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.

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.


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.

Books Case Studies