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SAT Program
There have been numerous articles and media coverage on the SAT program since its creation. The following provides a brief overview of a particular coverage:
  • People, December 18, 2000

    Bad to Worse

    Dr. Manijeh Nikakhtar, a Los Angeles psychiatrist and the author of Addiction or Self Medication: The Truth, says she received a letter from an imprisoned Downey in 1999 asking for advice on his condition. She reviewed his previous psychiatric evaluations and discovered “no one had done a complete evaluation,” she says. “I asked him flat out if he thought he was bipolar, and he said, ‘Oh yeah. There are times I spend a lot of money and I'm hyperactive, and there are other times I'm down.”' Yet instead of receiving treatment for that disorder, Nikakhtar says, Downey has invariably been referred to 12-step programs, which focus on his addictions (More).

  • Robert Downey Jr
    Freedom at last
    SAT Program
    CNN Programs - People in the News

    Actor's toughest role

    Beating addiction a struggle for troubled star

    (CNN)- "For the past several years, he has been through the revolving door of rehab programs and being arrested. It is so sad that such a bright person, his own life, his family life, life of his kid are all being destroyed because he really wants to feel better," said Dr. Manijeh Nikakhtar, a psychiatrist who received a letter from Downey while he was in prison. "He's not a criminal. He's a victim of drugs." Downey requested information about Nikakhtar's treatment methods, which go against the traditional 12-step type programs of drug rehabilitation.

    Nikakhtar visited Downey in prison, but she never formally treated him. "Nobody uses drugs for the sake of using drugs," she said. "Nobody is using drugs to get arrested or saying I am proud of using drugs. They usually hide using drugs. They feel bad about using drugs." Four months after Downey 's August 2000 prison release, he was arrested on Thanksgiving weekend for alleged cocaine and Valium possession and being under the influence of drugs. The Valium charge was reduced to a misdemeanor in May. (More).


  • Robert Downey Jr
    Freedom at last
    SAT Program
    Vanity Fair, August 2000

    Dr. Manijeh Nikakhtar, a psychiatrist and U.C.L.A. professor, has visited Downey in prison. She has two words for his pain: bipolar disorder. "So Robert has been self-medicating himself," she says.

    "He needs to be treated for his psychiatric disorder, not to be punished."

    Roughly 180 miles northwest of Los Angeles, a good three-hour drive up Highway 99, a prison stands under a hard gray sky. Pull over at any exit along the way--Earlimart, Pixley, Weed Patch--and you will likely see wild dogs roaming in packs or goats loitering outside nameless gas stations. Except for the prison itself--a barracks-like facility holding more than 6,000 inmates--there is nothing here but California wasteland, mile after mile of dry dirt. "In the winter it feels like you've landed on the surface of the moon," says Curtis Hanson, director of L.A. Confidential and Wonder Boys. "It's so desolate and sterile and depressing." This is where Robert Downey, Jr. one time Oscar nominee turned Inmate No. P50522-has been doing time since August 1999.
International Academic to Speak on Addiction
International Academic to Speak on Addiction

During the summer of 2001 a series of six seminars that focused on special topics in addiction and recovery were held at the Center for Inquiry–West and the SHARE! Facility in Marina del Rey, CA. 5. This SOS special series will be repeated at the new Center for Inquiry–West facility, Hollywood, CA, in 2002. SOS conveners are free to utilize this published material in SOS meetings as they see fit. In the current issue of the newsletter we offer the fifth installment of this continuing series of six seminars entitled "Recovery and the Dynamics of Aggression and Addiction." The topics for the series of six seminars are:

1. Nature and Nurture in the Cycle of Addiction

2. Understanding the Underlying Dynamics of Addiction

3. Brief Biological Review of Addiction and


4. The Mind, Its Function, and Addiction:

The Psychoanalytic View

5. Recovery and the Dynamics of Aggression and Addiction

6. Resolving Conflicts and Lifelong Recovery

Recovery and the Dynamics of Aggression and Addiction

by Manijeh Nikakhtar, M.D., M.P.H. and Louis F. Markert, Ph.D.

In our last article, we discussed the psychoanalytic view of the structure and function of the mind. We said that the mind, both conscious and unconscious, consists of three "systems" (id, ego, and superego) that vie for control or dominance. Healthy individuals live meaningful and productive lives by maintaining these systems in a state of balance or equilibrium. Unhealthy individuals fail to maintain such a balance. We will now expand this discussion by exploring the dynamics of aggression and assertiveness and their role in addiction and recovery.

Classical psychoanalytic theory holds that there are two classes of biological instincts or drives that govern motivation and behavior: Eros, or the life instincts, that push us toward self-preservation and pleasurable activities; and Thanatos, or the death instincts, that push us toward rest, inactivity and energy conservation. Eros includes sex, defined broadly as all pleasurable activity, and Thanatos included aggression. Both of these instincts provide biopsychic energy that must be guided or directed through the balancing function of the ego into socially adaptive and appropriate behavior. When the ego (the rational, realistic self) is effective in its function and leads the individual to appropriate goal-directed behavior, needs are met, anxiety and tension reduced, and a state of biological-psychological homeostasis achieved.

Aggression as Goal-directed Behavior

Contemporary psychoanalytic theorists, however, view basic "instincts" (e.g. aggression) more as psychological wishes and desires than strictly physiological drives. Thus, aggressive behaviors are seen as outlets for personal, social, cognitive wishes more than just biological drives. They explain the manifestations of aggression, such as rape, suicide, self-destruction, some cases of drug use, some acts of religious fanaticism, and high-risk gambling as ways of coping with and adjusting to life. Individuals are aware, consciously or unconsciously, of their "present state," but, on encountering life situations, perceive a more favorable or "ideal state." For example, a man might wake up in the morning and go to work routinely, feeling happy and no animosity toward anyone. At work, however, he is insulted or ridiculed, or worse, finds out his company is going bankrupt and he’ll shortly be out of work. The mismatch between his new "present state" (anxious, angry, insecure, upset) and his "ideal state" (happy, relaxed, secure, confident) moves him to wish for the present state to be closer to the ideal state and to act on this wish. He has a number of aggressive options, including removing his inhibitions by use of alcohol or drugs, assaulting his boss or co-workers, or committing suicide. And he has some prosocial options, such as standing up appropriately to those who insult him or beginning to update his resume and mount a job search to keep his career going.

Have you ever found yourself in an "undesirable present state" and sought through aggressive behaviors to change your situation to a more "ideal or desired state"?

Aggression is a hostile reaction triggered by anger or frustration resulting from obstacles we encounter in our effort to achieve our goal. Psychologically, our goal is usually to feel good, to not feel bad. Aggression is evoked by cues, such as social injustice or someone cutting in front of us on the freeway. Some aggression is instrumental in the sense that we act aggressively to achieve a goal. For example, we assault someone so we can rob him, or we inject heroin so we don’t have to feel stress.

If the conflicts of life are severe enough, major changes in behavior may occur as indirect expressions of instinctual aggressive needs. The perception of others and situations as dangerous or threatening can increase our tendency to develop defensive behaviors to diminish unpleasant feelings. Failure to achieve an appropriate sense of "success" and recognition in childhood, for example, can be a major source of anxiety, which may then be compensated for through competitive and mastery behavior. This competitiveness may progress from childhood experience to adulthood as aggression when one anticipates situations with feelings of inadequacy, failure or rejection.

  • International Academic to Speak on Addiction

    Beginning the SOS 2000 Clean and Sober event series, Manijeh K. Nikakhtar, M.D., M.P.H., founder of SAT Health Center, a revolutionary secular outpatient recovery program, will speak on "Addiction or Self-Medication: the Truth." Dr. Nikakhtar is a world-renowned professional in the field of psychiatry and psychoanalysis (More).


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