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The Almost Effect.

Article / Review by on March 4, 2012 – 5:39 pmNo Comments

 The Almost Effect

What is The Almost Effect™?

Welcome to The Almost Effect website. The Almost Effect was developed at Harvard Medical School in collaboration with many experts from Harvard Medical School, Hazelden and other institutions.

Most medical conditions present along a continuum that begins just to the right of “normal” if you were to look at it on a horizontal line. However, usually one doesn’t go from normal to a diagnosable condition right away…

Assistant Professor at Harvard Medical School and Chief Editor of Books at Harvard Health Publications, Dr. Julie Silver, talks about The Almost Effect™–a new book series from Harvard Health Publications and Hazelden.

medicinezine_com - The Almost Effect™ logo

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The Almost Effect was developed at Harvard Medical School in collaboration with many experts from Harvard Medical School, Hazelden and other institutions.

Associate Professor of Psychology at Harvard Medical School and Director of Law and Psychiatry Services at Massachusetts General Hospital, Ron Schouten talks about his forthcoming book, Almost a Psychopath. Schouten and co-author, James Silver, JD, explain that there is a subclinical syndrome for psychopathy.

Q & A With the Authors of The Almost Effect™ Series

Most medical conditions present along a continuum that begins just to the right of “normal” if you were to look at it on a horizontal line.  However, usually one doesn’t go from normal to a diagnosable condition right away.  At first, there are subtle signs and symptoms that suggest a shift is taking place from normal toward the right side of the horizontal line.  Metaphorically, we often think of this as a “grey area”, because it’s more murky than the “white” of normal or the “black” of a confirmed diagnosis.  What this means is that instead of two categories—normal and diagnosis—there is a spectrum from normal to a confirmed diagnosis which goes from white to grey to black.

Indeed, very often in medicine categories don’t make as much sense as a spectrum does.  Not surprisingly, the grey area between normal and a confirmed diagnosis can be more difficult to identify than the more clearly demarcated white or black.  What this means to people who are experiencing problems in the grey area is that they might not be recognized or addressed despite the fact that there is real pain and suffering occurring.

For example, an almost alcoholic doesn’t meet the diagnosis for alcoholism or alcohol dependency, but his drinking habits are not normal. The almost alcoholic may experience negative health effects like trouble sleeping or depressed moods.  He or she might have physical problems due to alcohol such as injury to the liver or nervous system.  The problems associated with the almost alcoholic may affect not only the individual but also loved ones, co-workers and friends.  In this grey area, there is significant unaddressed suffering.

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Recognizing The Almost Effect has two primary goals.  The goals are to:

1. alleviate pain/suffering now

2. prevent more serious problems later

The Almost Effect is not about labeling people but rather identifying genuine medical problems that involve emotional and/or physical suffering to the individual and those around him/her.  These books are written by Harvard doctors in collaboration with other experts who are well-versed in understanding and recognizing the entire spectrum from normal to a confirmed diagnosis, including grey areas that are often “subclinical” problems which do not meet the criteria for a diagnosis.  The Almost Effect books focus on helping readers to better understand the grey areas between normal and a confirmed diagnosis and offer suggestions about appropriate treatment interventions.  If you (or a loved one) are currently in a grey area, shifting left may allow you to live a happier, healthier life.



Is My (or My Loved One’s) Drinking a Problem?

Robert Doyle, MD and Joseph Nowinski, PhD


Determine if your drinking is a problem, develop strategies for curbing your intake, and measure your progress with this practical guide to taking care of yourself.

Every day, millions of people drink a beer or two while watching a game, shake a cocktail at a party with friends, or enjoy a glass of wine with a good meal. For more than 30 percent of these drinkers, alcohol has begun to have a negative impact on their everyday lives. Yet, only a small number are true alcoholics—people who have completely lost control over their drinking and who need alcohol to function. The great majority are what Dr. Doyle and Dr. Nowinski call “Almost Alcoholics,” a growing number of people whose excessive drinking contributes to a variety of problems in their lives.

In Almost Alcoholic, Dr. Doyle and Dr. Nowinski provide the tools to:

  • identify and assess your patterns of alcohol use;
  • evaluate its impact on your relationships, work, and personal well-being;
  • develop strategies and goals for changing the amount and frequency of alcohol use;
  • measure the results of applying these strategies; and
  • make informed decisions about your next steps.

Excerpt from Almost Alcoholic

I once overheard a mother counseling her grown daughter to avoid dating a man who she thought had a drinking problem. The daughter said, “Mom, he’s not an alcoholic!” The mother quickly responded with, “Well, maybe not, but he almost is.”

Is My (or My Loved One’s) Drinking a Problem
By Robert Doyle, MD, Harvard Medical School
and Joseph Nowinski, PhD
Hazelden Publishing/Harvard Health Publications
Publication Date: April 2, 2012
ISBN: 978-1-61649-159-8
Price: $14.95
250 pp.


Do I (or Does Someone I Know) Have a Problem with Manipulation and Lack of Empathy?

Ron Schouten, MD, JD and James Silver, JD



medicinezine_com - The Almost Effect™ logo

About Harvard Health Publications (HHP)


Harvard Health Publications (HHP)

Harvard Health Publications (HHP) is a division of Harvard Medical School and Harvard University. For over 30 years, Harvard Medical School has been a major publisher of health information for the general public. Through our various publications, we reach more than 90 million consumers each year through a collaboration of print, Web, and video publications—all carrying the unparalleled name and reputation of and expert faculty doctors of Harvard Medical School.

About Hazelden


Hazelden is the leading publisher of books and multi-media tools for those in recovery from addiction or who are dealing with related life issues. With the publication of Twenty-Four Hours a Day in 1954—the first daily meditation book written expressly for recovering alcoholics—Hazelden began a tradition of bringing readers information and inspiration to strengthen lifelong recovery and personal growth. Today, Millions of people make Hazelden books and electronic resources a part of their day. Hazelden publishes print books, e-books, mobile apps, multimedia tools, and other resources that inform and support prevention, intervention, treatment, and lifelong recovery from addiction. Translating research into practice, Hazelden is also the leading publisher of evidence-based alcohol, drug, and violence prevention and treatment curricula for professionals and organizations.

Learn more about Hazelden at

From Sid Farrar, Executive Editorial Director

In the fourteen years that I have directed the acquisitions and development of publications for Hazelden I have seen the assessment and treatment of addiction and mental health issues slowly evolve to accommodate the research and theoretical work of the pioneers and original thinkers in the behavioral health field. For example, research had shown over twenty years ago that the integrated treatment of co-occurring addiction and mental illness yielded far superior outcomes to treating the two disorders separately, which had been (and to some degree still is) the common practice. It has only been in the last four or five years that evidence-based integrated treatment models have been widely adopted and recognized as best practice; and we at Hazelden are proud to be a part of furthering that movement through our recovery and self-help product lines for consumers.

So when Dr. Silver came to me with the idea for co-publishing a series of consumer books with Harvard Health Publications addressing the subclinical symptoms and behaviors on the spectrum between “normal” and formal DSM diagnoses, I recognized an opportunity for Hazelden to play a part in moving the field forward and raising the consciousness of both consumers and professionals on a critical and neglected behavioral health issue.

All of us at Hazelden Publishing are very excited to work with Harvard Health Publications, and the stellar group of Harvard Medical School faculty members as well as the other authors and writers who have contributed to The Almost Effect™ series. I believe these books will break new ground in offering help and hope to millions of readers who will now have their problems recognized at last, and be given the long overdue guidance they need in finding solutions.

Sid Farrar
Executive Editorial Director
Hazelden Publishing

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