. They at least have the advantage of being only short interruptions to my work, as on the following morning I am always quite fresh and fit.

My treasure of a cook is suffering from an enormous hydrocele which makes it difficult for him to get up, and Moritz is obliged to keep in the dark on account of his inflamed eyes. Knudsen’s cook, a raw boy from somewhere in the bush, knows still less of cooking than Omari; consequently Nils Knudsen himself has been promoted to the vacant post. Finding that we had come to the end of our supplies, he began by sending to Chingulungulu for the four sucking-pigs which we had

bought from Matola and temporarily left in his charge; and when they came up, neatly packed in a large crate, he callously slaughtered the biggest of them. The first joint we were thoughtless enough to entrust for roasting to Knudsen’s mshenzi cook, and it was consequently uneatable; but we made the rest of the animal into a jelly which we ate with great relish after weeks of underfeeding, consuming incredible helpings of it at both midday and evening meals. The only drawback is a certain want of variety in the tinned vegetables. Dr. Jäger, to whom the Geographical Commission entrusted the provisioning of the expeditions—mine as well as his own—because he had more time on his hands than the rest of us, seems to have laid in a huge stock of Teltow turnips,[46] an article of food which is all very well for occasional use, but which quickly palls when set before one every day; and we seem to have no other tins left. There is no help for it—we must put up with the turnips; but I am certain that, once I am home again, I shall not touch them for ten years to come.

Amid all these minor evils, which, after all, go to make up the genuine flavour of Africa, there is at least one cheering touch: Knudsen has, with the dexterity of a skilled mechanic, repaired my 9 × 12 cm. camera, at least so far that I can use it with a little care.

How, in the absence of finger-nails, he was able to accomplish such a ticklish piece of work, having no tool but a clumsy screw-driver for taking to pieces and putting together again the complicated mechanism of the instantaneous shutter, is still a mystery to me; but he did it successfully. The loss of his finger-nails shows him in a light contrasting curiously enough with the intelligence evinced by the above operation; though, after all, it is scarcely surprising after his ten years’ residence in the bush. One day, at Lindi, he had occasion to wash a dog, which must have been in need of very thorough cleansing, for the bottle handed to our friend for the purpose had an extremely strong smell. Having performed his task in the most conscientious manner, he perceived with some surprise that the dog did not appear much the better for it, and was further surprised by finding his own nails ulcerating away in the course of the next few days. “How was I to know that carbolic acid has to be diluted?” he mutters indignantly, from time to time, with a troubled gaze at his mutilated finger-tips.

Since we came to Newala we have been making excursions in all directions through the surrounding country, in accordance with old habit, and also because the akida Sefu did not get together the tribal elders from whom I wanted information so speedily as he had promised. There is, however, no harm done, as, even if seen only from the outside, the country and people are interesting enough.

The Makonde plateau is like a large rectangular table rounded off at the corners. Measured from the Indian Ocean to Newala, it is about seventy-five miles long, and between the Rovuma and the Lukuledi it averages fifty miles in breadth, so that its superficial area is about two-thirds of that of the kingdom of Saxony. The surface, however, is not level, but uniformly inclined from its south-western edge to the ocean. From the upper edge, on which Newala lies, the eye ranges for many miles east and north-east, without encountering any obstacle, over the Makonde bush. It is a green sea, from which here and there thick clouds of smoke rise, to show that it, too, is inhabited by men who carry on their tillage like so many other primitive peoples, by cutting down and burning the bush, and manuring with the ashes. Even in the radiant light of a tropical day such a fire is a grand sight.

Much less effective is the impression produced just now by the great western plain as seen from the edge of the plateau. As often as time permits, I stroll along this edge, sometimes in one direction, sometimes in another, in the hope of finding the air clear enough to let me enjoy the view; but I have always been disappointed.

Wherever one looks, clouds of smoke rise from the burning bush, and the air is full of smoke and vapour. It is a pity, for under more favourable circumstances the panorama of the whole country up to the distant Majeje hills must be truly magnificent. It is of little use taking photographs now, and an outline sketch gives a very poor idea of the scenery. In one of these excursions I went out of my way to make a personal attempt on the Makonde bush. The present edge of the plateau is the result of a far-reaching process of destruction through erosion and denudation. The Makonde strata are everywhere cut into by ravines, which, though short, are hundreds of yards in depth. In consequence of the loose stratification of these beds, not only are the walls of these ravines nearly vertical, but their upper end is closed by an equally steep escarpment, so that the

western edge of the Makonde plateau is hemmed in by a series of deep, basin-like valleys. In order to get from one side of such a ravine to the other, I cut my way through the bush with a dozen of my men.

It was a very open part, with more grass than scrub, but even so the short stretch of less than two hundred yards was very hard work; at the end of it the men’s calicoes were in rags and they themselves bleeding from hundreds of scratches, while even our strong khaki suits had not escaped scatheless.

NATIVE PATH THROUGH THE MAKONDE BUSH, NEAR MAHUTA

I see increasing reason to believe that the view formed some time back as to the origin of the Makonde bush is the correct one. I have no doubt that it is not a natural product, but the result of human occupation. Those parts of the high country where man—as a very slight amount of practice enables the eye to perceive at once—has not yet penetrated with axe and hoe, are still occupied by a splendid timber forest quite able to sustain a comparison with our mixed forests in Germany. But wherever man has once built his hut or tilled his field, this horrible bush springs up. Every phase of this process

may be seen in the course of a couple of hours’ walk along the main road. From the bush to right or left, one hears the sound of the axe— not from one spot only, but from several directions at once. A few steps further on, we can see what is taking place. The brush has been cut down and piled up in heaps to the height of a yard or more, between which the trunks of the large trees stand up like the last pillars of a magnificent ruined building. These, too, present a melancholy spectacle: the destructive Makonde have ringed them— cut a broad strip of bark all round to ensure their dying off—and also piled up pyramids of brush round them. Father and son, mother and son-in-law, are chopping away perseveringly in the background—too busy, almost, to look round at the white stranger, who usually excites so much interest. If you pass by the same place a week later, the piles of brushwood have disappeared and a thick layer of ashes has taken the place of the green forest. The large trees stretch their smouldering trunks and branches in dumb accusation to heaven—if they have not already fallen and been more or less reduced to ashes, perhaps only showing as a white stripe on the dark ground.

This work of destruction is carried out by the Makonde alike on the virgin forest and on the bush which has sprung up on sites already cultivated and deserted. In the second case they are saved the trouble of burning the large trees, these being entirely absent in the secondary bush.

After burning this piece of forest ground and loosening it with the hoe, the native sows his corn and plants his vegetables. All over the country, he goes in for bed-culture, which requires, and, in fact, receives, the most careful attention. Weeds are nowhere tolerated in the south of German East Africa. The crops may fail on the plains, where droughts are frequent, but never on the plateau with its abundant rains and heavy dews. Its fortunate inhabitants even have the satisfaction of seeing the proud Wayao and Wamakua working for them as labourers, driven by hunger to serve where they were accustomed to rule.

But the light, sandy soil is soon exhausted, and would yield no harvest the second year if cultivated twice running. This fact has been familiar to the native for ages; consequently he provides in time, and, while his crop is growing, prepares the next plot with axe and firebrand. Next year he plants this with his various crops and

lets the first piece lie fallow. For a short time it remains waste and desolate; then nature steps in to repair the destruction wrought by man; a thousand new growths spring out of the exhausted soil, and even the old stumps put forth fresh shoots. Next year the new growth is up to one’s knees, and in a few years more it is that terrible, impenetrable bush, which maintains its position till the black occupier of the land has made the round of all the available sites and come back to his starting point.

The Makonde are, body and soul, so to speak, one with this bush.

According to my Yao informants, indeed, their name means nothing else but “bush people.” Their own tradition says that they have been settled up here for a very long time, but to my surprise they laid great stress on an original immigration. Their old homes were in the south-east, near Mikindani and the mouth of the Rovuma, whence their peaceful forefathers were driven by the continual raids of the Sakalavas from Madagascar and the warlike Shirazis[47] of the coast, to take refuge on the almost inaccessible plateau. I have studied African ethnology for twenty years, but the fact that changes of population in this apparently quiet and peaceable corner of the earth could have been occasioned by outside enterprises taking place on the high seas, was completely new to me. It is, no doubt, however, correct.

The charming tribal legend of the Makonde—besides informing us of other interesting matters—explains why they have to live in the thickest of the bush and a long way from the edge of the plateau, instead of making their permanent homes beside the purling brooks and springs of the low country.

“The place where the tribe originated is Mahuta, on the southern side of the plateau towards the Rovuma, where of old time there was nothing but thick bush. Out of this bush came a man who never washed himself or shaved his head, and who ate and drank but little.

He went out and made a human figure from the wood of a tree growing in the open country, which he took home to his abode in the bush and there set it upright. In the night this image came to life and was a woman. The man and woman went down together to the Rovuma to wash themselves. Here the woman gave birth to a stillborn child. They left that place and passed over the high land into the valley of the Mbemkuru, where the woman had another child, which

was also born dead. Then they returned to the high bush country of Mahuta, where the third child was born, which lived and grew up. In course of time, the couple had many more children, and called themselves Wamatanda. These were the ancestral stock of the Makonde, also called Wamakonde,[48] i.e., aborigines. Their forefather, the man from the bush, gave his children the command to bury their dead upright, in memory of the mother of their race who was cut out of wood and awoke to life when standing upright. He also warned them against settling in the valleys and near large streams, for sickness and death dwelt there. They were to make it a rule to have their huts at least an hour’s walk from the nearest wateringplace; then their children would thrive and escape illness.”

The explanation of the name Makonde given by my informants is somewhat different from that contained in the above legend, which I extract from a little book (small, but packed with information), by Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my results agree exactly with the statements of the legend. Washing?

Hapana—there is no such thing. Why should they do so? As it is, the supply of water scarcely suffices for cooking and drinking; other people do not wash, so why should the Makonde distinguish himself by such needless eccentricity? As for shaving the head, the short, woolly crop scarcely needs it,[49] so the second ancestral precept is likewise easy enough to follow. Beyond this, however, there is nothing ridiculous in the ancestor’s advice. I have obtained from various local artists a fairly large number of figures carved in wood, ranging from fifteen to twenty-three inches in height, and representing women belonging to the great group of the Mavia, Makonde, and Matambwe tribes. The carving is remarkably well done and renders the female type with great accuracy, especially the keloid ornamentation, to be described later on. As to the object and meaning of their works the sculptors either could or (more probably) would tell me nothing, and I was forced to content myself with the scanty information vouchsafed by one man, who said that the figures were merely intended to represent the nembo—the artificial deformations of pelele, ear-discs, and keloids. The legend recorded

by Pater Adams places these figures in a new light. They must surely be more than mere dolls; and we may even venture to assume that they are—though the majority of present-day Makonde are probably unaware of the fact—representations of the tribal ancestress.

The references in the legend to the descent from Mahuta to the Rovuma, and to a journey across the highlands into the Mbekuru valley, undoubtedly indicate the previous history of the tribe, the travels of the ancestral pair typifying the migrations of their descendants. The descent to the neighbouring Rovuma valley, with its extraordinary fertility and great abundance of game, is intelligible at a glance—but the crossing of the Lukuledi depression, the ascent to the Rondo Plateau and the descent to the Mbemkuru, also lie within the bounds of probability, for all these districts have exactly the same character as the extreme south. Now, however, comes a point of especial interest for our bacteriological age. The primitive Makonde did not enjoy their lives in the marshy river-valleys.

Disease raged among them, and many died. It was only after they had returned to their original home near Mahuta, that the health conditions of these people improved. We are very apt to think of the African as a stupid person whose ignorance of nature is only equalled by his fear of it, and who looks on all mishaps as caused by evil spirits and malignant natural powers. It is much more correct to assume in this case that the people very early learnt to distinguish districts infested with malaria from those where it is absent.

This knowledge is crystallized in the ancestral warning against settling in the valleys and near the great waters, the dwelling-places of disease and death. At the same time, for security against the hostile Mavia south of the Rovuma, it was enacted that every settlement must be not less than a certain distance from the southern edge of the plateau. Such in fact is their mode of life at the present day. It is not such a bad one, and certainly they are both safer and more comfortable than the Makua, the recent intruders from the south, who have made USUAL METHOD OF good their footing on the western edge of the CLOSING HUT-DOOR plateau, extending over a fairly wide belt of country. Neither Makua nor Makonde show in their dwellings anything of the size and comeliness of the Yao houses in the plain, especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a Makonde hamlet not far from Newala, on the road to Mahuta, is the

most important settlement of the tribe I have yet seen, and has fairly spacious huts. But how slovenly is their construction compared with the palatial residences of the elephant-hunters living in the plain.

The roofs are still more untidy than in the general run of huts during the dry season, the walls show here and there the scanty beginnings or the lamentable remains of the mud plastering, and the interior is a veritable dog-kennel; dirt, dust and disorder everywhere. A few huts only show any attempt at division into rooms, and this consists merely of very roughly-made bamboo partitions. In one point alone have I noticed any indication of progress—in the method of fastening the door. Houses all over the south are secured in a simple but ingenious manner. The door consists of a set of stout pieces of wood or bamboo, tied with bark-string to two cross-pieces, and moving in two grooves round one of the door-posts, so as to open inwards. If the owner wishes to leave home, he takes two logs as thick as a man’s upper arm and about a yard long. One of these is placed obliquely against the middle of the door from the inside, so as to form an angle of from 60° to 75° with the ground. He then places the second piece horizontally across the first, pressing it downward with all his might.

It is kept in place by two strong posts planted in the ground a few inches inside the door. This fastening is absolutely safe, but of course cannot be applied to both doors at once, otherwise how could the owner leave or enter his house? I have not yet succeeded in finding out how the back door is fastened.

MAKONDE LOCK AND KEY AT JUMBE CHAURO

This is the general way of closing a house. The Makonde at Jumbe Chauro, however, have a much more complicated, solid and original one. Here, too, the door is as already described, except that there is only one post on the inside, standing by itself about six inches from one side of the doorway. Opposite this post is a hole in the wall just large enough to admit a man’s arm. The door is closed inside by a large wooden bolt passing through a hole in this post and pressing with its free end against the door. The other end has three holes into which fit three pegs running in vertical grooves inside the post. The door is opened with a wooden key about a foot long, somewhat curved and sloped off at the butt; the other end has three pegs corresponding to the holes, in the bolt, so that, when it is thrust through the hole in the wall and inserted into the rectangular opening in the post, the pegs can be lifted and the bolt drawn out.[50]

MODE OF INSERTING THE KEY

With no small pride first one householder and then a second showed me on the spot the action of this greatest invention of the Makonde Highlands. To both with an admiring exclamation of “Vizuri sana!” (“Very fine!”). I expressed the wish to take back these marvels with me to Ulaya, to show the Wazungu what clever fellows the Makonde are. Scarcely five minutes after my return to camp at Newala, the two men came up sweating under the weight of two heavy logs which they laid down at my feet, handing over at the same time the keys of the fallen fortress. Arguing, logically enough, that if the key was wanted, the lock would be wanted with it, they had taken their axes and chopped down the posts—as it never occurred to them to dig them out of the ground and so bring them intact. Thus I have

two badly damaged specimens, and the owners, instead of praise, come in for a blowing-up.

The Makua huts in the environs of Newala are especially miserable; their more than slovenly construction reminds one of the temporary erections of the Makua at Hatia’s, though the people here have not been concerned in a war. It must therefore be due to congenital idleness, or else to the absence of a powerful chief. Even the baraza at Mlipa’s, a short hour’s walk south-east of Newala, shares in this general neglect. While public buildings in this country are usually looked after more or less carefully, this is in evident danger of being blown over by the first strong easterly gale. The only attractive object in this whole district is the grave of the late chief Mlipa. I visited it in the morning, while the sun was still trying with partial success to break through the rolling mists, and the circular grove of tall euphorbias, which, with a broken pot, is all that marks the old king’s resting-place, impressed one with a touch of pathos.

Even my very materially-minded carriers seemed to feel something of the sort, for instead of their usual ribald songs, they chanted solemnly, as we marched on through the dense green of the Makonde bush:—