Breaking the Addiction to Please: Goodbye Guilt.
Article Type: Book review
Subject: Books (Book reviews)
Author: Yeomans, Simone
Pub Date: 06/22/2010
Publication: Name: Annals of the American Psychotherapy Association Publisher: American Psychotherapy Association Audience: Academic; Professional Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2010 American Psychotherapy Association ISSN: 1535-4075
Issue: Date: Summer, 2010 Source Volume: 13 Source Issue: 2
Topic: NamedWork: Breaking the Addiction to Please: Goodbye Guilt (Nonfiction work)
Persons: Reviewee: Barbanell, Les
Accession Number: 233501753
Full Text: Breaking the Addiction to Please: Goodbye Guilt By Les Barbanell

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This is Dr. Les Barbanell's second book about what he has come to term the "Caretaker Personality Disorder." His first book about the topic, Removing the Mask of Kindness: Diagnosis and Treatment of the Caretaker Personality Disorder, was published in 2006.

In Breaking the Addiction to Please, Barbanell does a fine job explaining his theory that taking care of someone else can take on addictive dimensions that necessitate a thorough recovery process similar to recovering from other forms of addictions. He locates the roots of unhealthy needs to please others in traumatic childhood experiences related to emotional, physical, and sexual abuse that resulted in real or perceived abandonment, which in turn is unconsciously addressed by overcompensating to such a degree that the "please addict" will sacrifice his/ her own needs in order to avoid a repeat of the original trauma. According to Barbanell, however, the effect of over-pleasing others frequently turns out to be a rerun of the traumatic experience: Because of a lack of mutuality that includes a healthy balance of giving and receiving, please addicts are often taken for granted and taken advantage of, and so remain largely invisible for who they really are or want to be until they have exhausted their emotional reservoirs.

While Barbanell appears to draw from a wealth of professional experience, includes numerous examples from his practice, touches on doubtlessly important areas related to the addiction to please, and offers a "Selfless Personality Scale" that could prove valuable in a clinical setting, anyone expecting a more scholarly approach to the topic will be disappointed. With a list of only seven references that include his own book (mentioned above) along with five others published between 1957 and 1986, Breaking the Addiction to Please appears to be an invitation to discuss the possibility of the caretaker personality disorder rather than a substantiated account of how this disorder differs from or overlaps with others already included in the DSM-IV-TR. In Chapter 5, for instance, Barbanell offers a brief comparison with the narcissistic personality disorder. However, as his discussion of trauma and the self, his account of the narcissist in relation to the caretaker remains in the very first stages of acknowledging the complexity of the topic. Along the same line, Barbanell appears to place great emphasis on the role of the unconscious as the major source of both emotional survival of abuse as well as an initial hindrance to recovery, yet his discussion of it remains oversimplified.

Barbaneli has offered a new diagnostic category for the spectrum of personality disorders that appears worth considering. However, before it could be considered for inclusion in the DSM and thus also as an insurance category, it will need to be supplemented by thorough research to justify its diagnostic difference from already existing personality disorders.

--Reviewed by Simone Yeomans, Ph.D., M.S., MFT
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