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You can throw out most of the management ideas you find in colleges, graduate schools, company training programs, and the like if you’ll do just one, incredibly simple thing: PAY YOUR PEOPLE EXCEPTIONALLY WELL. Management advocates have it backwards, you see. Their pet saying is that the art of management is getting average people to perform exceptionally well. What they leave off is a small tag line. Let me provide you with the entire phrase: “The art of management is getting average people to perform exceptionally well, without paying them anything extra for their productivity.” That’s truly the tacit definition of a good manager, and most of the industrial psychology, job engineering, and yes, management consulting during the past 80 years has been dedicated to this goal. “Make us more money without making us spend more money.” But, alas, human nature and life itself don’t work that way—for long, or without unleashing counter-forces such as unions, restrictive legislation, workers compensation claims, and lawsuits. Somehow, business owners think it’s “cheating” or “dumb” or self-defeating to pay people exceptionally well. They’d prefer to be clever, to invest in labor saving technologies, to cut out the human touch everywhere they can, instead of handing over living, and indeed, prospering wages. But recall, if you will, that practical experiment undertaken by Henry Ford, by no means a soft touch. Ford invented the “$5 Day.” To attract and recruit the very best laborers in America to work on his modern assembly lines he offered that astonishingly high wage. From what I understand, this more than doubled the prevailing rates. People thought Ford was crazy, and I’m sure he was vilified by his fellow captains of industry. But his move paid off. He did get the best available people to work for him, and together, they made very, very good money. From time to time there have been companies that have raised pay substantially, through salaries, profit-sharing, stock options, attractive retirement packages, and the like. And quite often, they’ve reaped a reward from their employees, by way of output and loyalty. But nothing is as direct or as motivating as more money in that pay envelope. Most of the silly stuff you hear about today, such as RESISTANCE TO CHANGE is easily overcome when we align people’s interests and commit to sharing the goodies, all around. Workers that are accused of being change-haters suspect, or actually know, that the “new and improved” work processes that are often mandated by management result in money being removed from their pockets, through downsizing, job enlargement, team-building, and other devices. Are you going to willingly support something that will make you work harder, longer, and for less? “How can we pay people MORE?” should be the question. Answer that, and people will manage themselves and their peers, because they’ll be only too happy to keep a good thing going! vig rx oil best penis enhancement pills permanent penis enargement safe pnis enlargement penis enlarement supplement penis enlargment system penis enlargement tip cheap penis enlargement pill

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"Masturbation ... is not approved of the Lord nor this church, regardless of what may be said by those whose 'norms' are lower", President Kimball of the Church of Jesus Christ of Latter-Day Saints (1981) "Every sperm is sacred. Every sperm is great. If a sperm is wasted, God gets quite irate." Monty Python's The Meaning of Life. A quote often used by various churches in an effort to contain illicit acts amongst its people. Every sermon on masturbation would quote it, atleast all the sermons I have heard. Under the circumstances, is it difficult to imagine masturbation as one of the biggest taboos in our society? Even today? Scientific education has done a little to change it. Does that mean men and women don't masturbate? Certainly not. 99% of men and 70% of women masturbate according to various studies. The problem lies in the acceptance of the fact that you masturbate. Let me tell you a story... a story about you. One night you were sitting alone in your appartment eating pizza. You decided to check out some new sites on the net while you eat. So you log on to your ISP and start surfing. Inadverantely, you come across some piece of pornography(yes, the net is quite full of it!) Looking at those erotic (and often downright nasty photos) you feel a tingling between your legs. One thing leads to another and you end up spoiling your underpants. Now let me tell you another story. One night you were sitting alone in a bar drinking beer. And then a most gorgeous person enters the bar. The person that causes tingling between your legs just looking at him or her. You decide that you can't let go of this oppurtunity to get to know this wonderful creation of god. So you move towards this person and start small talk. One thing leads to another and you end up in your appartment. Whether you are a woman or a man, the next morning you wouldn't be jumping with joy in the first case. When you go out in the evening to meet your friends, you would not tell them about the hot site you found and how you jerked off to it. Nevertheless, in the second case, you would be telling anyone who cared to listen how you had the most wonderful experience of your life last night. Why? Well, maybe because self pleasure is, well, nothing special. You can do it anytime you want. Ofcourse seducing the person of your dreams is quite an accomplishment. No wonder you need an audience. But what if you have a friend like me. A friend who is crazy enough to ask you did you wank off yesterday night? Was it good? What would you do then? Would you tell your friend about the hot site and your experience? Would you simply say, "Yeah! It was great! What about you?" Or would you pretend nothing had happened and lie... something like you were somewhere else yesterday night, or maybe lead your friend to believe you got lucky with someone? I am guessing you would do the latter. Most certainly you won't acknowledge the act of masturbation. Rather you would evade the question and change the topic. And when your friend tells you about a hot conquest the same night, you would wish you had a bowl of water in which you could drown. Shame and guilt would come over you and you would change the topic in double quick time. Are you crazy? Noway! You are just one of the majority. And quite a majority at that! Way more majority that what George Bush had in the last elections! The reason - social conditioning! You are just like the boy who ran out of the cinema hall that was screening an adult film (mind you, he had no business of being there in the first place! But all the cinemas care about is the sale of their tickets!) Later in the day, the friend who had been at the movies with him, caught up with him and asked, "Why in the hell's name did you run out?" The boy answered, "My mom said that if I watched a woman getting naked I would turn to stone. And damn you Harry, a part of me was already turning into stone!" Unluckily, the social conditioning is wrong. It is as wrong as the social condition in 18-19th century India, where widows were forced to burn alive with their husbands. As wrong as the church was in burning Galileo for implying the Earth was not the centre of the universe. Lily Tomlin put it best, "We have reasons to believe that man first walked upright to free his hands for masturbation!" If god didn't want us to masturbate, maybe we would still be walking like dogs and horses! The social conditioning is a result of numerous myths, lies and scams perperated by numerous individuals for personal benefit. Unfortunately, this conditioning is like a hard nut, very tough to crack. However, with effort and chanelising your energies, you can break it. Remember, the nuts that crack the hardest, are often the ones that taste the best! You must be wondering, how the hell does it matter if you feel guilty about masturbation. Why should you spend time breaking this casing? Certain psychologists believe that guilt conscious, whether sexual guilt or in any other form, is the most destructive element for your mental health. Others believe it is one of the most destructive. But the greatest effect of guilt conscious in my experience has been a lack of confidence in self. Now you are an intelligent reader. I don't need to explain you the importance of self confidence. Be it your career, relationships or any other aspect of life, lack of confidence can bring your downfall. Now I am not implying that should you start to feel more comfortable about masturbation, you would succeed in all aspects of life. But it would be a nice step to take. An useless guilt that should, and can be eradicated from your mind. Remember, an ocean is made of small droplets of water. Get rid of a drop at a time and in due time, the ocean would be empty! Ofcourse it would take several millenia! Luckily, you don't have an ocean full of guily! Just some naggings here and there! The first step towards eradication of this guilt is knowledge. There are thousands of myths around masturbation. Most of them perperated by religion, unfortunately. But some perperated by scam runners. Lets take a look at the most important ones. 1. Masturbation is against the will of god. Bullshit. At one point the church considered anyone who was overtly passionate to his wife an adultrater. Follow that teaching and your wife would be committing adultery! Several clergymen have gone on record to say that not only the church's teachings about sexuality were unrelated to the scriptures, but that they caused more harm than good amongst people. Besides, nowhere in the religious teachings of any major religions is masturbation considered wrong. 2. Masturbation will cause impotency. Most males and even some females seem to think so. Wrong again. Lets tackle the males first. It is understandable that seeing their sperm flow out of their body, they think it may end sometime. Well, it will end one day... maybe when you are 100 years old. But until then don't worry. Your sperm bank is quite unlike Standard Chartered. You have unlimited credit here! Sperm is a completely renewable resource, renewable on an hourly basis! For women, well, there is no basis in the theory. Probably perperated by old ladies who never had an orgasm in their entire life! 3. Masturbation causes acnes, hair loss, skin diseases. This one is my favorite. Mainly because it is one of the better scams of all times! Your social conditioning would have you believe that masturbation is bad for your health. But bad how? No one would give you a satisfying answer! Now some scam artists saw this as an good oppurtunity to sell their products like hair growth lotions, etc. Since most people start masturbating during their teens, (the times of acne and other skin problems), they would have you believe that this is caused by masturbation! Unluckily for them, this is as untrue as the sun rising from the west! Masturbation has no physical side effects! 4. Masturbating will make you thin and skinny! Then there would be no need for diet pills and fitness regimes my friend! And most certainly 70% of USA wouldn't be overweight! 5. Only Kids masturbate! Why would you say that? I wonder! Well quite untrue, most adults masturbate... yup even after marriage! 6. Masturbation is for males. And it is for 70% of the women too. Thats right, two thirds of all females masturbate! 7. Only losers masturbate! Another of my favorites. Just goes to show just how much of a taboo is masturbation! First thing, 99% of males and 70% of females have masturbated atleast once in their lives. Now that is a hell of a lot of losers don't you think! Nothing more that I can add really... this is really the epitome of insecurity amongst people regarding self pleasure. 8. Masturbation is for homosexuals. Wow. Where did that one originate! Someone must make a etymology of these myths, would make for an interesting read! Just as untrue as all these myths, masturbation and homosexuality have nothing in common. Some people masturbate to their fantasies of opposite sex, others to their fantasies of same sex. Thats it. 9. Masturbation will make you blind! Others claim that masturbation is bad for your eyesights. However, their claims are unsupported by facts and medical advice. I suggest you talk to your general physician and he will explain you what a load of bull this is. 10. Masturbation changes the shape of your penis Well, it does make it rock hard. But believe me, once you orgasm, the hardness is gone! So no. Masturbation has absolutely no effect on how your penis looks. There are loads more of these myths circulating around the world. If you have a query about masturbation, ask me, I would happily lay your fears to rest. My email is advice@pornographytimes.com Now lets move on in an attempt to get rid of your guilt. Clearly, all the reasons that made masturbation such a taboo are baseless. So why should you feel guilty about something that is normal and actually healthy? Healthy? Yes that too! This January, I recieved an email from a woman who had some major problems in her marriage. Due to her career and that of her husband, their sexual life was inexistant. Both held jobs in big MNCs and were frequently out of town. Sometimes, they would see each other once a month! Nevertheless, they were very much in love. Her problem was, that inspite of all their love, they were getting into petty fights with each other. The woman was even experiencing problems during work, getting angry for no apparent reasons, shouting on her team. Her temperament was a creation of the stress caused by extensive work and lack of pleasurable activities. Add to that sexual frustration. My advice to her was twofold. First, I told her that she would have to slow down, and so should her husband. They must make time for their hobbies, maybe try and get in some physical exercise when they could. Most certainly, they needed to see more of each other. They should onsider talking off a couple of days and just be together. Second, while she was alone, she should consider fantasy therapy. Namely, reading erotic novels, watching erotic movies... exciting herself and eventually masturbating as regularly as she could. Three months later, I recieved a thank you letter from her. Apparently she had put my advice to practice (which is quite rare!) and it had actually helped. (Which is not so rare!) How did masturbating help her? Because most of her problems arose from stress and lack of physical activities. And masturbation, like sex, is the perfect medicing. When you orgasm, your mind gets cleared of the regular day to day problems. Your body gets excited and the blood flow increases. Sometimes, you even sweat! A complete and perfect exercise for those with lack of time! The next step in getting rid of your guilt is self belief. Something, no outsider can help you with. Here is what I would counsel. Read as many articles on the internet as you can relating to masturbation. Just so that you know that I am not bullshitting you. Any queries you have, don't be afraid to ask me or another sex advisor on any of the reputed websites. Remember, the first step is knowledge and the second step is belief. And knowledge leads to belief. 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Recently I wrote an article entitled, "Future Internet: Collaboration without loss of individuality: Example 1: Ebay". Since then it has come to my attention that like all other areas of life the comedians and jokers have invaded and put their mark on this incredible new phenomenon. I am by no means against humour as I am a firm believer in the idea that laughter is the greatest medicine of all. If humanity just learned to laugh at ourselves a little bit more instead of taking everything in life so seriously, I think we could achieve both individual and social harmony much more quickly. There are several websites on the Internet already dedicated to weird things that have been offered and even bought on www.ebay.com. A few that I've seen are found at: http://www.whowouldbuythat.com/, http://www.weird-websites.com/WeirdEbay.htm, and www.whattheheck.com/ebay/. Certain eccentric as well as just plainly silly people have tried to sell anything from their own virginity (had to be a hoax) to the now infamous 'ghost in a jar'. The 'ghost in a jar' sale was so popular that a whole slew of copycats have followed suit ranging from 'ghost droppings' to a 'ghost in a bra'. The 'What the heck' site seems to have the most comprehensive list with items being categorised into: Fan favourites, People, Body parts and fluids, Animal Kingdom, Metaphysical Stuff, Face it you're addicted to Ebay, Technology and accessories, Health and Beauty, Dirt, Water etc, Just plain evil, Gross, Weird inventions, and Stuff we've yet to categorise. One of my favourites is for the sale of Snow. Here's what the seller had to say about the product: "So far, we've got over a foot, and it's still coming down. We really don't need more than a few inches here, so we're making the rest available to the highest bidder. Due to the perishable nature of snow, and because not even 4WD vehicles are having much luck on our local roads, the winning bidder must make arrangements for pickup. This snow doesn't pack very well, so you'll have to make your own packing arrangements as well. Note that I'm only offering the excess snow from our own property. If you need it, I may be able to arrange for you to get more. I'll accept cash or money order for payment. If you clear a path from Interstate 40 to my house, I'll discount your winning bid, charging only an amount equivalent to the Ebay fee for the closing bid. Take our snow, please..." I also laughed when I saw that drug-free urine, raccoon's penis bones, the Internet (someone bid 1 billion dollars-it's real worth would be priceless), nine used toothbrushes, dirt from the US civil War, a UFO Finder, a Russian sub (a real one!) and Absolutely Nothing were on sale. Here's what the seller said about the latter: "ABSOLUTELY NOTHING for sale, zero, zilch, nada. NO RESERVE on this vastly under appreciated commodity. Why suffer the disappointment of shelling out big bucks on junk you don't want, can't afford, and don't need, when, for a small fee, you can completely bypass the disappointment! You expect nothing, and that's precisely what you will get. I'm hoping I can build up a regular clientele for absolutely nothing, because finding nothing is much easier to acquire than most of the other items I sell. And shipping costs are minimal, because, well, nothing weighs nothing. And it's very cheap for me to buy, as it costs me nothing. So forget about those Beamers, those houses in the suburbs, those electronic gadgets, those fashionable clothes that are outdated before you leave the store; THEY won't bring you happiness, NOTHING will! The ancient Chinese Sage advised us that less is more. Therefore, NOTHING is most. Here is your chance to FINALLY get exactly what you've always deserved! Bid with confidence, because I guarantee NOTHING! Aren't you weary of everyone whining that they can't find NOTHING to buy? Well, here it is, ladies and gentlemen, step right up and mail me your dollars, I have an unlimited supply of what you really need most in your life, but were never quite sure how to acquire it. You could pay hundreds, thousands, even tens of thousands of dollars for the same thing from any one of a hundred political organizations, religious groups, or federally mandated taxing organizations, and not get one single thing that I'm not providing for a nominal fee of a $1.00 bid. And don't despair if you get sniped out at the last minute this week, I'll have a fresh supply available next week as well. Item is guaranteed to be exactly as described. California residents please add 8.25% sales tax." So, with every great step forward for humanity we have our tricksters helping us along with their great powers of humour. With Ebay a new way of collaborative consumerism has entered the so-called 'first world' psyche. The question is: Where do we draw the line between supply and demand for what we need to have a sustainable existence, and buying for the sake of addiction to shopping? I recently heard of a new term coined Affluenza. It is the disease of always wanting more money and material objects even if it means having a lesser quality of life. Hey, someone has even sold the 'Meaning of life' on Ebay for a mere $3.26! This article has an accompanying image that can be viewed at http://www.m6.net/articles/images/comic.gif top penile enlargement pills penis elargement surgery photo penis enlarement video vimax penis enlargement program best penis enargement pills do penis elargement pills work safe penile enlargement prosolution penile enlargement pills penis elargement excercises

It’s a sad fact that, in these modern times, somewhere between 10% and 20% of adult women have never experienced an orgasm, and as much as 50% of women don’t orgasm during sex. Sexual and sensual education have advanced to where we now understand much more about the female orgasm, such as the fact that women have two completely different places they can stimulate in order to bring themselves to full satisfaction. Since the vibrator was specifically created to allow women to experience orgasms, it remains the best tool for women to discover what they enjoy, and what stimulates them in the best way to achieve the ultimate O. The first step, of course, is acquiring a vibrator. Most “adult stores” are pretty cheesy and uncomfortable for women to shop in, which is why the internet is such a popular medium for adult toy shopping. Look at the pictures, read about the materials, and choose something you find attractive and that looks fun. This is the first step on a wonderful journey, so enjoy it! To have the best experience with your vibrator, give yourself some time with it. Before you even switch it on, get relaxed and turned on. Take a long bubble bath, read an erotic story, get yourself in the mood. For most women, orgasms are as much psychological as they are physiological. If your mind isn't in the right place, your body won't be either. Get comfortable on your bed, on a rug in front of your fireplace, or just stay in the tub if you’ve purchased a waterproof vibe. Relax, start slow, and get to know your vibrator and your body. Touch different parts of your genitals with your vibrator. Discover what feels good, then keep doing it. Let your arousal build and let nature take its course. There really isn't any "right" way to use a vibrator or to bring yourself to orgasm. The most important thing to remember is that a vibrator is a tool to help you stimulate yourself; while it can help you reach a climax, it's not an instant orgasm machine. You control it and use it in the way that feels best to you. Experiment with your vibrator, try its different features, and apply it to different areas of your body to see what the sensations are like. Most women respond to clitoral stimulation, but you may prefer more or less intensity, or more or less direct stimulation. The labia and vulva are also sensitive. If your vibrator is insertable, give that a try. Some women find penetration and vibration inside the vagina very pleasurable. A vibrator is the best tool you can use to find and stimulate your G-spot. This little node of pleasure is on the front wall of your vagina, a couple of inches in. It can take a few tries to find this spot, and not everyone who finds it actually likes it because of how sensitive it can be. Some women can't find it at all. All of these things are normal, so you just have to see what works for you. Many women need clitoral rather than vaginal stimulation to actually bring them to orgasm, so if vaginal penetration with your vibrator isn't getting you anywhere, go back to using the vibrator on your clitoris. One technique you can use with a smooth insertable vibrator is to place the tip against your clitoris, then slide the shaft down between your labia, insert the vibrator and slide it into your vagina, and then bring it back up in a reverse stroke, sliding along the clitoris again on the way up. Once you discover what feels good, keep doing it, relax, and let your arousal build. If you find that the vibrator brings you to the point of climaxing too quickly, back off and try a less intense form of stimulation, or even use your hand for a while and go back to the vibrator. You’ll find that, like many things, the more you practice achieving orgasm, the easier it’ll become. Orgasm during sex is whole different thing, of course. One of the best things you can do is simply to masturbate often and keep all of your sexual organs in good shape. Masturbation helps your body to establish a habit of orgasming - if you can bring yourself to orgasm every time you get turned on, your body learns how to get there more easily when you're having sex with someone else. Easy, practical things you can do to help your body are drinking lots of water and avoiding alcohol to keep everything downstairs healthy and lubricated. Do your Kegels – these exercises tone and tighten the muscles you use during sex, heightening the sensations you experience during sex. A set of Smartballs (an updated, silicone-coated version of Ben Wa balls) are a really easy, comfortable way to keep your PC muscles in shape. If you are like most women, and you orgasm from clitoral stimulation, there are a hundred toys out there you can wear during sex. These vibrators are designed to stimulate your clitoris during sex. Probably the easiest to use are vibrating penis-rings, which your partner wears around his penis and has an attachment where you can insert a vibrating bullet. A nice version of this is the Clearly Sensual Vibrating Cock Ring. Another fun toy you can use during sex is a strap-on clitoral stimulator such as the Venus Butterfly or the Micro Butterfly Arouser. Elastic straps around the waist and/or thighs hold a small vibrator in place while you make love. One of the more unique toys of this nature is the Vibrating Lover’s Thong, which not only vibrates on your clitoris, but has a double row of beads that stimulate your lover as he moves in and out. Technology and research have opened up a whole new world of possibilities when it comes to female orgasms. Take advantage of what’s available, and you may find yourself fulfilled in ways you never imagined possible. penis enlargment penile enlargement before and after photo natural penis enlargement and lengthening magna rx picture testimonials free penis elargement video penis enlagement doctor manual penis enlargment penis enlagement technique penis elargement excercises

Many people assume they need to consume Alcohol to have Good Sex? For most Americans, consuming alcohol seems to be part of our cultural heritage. We drink at weddings, funerals, birthdays, and pretty much to celebrate anything and everything. We learned from a young age by watching our parents and other adults, that drinking is a sign of maturity. Many people, especially young adolescents, expect that alcohol use will lower tension and anxiety and increase sexual desire and pleasure in life (Seto & Barbaree,1995). About 1 in every 7 adults in the United States meet criteria for alcohol dependency, according to a large NIMH epidemiological study (Grant, 1977). Men are four times more likely than women to be heavy drinkers and are twice as likely to be alcohol abusing or alcohol dependant. Most males and many females find it difficult to imagine not drinking any alcohol at least on weekends and find it almost impossible to think of having sex without previously having a few drinks. These fundamental values appear to be deeply embedded in our culture. Somewhere along the line, we got the message that we need alcohol to have good sex. Does Alcohol Enhance or Hurt our Sexual Performance? I recently heard a stand-up comedian refer to the term, “Whiskey – Dick” when describing his “friends who had drank too much and had difficulties with orgasm even while using Viagra. Shakespeare once said that excessive drinking, “provokes the desire but takes away the performance.” Alcohol reduces inhibitions and gives us a mellow feeling. It makes us more relaxed and more talkative. It can make shy people fe//el confident and bold. These effects can facilitate our sexual desires by developing our social skills. However, these positive effects are only present in the early stage of intoxication i.e. when we’ve consumed 1-2 drinks (assuming you haven’t already developed a tolerance for alcohol). Sexual Impotence On the other hand, alcohol’s negative effects on sexual performance have been widely documented. Men and women who have several drinks may find it very hard to achieve orgasm. Difficulties with achieving orgasm after alcohol consumption can be understood because alcohol dilates small blood vessels all over the body so that there is less engorgement of blood in the sexual organs. This leaves the penis flaccid or only partially erect so that sexual penetration is difficult. Women may find that they have decreased vaginal lubrication making sexual intercourse unpleasant and sometimes painful (Raff, 2006). Impotence is the constant inability of a man to maintain an erection for sexual purposes. It is estimated that impotence affects over 30 million men in the United States (NIHCS, 1992). Masters and Johnson, identified alcohol as a common factor in impotence in their monumental work on human sexual inadequacy. Alcohol damages the central nervous system and destroys brain cells, and if the damage is prolonged enough, it can result in irreversible sexual impotence even while a person is sober. Alcohol is also a factor in loss of sexual control or premature ejaculation. Even a couple of beers before sex can spoil a man's erection and ruin his ejaculatory control. Up to 80 percent of men who drink heavily are believed to have serious sexual side effects, including impotence, sterility, or loss of sexual desire. Heavy drinking over a long period of time can irreversibly destroy testicular cells, leaving men with shrunken testicles. Both sexual drive and sexual capacity can be damaged. Alcohol also suppresses testosterone levels even in social drinkers by suppressing the secretory activity of the Leydig cells (Flatto, 1990). Alcohol and High-Risk Sexual Behaviors A history of heavy alcohol use has been correlated with a lifetime tendency toward high-risk sexual behaviors, including multiple sex partners, unprotected intercourse, sex with high-risk partners (e.g., injection drug users, prostitutes), and the exchange of sex for money or drugs (Windle,M.,1997). There may be many reasons for this association. For example, alcohol can act directly on the brain to reduce inhibitions and diminish risk perception (MacDonald,T.K.,2000). However, expectations about alcohol’s effects may exert a more powerful influence on alcohol-involved sexual behavior. Studies consistently demonstrate that people who strongly believe that alcohol enhances sexual arousal and performance are more likely to practice risky sex after drinking (Cooper,M.L.,2002). Some people report deliberately using alcohol during sexual encounters to provide an excuse for socially unacceptable behavior or to reduce their conscious awareness of risk (Derman,K.H.,1998). According to McKirnan and colleagues (McKiran,D.J.,2001), this practice may be especially common among men who have sex with men. This finding is consistent with the observation that men who drink prior to or during homosexual contact are more likely than heterosexuals to engage in high-risk sexual practices (Avins,A.L.,1994). Alcohol and AIDS People with alcohol use disorders are more likely than the general population to contract HIV (human immunodeficiency virus) - the agent that causes acquired immunodeficiency syndrome (AIDS). Similarly, people with HIV are more likely to abuse alcohol at some time during their lives (Petray,N.M.,1999). Alcohol use is associated with high-risk sexual behaviors and injection drug use, two major modes of HIV transmission. What are signs of problem drinking? The primary signs of problem drinking are: Having health, legal, social, academic or financial problems as a result of drinking. For example, missing class or work because of drinking or hangovers, not be able to have fun or express oneself without drinking, fights or problems with roommates or significant others, spending excessive amounts of money on alcohol, blackouts/passing out, trips to the ER, being defensive when someone mentions your drinking, needing to drink more to achieve the same effects (tolerance), frequently drinking with the primary purpose of getting drunk, and/or repeatedly driving under the influence. These are only guidelines and each case is different. If you're concerned about your drinking or a friend's drinking, get more information! Screening for Alcohol Dependence Screening tools are available to assist counselors and therapists with diagnosing alcohol abuse and dependence such as the SMAST below. Short Michigan Alcoholism Screening Test (MAST) 1. Do you feel you are a normal drinker? (By normal we mean you drink less than or as much as most other people.) 2. Does your wife, husband, a parent, or other near relative ever worry or complain about your drinking? 3. Do you ever feel guilty about your drinking? 4. Do friends or relatives think you are a normal drinker? 5. Are you able to stop drinking when you want to? 6. Have you ever attended a meeting of Alcoholics Anonymous? 7. Has drinking ever created problems between you and your wife, husband, a parent, or other near relative? 8. Have you ever gotten into trouble at work because of drinking? 9. Have you ever neglected your obligations, your family, or your work for two of more days in a row because you were drinking? 10. Have you ever gone to anyone for help about your drinking? 11. Have you ever been in a hospital because of drinking? 12. Have you ever been arrested for drunken driving, driving while intoxicated, or driving under the influence of alcoholic beverages? 13. Have you ever been arrested, even for a few hours, because of other drunken behavior? Individuals that answer – Yes to three or more questions indicate probable alcoholism, two yes answers indicate probable alcoholism, and fewer than two yes answers indicate that alcoholism is not likely (Selzer, M., Winokur, A. & Van Rooijen, C.; 1975). Note: If after reading the above, you started rationalizing to yourself, “Well, I can stop drinking anytime I want to, but I usually stop when I run out of money.” (As my old graduate professor use to say) STOP BULL-SH#%ting yourself and go see a certified alcohol counselor. Co-morbidity & Alcohol Dependence Alcohol abuse and dependence are among the most destructive of the psychiatric disorders (Volpicelli, 2001). Addictions such as alcohol dependence and other addictions as a rule do not develop in isolation. Over 37 % of alcohol abusers suffer from at least one coexisting addiction and/ or mental disorder (Rovner, 1990). Individuals can shift from one addiction to another or sustain multiple addictions at different times. The National Co-morbidity Survey (NCS) that sampled the entire U.S. population in 1994, found that among non-institutionalized American male and female adolescents and adults (ages 15-54), roughly 50% had a diagnosable Axis I mental disorder at some time in their lives. This survey’s results indicated that 35% of males will at some time in their lives have abused substances to the point of qualifying for a mental disorder diagnosis, and nearly 25% of women will have qualified for a serious mood disorder (mostly major depression). A significant finding of note from the NCS study was the widespread occurrence of co-morbidity among diagnosed disorders. It specifically found that 56% of the respondents with a history of at least one disorder also had two or more additional disorders. These persons with a history of three or more co-morbid disorders were estimated to be one-sixth of the U.S. population, or some 43 million people (Kessler, 1994). Poor Prognosis We have come to realize today more than any other time in history that the treatment of lifestyle diseases and addictions such as alcoholism are often a difficult and frustrating task for all concerned. Repeated failures abound with all of the addictions, even with utilizing the most effective treatment strategies. But why do 47% of patients treated in private treatment programs (for example) relapse within the first year following treatment (Gorski,T., 2001)? Have addiction specialists become conditioned to accept failure as the norm? There are many reasons for this poor prognosis. Some would proclaim that addictions are psychosomatically- induced and maintained in a semi-balanced force field of driving and restraining multidimensional forces. Others would say that failures are due simply to a lack of self-motivation or will power. Most would agree that lifestyle behavioral addictions are serious health risks that deserve our attention, but could it possibly be that patients with multiple addictions are being under diagnosed (with a single dependence) simply due to a lack of diagnostic tools and resources that are incapable of resolving the complexity of assessing and treating a patient with multiple addictions? New Proposed Diagnosis Since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning, it is no wonder that repeated rehabilitation failures and low success rates are the norm instead of the exception in the addictions field. Treatment clinics need to have a treatment planning system and referral network that is equipped to thoroughly assess multiple addictions and mental health disorders and related treatment needs and comprehensively provide education/ awareness, prevention strategy groups, and/ or specific addictions treatment services for individuals diagnosed with multiple addictions. Written treatment goals and objectives should be specified for each separate addiction and dimension of an individuals’ life, and the desired performance outcome or completion criteria should be specifically stated, behaviorally based (a visible activity), and measurable. To assist with resolving this problem a multidimensional diagnosis of “Poly-behavioral Addiction,” is proposed for more accurate diagnosis leading to more effective treatment planning. This diagnosis encompasses the broadest category of addictive disorders that would include an individual manifesting a combination of alcohol and substance abuse addictions, and other obsessively-compulsive behavioral addictive behavioral patterns to pathological gambling, religion, and/ or sex / pornography, etc.). Behavioral addictions are just as damaging - psychologically and socially as alcohol and drug abuse. They are comparative to other life-style diseases such as diabetes, hypertension, and heart disease in their behavioral manifestations, their etiologies, and their resistance to treatments. They are progressive disorders that involve obsessive thinking and compulsive behaviors. They are also characterized by a preoccupation with a continuous or periodic loss of control, and continuous irrational behavior in spite of adverse consequences. Poly-behavioral addiction would be described as a state of periodic or chronic physical, mental, emotional, cultural, sexual and/ or spiritual/ religious intoxication. These various types of intoxication are produced by repeated obsessive thoughts and compulsive practices involved in pathological relationships to any mood-altering substance, person, organization, belief system, and/ or activity. The individual has an overpowering desire, need or compulsion with the presence of a tendency to intensify their adherence to these practices, and evidence of phenomena of tolerance, abstinence and withdrawal, in which there is always physical and/ or psychic dependence on the effects of this pathological relationship. In addition, there is a 12 - month period in which an individual is pathologically involved with three or more behavioral and/ or substance use addictions simultaneously, but the criteria are not met for dependence for any one addiction in particular (Slobodzien, J., 2005). In essence, Poly-behavioral addiction is the synergistically integrated chronic dependence on multiple physiologically addictive substances and behaviors (e.g., using/ abusing substances - nicotine, alcohol, & drugs, and/or acting impulsively or obsessively compulsive in regards to gambling, food binging, sex, and/ or religion, etc.) simultaneously. New Proposed Theory The Addictions Recovery Measurement System’s (ARMS) theory is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between multiple risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. Multiple influences trigger and operate within high-risk situations and influence the global multidimensional functioning of an individual. The process of relapse incorporates the interaction between background factors (e.g., family history, social support, years of possible dependence, and co-morbid psychopathology), physiological states (e.g., physical withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). To put it simply, small changes in an individual’s behavior can result in large qualitative changes at the global level and patterns at the global level of a system emerge solely from numerous little interactions. The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The ARMS’ theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension. The ARMS acknowledges the complexity and unpredictable nature of lifestyle addictions following the commitment of an individual to accept assistance with changing their lifestyles. The Stages of Change model (Prochaska & DiClemente, 1984) is supported as a model of motivation, incorporating five stages of readiness to change: pre-contemplation, contemplation, preparation, action, and maintenance. The ARMS theory supports the constructs of self-efficacy and social networking as outcome predictors of future behavior across a wide variety of lifestyle risk factors (Bandura, 1977). The Relapse Prevention cognitive-behavioral approach (Marlatt, 1985) with the goal of identifying and preventing high-risk situations for relapse is also supported within the ARMS theory. Conclusions Considering the wide range of alcohol abuse and sexual behaviors in our world today, one should always take into account an individual’s ethnic, cultural, religious, and social background prior to making any clinical judgments, and it would be wise to not over-pathologize in this area of Dependency. However, since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning - poly-behavioral addiction needs to be identified to effectively treat the complexity of multiple behavioral and substance addictions. Since chronic lifestyle diseases and disorders such as diabetes, hypertension, alcoholism, drug and behavioral addictions cannot be cured, but only managed - how should we effectively manage poly-behavioral addiction? The Addiction Recovery Measurement System (ARMS) is proposed utilizing a multidimensional integrative assessment, treatment planning, treatment progress, and treatment outcome measurement tracking system that facilitates rapid and accurate recognition and evaluation of an individual’s comprehensive life-functioning progress dimensions. The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The ARMS’ theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension. Partnerships and coordination among all service providers, government departments, and health insurance organizations in providing treatment programs are a necessity in addressing the multi-task solution to Alcohol Abuse and Poly-behavioral addictions. 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