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Nobody votes in favour of having a chronic (long-term) illness. We would all much rather have something that was temporary and preferably treatable with surgery. "Cut it out, throw the bad bit away and sew up the wound" is the ideal therapeutic principle. "Take a tablet for a time to make it better or help you sort it out" would be the next to ideal treatment. "Learn how to live with this condition and diminish its effects on a day-to-day basis" does not have quite the same ring as the other two. In general patients do not like the idea of having to live with a condition and they are reluctant to take on the discipline of daily adjustments to behaviour. However, patients with neurotransmission disease, or any other chronic disease, have to do exactly this. Sufferers from chronic illnesses of any kind fight against this acceptance every inch of the way. They would rather have almost any other diagnosis. They don't mind accepting that they have been traumatised and they are usually content to be given a diagnosis of depression, particularly if they can attribute it to the words or actions of someone else, and they will even accept that they have had some form of "breakdown" because that concept relieves them of personal responsibility. However, a diagnosis of a chronic illness due to an addictive or compulsive nature will be totally and absolutely rejected, not only by the sufferer, but often also by friends and family and by colleagues at work, if they get to hear of it. That diagnosis seems preposterous and even offensive.

Accepting the diagnosis of a chronic illness requires a process of surrender and this goes against the grain of our upbringing and culture: we are taught to fight, not to give in. However, there is a fundamental difference between fighting against difficult odds and fighting against impossible odds and these should not be confused. It shows even greater courage to surrender, recognising that one is totally defeated, than it does to continue fighting when there is not only a possibility but even a probability that things will not work out well. We admire Butch Cassidy and the Sundance Kid when they come out for their final battle, knowing that they are in deep trouble. We may not admire what they did that brought them to that dreadful final day of reckoning but we admire their spirit in fighting on. The fact that they were annihilated leaves us sad, but we still admire the magnificence of their failure.

For people who are fighting against neurotransmission disease there is a similarity to Butch Cassidy and the Sundance Kid in that they go on fighting to the very last. Many do indeed fight to the death and lose their lives in the battle against impossible odds. Fortunately, many nowadays have the opportunity to surrender and begin a new life, working the Twelve Step programme. This is a new daily battle requiring considerable courage at first. As time goes on, however, the daily battle is transformed into a daily reprieve: they come to recognise that life is easier when an addictive tendency is accepted rather than fought. Of course there are also battles to be fought professionally and personally, socially and culturally, but those are the same battles that anyone else has to fight. The battle against neurotransmission disease, however, comes to be seen as utterly pointless. There is no chance whatever of victory. There is only the

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