Book cover for Prevention from the Inside-Out by Jack Pransky“Every now and then a single book precipitates a revolution in human understanding and practice. Examples that come to mind are Sir Francis Bacon’s Novum Organum, which opened the door to an empirical science grounded in inductive reasoning; Thomas Paine’s Common Sense, which fanned the spirit of the American revolution; and Thomas Kuhn’s The Structure of Scientific Revolutions, which illuminated the paradigmatic nature of fundamental change in our understanding of the world around us.

Whether Jack Pransky’s latest book on prevention – Prevention from the Inside Out – turns out to have an equally revolutionary effect on the mental health field remains to be seen. I have no doubt, however, that it should. At the very least, it deserves the thoughtful attention of mental health practitioners and those who set priorities and shape the field’s future.

From the book’s forward by Donald C. Klein, Ph.D., Union Institute and University
author, New Vision, New Reality
coauthor, Primary Prevention: An Idea Whose Time Has Come

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With the aid of the scientific method, we have gained an encompassing view of the physical world far beyond the dreams of earlier generations. The great adventure is now beginning to turn inward, toward ourselves.
— Edward O. Wilson, Consilience, 1998

TABLE OF CONTENTS

Acknowledgements

Preface

Foreword – Donald Klein, Ph.D.

Introduction

I. Helen

II. Discovering the Meaning of Inside-Out Prevention

III. A New Look at the Field of Prevention

IV. Miss Beverley (Part I)

V. Making A Case for Prevention from the Inside-Out

VI. The Three Principles

VII. Kristen (Part I)

VIII. The Evolution of Health Realization

IX. Elsie (Part I)

X. Health Realization Research

XI. Judy (Part I)

XII. A Qualitative Study Measuring Effects of Health Realization Training on Participants

XIII. The Application of Health Realization as an inside-out process in a community

XIV. Applications in Action: Beverley (Part II); Elsie (Part II); Kristen (Part III); Judy (Part II)

XV. Applications to Special Populations within the Community

XVI. A New look at Alcohol and Other Drug Abuse from an Inside-Out Perspective

XVII. A New look at Violence Prevention from an Inside-Out Perspective

XVIII. Counseling from an Inside-Out Perspective

XIX. Spirituality and Other forms of Inside-Out Prevention

XX. Desi

XXI. Speculation: Scientific Basis for How the Formless Comes into Form

XXII. Barbara

Bibliography

Appendix

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PREFACE

You could have knocked me over with a feather.

In 1991 when I first became exposed to this new inside-out approach to the prevention of problem behaviors, what I heard went against everything I believed. All my life I had fought against oppression in the form of violence against others, in the form of poverty, in the form of a system keeping wealth and power consolidated in the hands of a few at the expense of the many, in the form of drug pushers (including the corporate kind) and environmental profiteers who put profit over people’s health. Even more, I worked to improve conditions in the more immediate environments of family and school to build healthy self-perceptions in young people to reduce problem behaviors. Now I was being told the answer lay within? No way! I was a trained community organizer. I had written a book, Prevention: The Critical Need (Pransky, 1991), espousing that the answer to prevention lay primarily in changing external conditions. This direction seemed crystal clear. How could I accept that instead of changing external conditions that put people at risk and building resiliency through creating healthy environments, my focus should be the internal, within people’s minds? I could not fathom it.

Still, I couldn’t turn away. Why? Because it worked better than anything I had seen in all my years in prevention. I had always been about what works. Besides, this new approach sounded intriguing. I had begun traveling my own spiritual path, and this understanding seemed aligned. It had a ring of truth. As my initial book was about to go to press I managed to squeeze in a little something about it, but at the time I saw it merely as a new, innovative approach. I didn’t realize it was a completely new paradigm (a term I do not use lightly), a completely new direction, a completely new way of conducting prevention business, or any business for that matter. I had been looking at problems and solutions from the outside-in; this approach required looking from the inside-out. It played tug-of war with my mind, because no way could my thinking about prevention change—or so I thought.

Yet that is precisely the point: My thinking changed! The fact of thought— that no matter what terrific things we do in the name of prevention, even if precisely researched-based, if people’s thinking does not change, their feelings and behavior will not change—is one of the two critical elements I realized I had missed entirely. And I was not alone. Nearly the entire field had left out the key variable that determines people’s behavior. The significance of this cannot be understated.

I realized, too, that I missed another critical factor. I realized that subtly, inadvertently, certainly not intentionally, I saw the people with whom we work as incomplete, not whole—unless we did something with them or to them or for them. This shocked me, because I had always insisted on seeing people’s strengths, not their deficits. But a closer look revealed that I believed if we only changed unhealthy conditions or created healthy conditions then people would do fine. If we provided them supports or skills with the right information then they would do fine. If we built resiliency or healthy self-perceptions then they would do fine. In other words, people weren’t fine or whole unless we did something. This was humbling. Again, I was in good company. Nearly the entire field appeared to miss that within everyone’s spiritual essence, so to speak, they are already perfectly whole and complete, that when people are connected with their “Health” or internal well-being or “spiritual essence” they do not commit the acts we are trying to prevent. Now I see that everyone has within them all the wisdom and common sense they will ever need to overcome any problem behavior or difficulty they encounter. Instead of doing all these things from the outside in hopes it will strengthen them on the inside, we could help them realize the inside directly—help them see they already have all the resources within that they will ever need to make it out of their plight. We could help them see their innate essence that provides automatic strength and hope and what separates them from it, so on their own they would be guided toward Health and well-being and away from problems.

I consider these two points so crucial that I repeat them in a slightly different way in Chapter II. [1] But remember, none of this is the real reason I changed. The reason I turned away from a focus on external conditions and inward toward the human mind and human spirit is because it works better. People change to a far greater extent. Their lives truly become healthier on a grand scale. Their relationships improve. And these people, now changed from within and seeing themselves and their lives from a new, healthier perspective, then work to create healthier conditions and change the oppressive conditions in which they find themselves. This is the paradox. By focusing within, the external ends up changing to an even greater extent than if we focused directly on it. The more I explored this inside-out direction, the more I had no choice but to completely change my approach to prevention.

Does this mean I am suggesting that the outside-in focus practiced by most of the field and extolled in Prevention: The Critical Need is the wrong direction or a waste of time? Not at all! Outside-in prevention is helpful to people; it does reduce problems—to a certain extent. All I am saying is, from what I have observed first-hand—and I now speak from personal experience as well as the experience of hundreds of others around the country and world who practice it—prevention from the inside-out has far more life-changing impact. Therefore, if we are truly interested in reducing problem behaviors and enhancing well-being, it is critically important for the field to thoroughly examine this inside-out approach and become trained in it. Then prevention and health promotion practitioners can make their own informed decisions.

All I want is equal time and resources. I would settle for 50% of prevention time and resources to be devoted to the inside-out approach. Right now it is probably more like .01% (that’s a wild guess). The scale needs to be tipped.

Because I have seen its results firsthand, both in myself and others, I gave up trying to convince others of the worth of this inside-out approach. “Convincing” is not this book’s intent. Its intent is “exposure.” The message will either strike you or it won’t, and if it doesn’t it won’t matter because you will continue to do what you are doing. But if out of it you become as intrigued as I was, or have an insight that opens your eyes to something new, then on your own you will want to pursue it further, as I did. And if the field of prevention begins to change a little as a result, so much the better.

This book is for anyone who works with others, or anyone who wants to understand themselves better, or anyone interested in their own or others’ well-being. It is geared for those who work with others preventively, but it has implications and relevance for all of health and human services, as well as for those who work in treatment, corrections, education, and human resources.

So I invite you to settle back and enjoy something within the prevention field that I hope is refreshingly different. I invite you to be open to the new. I invite you to see the potential and power of inside-out prevention. It is not necessarily easy to grasp at first—at least it wasn’t for me (but it takes me a while). It may take a few readings or further exploration. But if you are touched by its power and its hopefulness, perhaps you too will not be able to turn away from this direction, as I couldn’t.

Jack Pransky
Cabot, VT
August, 2001

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FOREWORD

Donald C. Klein, Ph.D.
Union Institute and University
author, New Vision, New Reality
coauthor, Primary Prevention: An Idea Whose Time Has Come

Every now and then a single book precipitates a revolution in human understanding and practice. Examples that come to mind are Sir Francis Bacon’s Novum Organum, which opened the door to an empirical science grounded in inductive reasoning; Thomas Paine’s Common Sense, which fanned the spirit of the American revolution; and Thomas Kuhn’s The Structure of Scientific Revolutions, which illuminated the paradigmatic nature of fundamental change in our understanding of the world around us. Whether Jack Pransky’s latest book on prevention – Prevention from the Inside Out – turns out to have an equally revolutionary effect on the mental health field remains to be seen. I have no doubt, however, that it should. At the very least, it deserves the thoughtful attention of mental health practitioners and those who set priorities and shape the field’s future.

Both scholarly and impassioned, it is grounded in thoroughgoing familiarity with theory and practice having to do with prevention and health promotion in mental health. It is based on Pransky’s personal wisdom drawn from his own and others’ intimate life-transforming experiences. And it is informed by a lucid synthesis of the writings of sages, scholars, and scientists who in recent years have been delving into the mysteries of energy fields and mind-body relationships. It conveys knowledge of a simple, yet transcendent, insight that is capable of transforming one’s life.

In my view, Pransky’s work is compatible with the familiar tri-partite public health model of host, agent, and environment. It singles out the host as the focus for the “inside-out approach.” However, Pransky faults the concentration of traditional host-oriented approaches that seek to shore up individuals’ deficiencies or to impart knowledge, skills, and understandings that will overcome their inabilities to cope successfully with life challenges. His contribution is oriented to the strength of the host. It is based on the simple, yet profound recognition that every human being is born with the capacity to function successfully and, despite virtually whatever adversities life has to offer, continues to possess that capacity throughout life. What he terms the “inside-out approach” adds a major new and exciting possibility to the armamentarium of prevention and promotion in mental health.

I am one of those who, from my own personal experience, knows whereof Pransky speaks. Much of my professional lifetime was spent on exploring approaches to primary prevention in the mental health field. From 1953-63 I directed an experimental preventively-oriented community mental health program in Wellesley, Massachusetts associated with the Harvard School of Public Health (Klein, 1968). The next ten years saw a dramatic upsurge in the development of community-based programs in the field. In 1976 I was one of the prime movers of the Pilot Conference on Primary Prevention sponsored by the National Institute of Mental Health. In the mid-1970s, however, I became aware of a promising new development. A friend and colleague (Dr. Roger Mills, then Director of the Lane County, Oregon mental health program) alerted me to the impressive effect a wise teacher, Sydney Banks, had been having on the emotional and physical well-being of hundreds of people in British Columbia simply by talking with them about the wisdom he had gained from his own sudden and unexpected personal enlightenment. At Roger’s urging, my wife Lola and I paid two visits to British Columbia to see for ourselves. We talked with couples whose lives had been dramatically transformed by, to use a slang expression common to that area of Canada at the time, “twigging” to what Sydney had to say. Even more impressive was the second visit, during which we spent three days at a resort with individuals and their families who had been affected by Sydney’s teachings. Among them were about twenty children of varying ages, who spent much of their time playing with one another in and out of the pool. We were amazed to notice that during the entire three days we did not hear one child cry. Neither did we notice any instance of a child teasing or getting angry at another. Nor did we observe any parents scolding or disciplining their children. Clearly something extraordinary was going on here. These were healthy, active, apparently normal children. Absent were the usual flare-ups of negative emotions or indicators of sibling rivalry that one would ordinarily expect to observe not once but many times in a group such as this over a three-day period.

When we talked with Sydney, his only response was, “All you need to do is set your mind aside.” When I replied that I was an intellectual whose mind was a tool of his trade, he responded, “Don’t worry about it.” Towards the end of our second visit, we spent a memorable winter’s evening with Sydney, his wife, and mother-in-law in their home by the edge of a ship channel on SaltSpring Island, British Columbia. We walked through a tunnel of over-arching, snow covered trees to the house and sat quietly talking with Sydney about the wisdom he had discovered, as through a picture window we saw an occasional ghostly freighter glide by. We came away from that evening with at least a glimmer of understanding of what Sydney was talking about. From that time on, our lives, too, were transformed as we discovered what I have in recent years come to speak and write about as one’s inherent “power of appreciation” (Klein, 1988, 2001.)

I use the term “appreciation” to refer to the capacity we are born with to feel at one with the universe and to experience the awe and wonderment of life. Everybody I’ve talked with has experienced such appreciation more than once in their lives but, with rare exceptions, only under special circumstances. After leaving SaltSpring Island that evening in the 1970s we realized that we felt such awe and wonderment when we watched beautiful sunsets. What happens, we asked ourselves, when the sun goes down and that wondrous feeling disappears? Where does that feeling go? And where is it now? The answer was obvious. The feeling does not go down with the sun. It remains within each of us. Somehow we had bought into the idea that we needed special occasions, such as sunsets, to make it okay to experience that good feeling. Then we remembered something Sydney had said, which neither of us understood at the time, to the effect that the way to gain knowledge and understanding was to “allow” oneself to have “good” feelings. Until that moment we had interpreted his remarks as the equivalent of the kind of advice Pollyana might offer, such as: “See the good in everything” or “In every cloud there’s a silver lining.” Now, however, the light dawned. We became aware that it was the good feeling that mattered, not having to justify those feelings. We now knew that we had such feelings within ourselves and we were in control of them. That is, we could, if we chose, experience those feelings no matter what was happening in our lives!

From that time on, with occasional lapses into anger and other negative ways of responding, we viewed life and one another through the remarkable lens of appreciation. It was as if our windows to the world had been scrubbed clean of all manner of intellectual and emotional dirt. We experienced deep joy, more available energy, creative possibilities, and a far clearer sense of how to deal with whatever challenges presented themselves…

Thus, from two decades of immersion in community-based preventive programs in mental health plus my own transformative personal discoveries, I welcome Jack Pransky’s important contribution. Drawing from my own professional and personal discoveries, I believe that, provided the field is ready for a paradigm shift, Prevention from the Inside Out offers the basis for a profound revolution in the nature and focus of mental health work.

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[1] In fact, throughout this book I repeat many points in different ways because some people will relate to them better when stated differently, or they will hear them differently later after they have absorbed more. Therefore, what may sound redundant in some places is for a purpose.