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How to Become a Substance Abuse Counselor – Step by Step Video

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Counselor Interns HeadQuarters

Whether you are an undergraduate student considering a career in substance abuse counseling, or a graduate student contemplating  the possibility of changing careers, this video will give step-by-step instructions to become a substance abuse counselor in the US.

You can follow the instructions while watching the video. Simply open a new tab where you can do each step.

For substance abuse counselors in Texas (LCDC), visit the Eligibility Criteria and Application Requirements, in the LCDC page under the Counseling Licenses tab.

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LCDC Checklist: Eligibility and CI Registration

Applying for registration as a counselor intern (CI) is the first step towards becoming a Licensed Chemical Dependency Counselor (LCDC)

To be eligible for a CI registration, a person must:

(1) be at least 18 years of age…read more Counselor Interns HeadQuaters: LCDC

Substance Abuse Counseling – The Profession

The substance abuse counseling profession is a vocation or occupation that requires advanced education and training. Twenty years ago, treatment was provided by people in recovery from alcohol and other drug (AOD) addictions, who would only use their own experiences to help others. The problem with this is that recovering individuals do not know how to treat different issues that co-occur with addiction such as poly-drug use and mental disorders. Although recovering individuals are able to relate to others dealing with addictions, mainly to the same drug of choice, they do not have the training and the skills to understand the differences among drugs of abuse, their effects on the brain and the body, and the believes and attitudes of people from diverse cultural and ethnical backgrounds.

The substance abuse prevention field is in its early stages, i.e., it is just developing as a discipline. The goal is to create standards of training and practice so that practitioners are able to handle the complexity of substance abuse and everything that comes with it. Part of the training for alcohol, tobacco, and other drug (ATOD) prevention professionals, is to explore their own attitudes about ATOD. It is not surprising to find practitioners who debate over terminology such as recovered vs. recovering addict, or the 12-Steps and the Big Book vs. religion and the bible.

Concepts such as use, abuse, misuse, dependence, and addiction vary from person to person. Substance abuse prevention professionals need to keep in mind that use and abuse of substances is not determined by their own experiences, but by standard definitions. For instance, substance use is the ingestion of alcohol or other drugs (AOD) without experiencing any negative consequences. Substance misuse is when a person experiences negative consequences from the use of AOD, or when the use of them is illegal. Substance abuse is the continued use of AOD in spite of negative consequences.

Addiction, also called dependence, is the compulsive use of alcohol, tobacco, and other drugs (ATOD) regardless of the consequences.

Substance abuse prevention strategies used in the past have been ineffective. Strategies such as Just Say No, Prohibition, and the illegalization of drugs that used to be legal, have not given the results expected. The criminalization of people who suffer from addiction is probably one of the least effective strategies.

Research in substance abuse prevention is helping develop effective theories that include risk and protective factors and resiliency, just to mention a few.

Reference: Substance Abuse Prevention – Julie A. Hogan 

Rational Emotive Behavior Therapy (REBT) – Albert Ellis

1. View of Human Nature

a. REBT assumes that the individual has the capacity to be completely rational, irrational, sensible or crazy, which Ellis believed is biologically inherent .
b. Ellis was most concerned with irrational thinking especially that which creates upsetting or irrational thoughts.
c. Most common irrational beliefs that clients find disturbing (Ellis, 1984, p.266)

i. It is absolutely essential to be loved or approved of by every significant person on one’s life.
ii. To be worthwhile, a person must be competent , adequate, and achieving in everything attempted.
iii. Some people are wicked, bad, and villainous and therefore should be blamed or punished.
iv. It is terrible and a catastrophe whenever events do not occur as one hopes.
v. Unhappiness is the result of outside events, and therefore a person has no control over such despair.
vi. Something potentially dangerous or harmful should be cause to great concern and should always be kept in mind.
vii. Running away from difficulties and responsibilities is easier than facing them.
viii. A person must depend on others and must have someone stronger on whom to rely.
ix. The past determines one’s present behavior and thus cannot be changed.
x. A person should be upset by the problems and difficulties of others.
xi. There is always a right answer to every problem, and a failure to find this answer is a catastrophe.

d. Individuals are easily disturbed because of gullibility and suggestibility
e. Ellis was a proponent of the individual thinking of their behavior as separate from their personhood, i.e. “I did a bad thing” rather than “I am a bad person.”
f. Ellis believed that each individual has the ability to control their thoughts, feelings and their actions. In order to gain this control, a person must first understand what they are telling themselves (self-­talk) about the event or situation .
g. Cognitions about events or situations can be of four types: positive, negative, neutral, or mixed. These cognitions result in similar thoughts with positive leading to positive thoughts, negative leading to negative thoughts, etc.

2. Role of the Counselor

a. Counselors are direct and active in their teaching and correcting the client’s cognitions.
b. A good REBT counselor must be bright, knowledgeable, empathetic, persistent, scientific, interested in helping
others and use REBT in their personal lives (Ellis, 1980).
c. The counselor does not rely heavily on the DSM-­IV categories.

3. Goals

a. The primary goal is to help people live rational and productive lives.
b. REBT helps people see that it is their thoughts and beliefs about events that creates difficulties, not the events or situations themselves
c. REBT helps the client to understand that wishes and wants are not entitlements to be demanded. Thinking that involves the words must, should, ought, have to, and need are demands, not an expression of wants or desires.
d. REBT helps clients stop catastrophizing when wants and desires are not met
e. REBT stresses the appropriateness of the emotional response to the situation or event. An situation or event need not elicit more of a response than is appropriate
f. REBT assists people in changing self-­defeating behaviors or cognitions
g. REBT espouses acceptance and tolerance of self and of others in order to achieve life goals

4. Techniques

a. The first few sessions are devoted to learning the ABC principle:

i. Activating event
ii. Belief or thought process
iii. Emotional Consequences

b. Cognitive disputation is aimed at asking the client questions challenging the logic of the client’s response.
c. Imaginal disputation has the client use imagery to examine a situation where the become upset. The technique is used in one of two ways:

i.The client imagines the situation, examines the self-­talk, and then changes the self-­talk leading to a more moderate response.
ii.The client imagines a situation in which they respond differently than is habitual, and are asked to examine the self-­talk in this

d. The Emotional Control Card is an actual card intended for the client to carry in their wallet which has a list of inappropriate or self-­destructive feelings countered with appropriate nondefeating feelings. In a difficult situation, the client has this reference card on their person to help them intervene in their own self-­talk. (source: http://www.liverehab.com/rational-emotive-behavioral-therapy)
e. Behavioral disputation involves having the client behave in a way that is opposite to the way they would like to respond to the event or situation.
f. Confrontation occurs when the counselor challenges an illogical or irrational belief that the client is expressing.
g. Encouragement involves explicitly urging the client to use REBT rather than to continue self-­defeating responses.

Study Materials: Learn About the Addiction Counseling Field

Hello dear readers and subscribers,

This is just a quick reminder of the new study materials available for you to download, print, share, etc…

Visit the Downloads page to download documents in pdf.

Visit the Resources page for suggested textbooks, websites, videos, and more…all about the substance abuse counseling field.

Visit the Online Quizzes for links to practice quizzes. No passwords or any other requirements are needed.

Visit the home page (click on header image) to check out the headlines of my posts from my other blogs.

Remember: The study guide for IC&RC ADC exam will be moved to my Blogger blog http://lcdcecstudyguide.blogspot.com/. The WordPress blog (the one you are reading right now) will still have some of the previous content from the study guide. However, I will publish many other things that are not included on the test.

I hope this is helpful. Feel free to contact me with any questions and suggestions you have.

Reasons for Using Substances

Contributor: Yvette McBride Thomas

People like to feel good. Many experiences in our world are geared toward altered states of consciousness–natural highs. These “natural highs” are derived from many experiences: roller coaster rides, skydiving, white water rafting, dancing, or anything else that can produce an adrenaline rush. Our enjoyment of these sensations begins at an early age. Small children will spin around in circles or scare each other in order to feel this altered state of consciousness. Unfortunately, “artificial highs” from drugs or alcohol are easier to obtain than natural highs, and drugs are readily available to children at an early age. The following seem to be the most common reasons for drug use today.

Parental or Guardian Influence

As seen in the previous section, the “pill for every ill” attitude that is seen in the home has a major impact on children. Approximately 80% of children’s values, morals, work ethic and attitude are derived before age 8. A child is exposed to his/her parents for the majority of his/her life before age 8. Therefore, parents will have the greatest influence on their children. A child learns many lifelong habits and attitudes from his/her parents. Unfortunately, in about 80% of cases, a child’s first exposure to alcohol and drug use is in the home. Children may see a parent drinking alcohol, popping pills or doing other drugs. Parents may have a liquor cabinet, a steady supply of beer in the refrigerator, or other drugs in the home. The influence of a child’s parents cannot be emphasized enough. Parents need to understand this and be proper role models for their children. What is the subliminal programming that is occurring every time a child opens the refrigerator and sees beer? It becomes the norm. We are not saying that parents should never drink beer in the home, but rather that they must assess the role that alcohol plays in their home.

Unfortunately, too, some children are exposed to illegal drugs from the time of their birth. Worse, some are exposed even before birth, if the mother uses during pregnancy. Such babies may be born addicted to drugs (i.e., “crack babies”). Infants may be exposed to drugs in the mother’s breast milk or in the home environment. One client in drug treatment described a baby picture of himself, in which a bottle of beer and a marijuana “joint” were photographed with him in his crib. He grew up believing that drug and alcohol use was normal for everyone. He began using at age eight and was chemically dependent and involved in the courts by age 17. Another client in treatment, an adolescent, shared a story of being beaten by her father-for smoking his marijuana. She had the black eye to prove it.

Peer-Group Influence 

Most people are aware that during the adolescent years, a person’s most influential group is their peer group. When their peers are using substances, teens often feel a need to use them as well, in order to gain acceptance, to be “tight” with their friends. Using substances because “everyone else does” may not seem to be a valid reason to adults, but to high school and junior high students, it is compelling. Failure to join in can cause a teen to become an outcast from the group-the worst fate imaginable to many teenagers. So they will often do whatever it is that their friends are doing so that they can fit in.

Even “good” kids may submit to peer pressure. For many adolescents, using drugs or alcohol can make them feel rebellious, as if they are being independent and carving out their niche in the world. It may also make them feel “grown up”. As a person grows older, he/she may decide to continue using or to stop using for many different reasons. He/she may outgrow the peer group influence but may not outgrow the substance involvement.

To Get An Effect or To Get High (Pleasure)

The majority of people using substances do so to get the mood-altering effect or some type of pleasurable sensation. Many available substances will induce a feeling of euphoria. People who use substances for pleasure, who have few problems with their substance use, are often labeled “social” users. These individuals can drink or get high on weekends just to feel good and have no resulting problems. Other persons who get involved in this type of substance use will eventually develop major substance abuse problems. No one can predict before beginning use if he/she will become drug- or alcohol- dependent.

Curiosity and Boredom

Curiosity is the most familiar reason given for first trying a substance. Curiosity is quickly satisfied. Therefore, if the person chooses to continue using the drug, he/she does so for other reasons. With the current availability of many substances, people are aware that if they want to try substances, they can. Young people are naturally curious; they are attracted to new and exciting things. Adolescents want immediate gratification and often don’t look at the possible consequences. This also leads them into trying many different drugs, to experiment with the different highs. This need for immediate gratification also allows them to get bored very easily. Obtaining and using illegal drugs is often viewed as exciting or “cool” by adolescents and can take up a large amount of time, thus alleviating their boredom.

Internal Issues

Internal issues correlate with serious substance abuse problems. Internal pressures to use include: stress, low self-worth, depression, anxiety and nervousness. Low self-esteem has been found to be a major factor in an individual’s choice to begin using substances. Alcohol and drugs are called mood-altering substances for a reason. Drugs alter (change) the mood (emotions) of the individual. They may either exacerbate an existing problem or create a new one. Many drugs also contribute to additional internal issues, such as depression, anxiety, or low self-esteem. Once again, substances may provide an easy but temporary method of dealing with these internal issues but usually cause additional problems. Often, the user doesn’t realize that substance use does not solve problems. When the substance wears off, the problem is still present, and often there are additional problems resulting from the substance use.

External Pressures

An individual may use substances to escape external pressures. These external pressures–situations with which an individual may feel uncomfortable-may include school problems, work difficulties, family problems, peer pressure, relationship issues, etc. If an individual feels upset about a certain situation and gets drunk or high, he/she may feel relief from the problem. This escape, however, will only last for a limited period of time. When the individual is no longer high, the problem will return. Using drugs or alcohol as an escape is only temporarily effective–and very dangerous.

An individual may begin to regularly rely on the drug or alcohol as a coping mechanism. This leads to addiction and produces an individual who has no other coping skills for difficult situations. Often, the use of drugs creates additional external pressures and exacerbates the existing ones. A vicious cycle occurs: the individual uses drugs or alcohol to deal with existing problems and the use causes more problems. The individual then uses more drugs to deal with these new problems. This additional use then causes more problems, which leads to more use. It is a never-ending cycle of use and problems.


15 Types of Distorted Thinking

Contributor: Yvette McBride Thomas

Thought Distortions

  1. Tunnel vision
  2. Awfulising
  3. Black & White Thinking
  4. Generalization
  5. Assumption
  6. Projection
  7. Negative Thinking
  8. Self-consciousness
  9. Blame
  10. Unfairness
  11. Emotional Reasoning
  12. Manipulation
  13. Shoulds
  14. Got To Be Right
  15. Heaven’s Reward

1. Tunnel vision :

Example: “I expect it’ll be another boring party”.

It is being stuck in a mental groove. In particular you look for that which confirms your fear or prejudice, remember it from the past and expect it in the future. You ignore other points of view or the possibility of alternative solutions.

2. Awfulising :

Example: “I can’t bear going on these awful buses”.

This attitude is saying that it’s unacceptable if things aren’t as you would prefer them to be. You take the negative aspect of a situation and magnify it. To handle this, recognize when you use words like terrible, awful, disgusting, etc. and in particular the phrase “I can’t stand it”. Examine their rationality.

3. Black & White Thinking :

Example: “You’re either for me or against me”.

Things are black or white, wonderful or terrible, a great success or a total failure, brilliantly clever or really stupid, a certainty or a complete mystery, friend or enemy, love or hate – there is no middle ground, no room for improvement, no room for mistakes. judgments on self and others swing from one emotional extreme to another and are easily triggered. It is important to remember that human beings are just too complex to be reduced to dichotomous judgments, and that all qualities fall somewhere along a continuum, containing elements of either extreme.

4. Generalization :

Example: “I’ll never be any good at tennis” (after one poor game).

In this distortion you make a broad, generalized conclusion, often couched in the form of absolute statements, based on a single piece of evidence. If something bad happens once, you expect it to happen over and over again. If someone shows evidence of a negative trait, this is picked up on and exaggerated into a global judgment. This inevitably leads to a more and more restricted life and your view of the world becomes stereotyped. Cue words that indicate you may be over-generalizing are: all, every, none, never, always, everybody and nobody. To become more flexible use words such as: may, sometimes and often, and be particularly sensitive to absolute statements about the future, such as “No one will ever love me”, because they may become self-fulfilling prophecies.

5. Assumption :

Example: “Nothing can change the way I feel”.

Making an assumption, presupposes knowledge that you do not have. Assumptions are often popular beliefs that have been adopted without examining their basis in fact, such as “I’m over the hill now that I’m forty”. Making decisions based on assumptions may lead to disaster, as when an executive assumes that a new product will sell well, having made no market research. Often, taking things for granted causes people to be blind to possible solutions – assuming no-one can help them, a couple’s marriage may go on the rocks, when they could seek counseling. Question: What leads you to believe this? Why do it this way? Who says? What alternatives are there? What would happen if you did? What would happen if you didn’t? As a practical matter, all of us must proceed with the business of living by relying on “maps” of the world which we have taken on trust and which we have not tested and often cannot test. To supplement personal experience, we absorb a constant stream of reports, descriptions, judgments, inferences and assumptions coming from a multitude of sources. From this abundance of stored information, you piece together a mental “model” of the world and its workings that literally becomes your world view. However, people do vary considerably in the extent of their misinformation and in the degree to which they actively seek out new information, take opportunities to correct or update their mental models, and expose themselves to new experiences.

6. Projection :

Example: “I know he doesn’t like me”.

Making false assumptions about what other people think depends on a process called projection. It is like mind-reading – putting words into peoples’ mouths. You imagine that people feel the same way you do and react to things the same way. If you get angry when someone is late, you assume that another will feel the same way about you or others, in that situation. If you don’t like yourself, you assume others also think that way. The answer is not to jump to conclusions about what other people think and feel.

 7. Negative thinking :

Example: “We haven’t seen each other for two days – I think the relationship is falling apart”.

You read a newspaper article about some misfortune and wonder if that could happen to you. Predicting negative consequences is a defense, to protect oneself from disappointment by expecting the worst. Consider, what are the realistic odds of that happening?

8. Self-consciousness :

Example: “Quite a few people here seem smarter than I am”.

This is the introverted tendency to relate everything around you to yourself, to think people must be judging you, or to think that everything they do or say is a reaction to something about you. It is the habit of continually comparing yourself to other people, based on the underlying assumption is that your worth is questionable. You are therefore continually forced to test your value as a person by measuring yourself against others. If you come out better you have a moment’s relief; if you come up short, you feel diminished. Your worth doesn’t depend on being better than others, so why start the comparison gamble?

9. Blame :

Example: “It’s your fault we’re in debt”.

If you see yourself as externally controlled, you see yourself as helpless, a victim of fate or “the system”. You don’t believe you can really affect the basic shape of your life, let alone make any difference in the world, so you try and manipulate others to take care of your interests. Someone else is to blame and is responsible for your pain, your loss, your failure. The truth is that we are constantly making decisions and every decision affects and steers our lives. It is your responsibility to assert your needs, to say no or go elsewhere for what you want. In some way we are responsible for nearly everything that happens to us, including our distress and unhappiness. Taking responsibility means accepting the consequences of your own choices. Ask yourself: What choices have I made that resulted in this situation? What decisions can I now make to change it? The opposite distortion is also very common – the fallacy that makes you responsible for the pain or happiness of everyone around you. You carry the world on your shoulders. You have to right all wrongs, fill every need and balm each hurt; if you don’t you feel guilty and turn the blame on yourself. Blaming yourself means labeling yourself inadequate if things go wrong. With this viewpoint you are very easily manipulated. The key to overcoming this fallacy is to recognize that each person is responsible for himself – taking responsibility doesn’t imply that you are also responsible for what happens to others. Remember, part of respecting others includes respecting their ability to overcome or accept their own pains, make their own decisions and be in control of their own lives.

10. Unfairness :

Example: “It’s not fair, he should take me out more often”.

The consideration of unfairness results from resentment that the other person does not want or prefer the same as you, or that events do not turn out in your favour. The person gets locked into his or her own point of view, with a feeling of ever-growing resentment. Be honest with yourself and the other person. Say what you want or prefer, without getting involved in the fallacy of unfairness: that people and situations shouldn’t be the way they are.

11. Emotional reasoning :

Example: “I feel depressed, life must be pointless”.

You believe that what you feel must be true – automatically. If you feel stupid then you must lack intelligence. If you feel guilty then you must have done something wrong. If you feel angry, someone must have taken advantage of you. However, there is nothing automatically true about what you feel – your feelings can lie to you, they can be based on misconceptions. If your feelings are based on distorted thoughts, then they won’t have any validity. So be skeptical about your feelings and examine them as you would a used car.

12. Manipulation :

Example: “If we had sex more often, I’d be more affectionate”.

The only person you can really control or have much hope of changing is yourself. When you pressure people to change, you are forcing them to be different for your own benefit. Strategies for manipulating others include blaming, demanding, withholding and trading – in order to make the other feel obliged. The usual result is that the other person feels attacked or pushed around and resists changing at all, or feels resentful if they do. The underlying fallacy of this thinking style is that your happiness depends on controlling the behavior of others. In fact your happiness depends on the many thousands of large and small decisions you make during your life.

13. Shoulds :

Example: “You should never ask people personal questions”.

In this distortion, you operate from a list of inflexible rules about how you and other people should act. The rules are right and indisputable. Any particular deviation from your particular values or standards is bad. As a result you are often in the position of judging and finding fault. People irritate you, they don’t act properly or think correctly. They have unacceptable traits, habits and opinions that make them hard to tolerate. They should know the rules and they should follow them. Of course, the answer is to focus on each person’s uniqueness: his or her particular needs, limitations, fears and pleasures, and consequently different values. Personal values are just that – personal. You are also making yourself suffer with shoulds, oughts and musts (or their negatives). You feel compelled to do something or be a certain way and feel guilty if you don’t, but you never bother to ask objectively if it really makes sense. Some people beat themselves up constantly for being incompetent, insensitive, stupid, too emotional, etc. They are always ready to be wrong. The psychiatrist Karen Horney called this the “tyranny of the shoulds”.

14. Got to be right :

Example: “I’ve been doing this longer than you, so I know what I’m talking about”.

In this very common distortion you are usually on the defensive, needing to prove to yourself and others that your views, assumptions and actions are all correct. You never make mistakes! If you’ve got to be right, you don’t listen. You can’t afford to – listening might reveal that you are wrong sometimes. Your opinions rarely change because if the facts don’t fit what you already believe you ignore them. This makes you lonely, because being right seems more important than an honest, caring relationship. The key to overcoming being right, is active listening – making sure you really understand what’s been said to you, to appreciate the other’s point of view and what you can learn from it, which is effort better spent than in devising rebuttals and attacks. Remember that other people believe what they are saying as strongly as you do, and there is not always just the one right answer.

15. Heaven’s reward :

Example: “I worked and raised these kids and look what thanks I get”.

This distorted thinking style accepts pain and unhappiness because “those who do good are rewarded in the end”. You expect all your sacrifice and self-denial to pay off, as if there was someone keeping score. You feel hostile and bitter when the reward doesn’t come. In reality the reward is now. Your relationship, your progress toward your goals, and the care you give to those you love, should be intrinsically rewarding. If not, you need to rearrange your activities to provide some here-and-now reward, dropping or sharing the activities that chronically drain you – Heaven is a long way off and you can get very tired waiting.


The best way to practice identifying Thought Distortions in everyday life is to take particular notice of one of the distortions for one day, and notice whenever it is used – by others or by yourself! Frequently, several Distortions are combined in a statement, or a statement fits into several categories of Distortion. These are commonly rationalizations – i.e. seemingly plausible explanations, excuses or justifications, which in fact are ignoring or fudging the real issue. For example. “I don’t need to work hard on this job because no one else will,” is an assumption, a generalization, negative thinking, tunnel vision, projection, and so on.

Unclear Thinking

Without us being aware of it, the way we usually think serves to riddle our minds with inconsistencies and irrationalities. This unclear thinking then leads to the Thought Distortions listed above. This occurs because language is a representation of human experience and not the experience itself. Language is an abstraction and in many cases a person will delete, distort or generalize in his verbal thoughts or statements about the actual experience. We can’t speak all of the meaning underlying our thoughts or every statement would be too long and pedantic but there is a danger in simplifying our thoughts too much. This is usually done to avoid confronting the whole truth about a situation. A situation can be seen as final and fixed rather than ongoing and changeable, so that responsibility is avoided and nothing can be done about it. For example:

I’m angry“. About whom? About what?

That’s not right“. What specifically is not right?

I realize I’m stupid“. How specifically do you realize you’re stupid?

I want love“. Who do you want loving from?

Nobody loves me“. Who specifically does not love you?

I have to clean the house before my husband gets home“. What would happen if you didn’t?

It’s impossible to talk to my boss“. What stops you?

My wife makes me angry“. How specifically does your wife make you angry?

I handled that meeting badly“. Badly compared with what?

I know he dislikes me“. How do you know he dislikes you?

It’s wrong to love two people at the same time“. It’s wrong for whom to love two people at the same time?

“I have a bad memory“. What do you have trouble memorizing and how do you go about it?

I can’t relax“. What prevents you? What would happen if you did?

I can’t cry“. Is that can’t or won’t?

“Without us being aware of it, the way we usually think serves to riddle our minds with inconsistencies and irrationalities.” The idea is to shift one’s state of being to at least acknowledge the possibility of choice, and to revise one’s fixed ideas. This is not to say one should question one’s every word, but if you find yourself feeling dissatisfied, look out for what you are deleting, distorting or generalizing about your experience, and how are you reducing your choices.

Each day, take one of the above Thought Distortions and spot when you find yourself or a person you are talking to using the Distortion. Also note on TV when this occurs. Just recognizing it as such – i.e. that it is an irrational thought – will enable you to be free of the Distortion or will enable you to better understand your fellow man.

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