Friday, November 7, 2014

Demystifying Narcissistic Personality Disorder

 


     Most are familiar with the story of narcissus, the Greek myth about a man who falls hopelessly in love with his own reflection seen in a pond where he stops to get a drink of water after a day spent walking through the woods. The myth has a variety of endings. One popular ending describes narcissus dying from starvation and thirst because he can not tear himself away from his own reflection. I find this particular ending to be most helpful for describing narcissistic personality disorder ( NPD) since at the core this disorder is an inability for one to receive or give love; in essence individuals with NPD are starving themselves of affection.

  The term narcissist or referring to one as having NPD is commonly said today. And narcissism may truly be on the rise as a result of our culture's obsession with social media, youth and physical appearance.

To be diagnosed with NPD a person must meet five or move of the following symptoms:

-has a grandiose sense of self importance. Exaggerates achievements and talents and expects to be recognized as superior without commensurate achievements.

- is preoccupied with fantasies of unlimited omnipotence, success, intelligence, beauty and ideal love.

- believes that he or she is special or unique and can only be understood by or should only associate with other special or high status people or institutions.

-requires excessive admiration

- has a strong sense of entitlement. Have unreasonable expectations of receiving favorable treatment or automatic compliance with his or her own expectations.

- is exploitative of others by taking advantage of others to achieve his or her own goals.

- lack empathy. Is unable and unwilling to recognize or identify the emotional needs and feelings if others.

- is often envious of others and or believes that others are envious of him or her.

- regularly behaves in arrogant and hairy ways.

NPD affects more men than women, is seen in approximately 7% of the general population and can range from mild to severe. It is thought that both biological and psychological factors contribute to the disorder. In regards to biological factors, studies suggest that individuals with NPD are more emotionally sensitive in temperament. Studies investigating psychological factors contributing to NPD indicate several psychosocial factors. The main ones being abuse or neglect in childhood, excessive praise for good behaviors and excessive criticism for bad behaviors in childhood, overindulgence and over evaluation by parents and or peers, unpredictable and unreliable caregiving and learning manipulative behaviors from parents and caregivers.

It is important to recognize that individuals with NPD struggle with profound feelings of shame, fear of rejection and feel emotionally threatened when criticized. Individuals with NPD often react with intense rage, hostility and aggression to any criticism, real or imagined. This type of reaction causes others to retreat or distance themselves from them, all of which inhibits people with NPD from having genuine and meaningful relationships.
.

Although NPD is a treatable disorder, most people with NPD do not voluntarily seek treatment because they are unable to acknowledge their self-destructive behaviors and thoughts. Psychoanalytic-Psychodynamic therapy, cognitive and behavioral therapy and group therapy have all been shown to be effective treatment approaches for treating NPD. As with all therapy, building a strong and positive therapeutic relationship is key for successful treatment. When an individual with NPD develops a therapeutic relationship that is secure and safe he or she can work through his or her profound feelings of shame and rejection without feeling emotionally threatened. One important therapeutic goal is to help the person with NPD develop the ability for self-compassion, compassion for others, and empathy; all necessary skills for developing meaningful relationships and for having the ability to give and receive love.

If you or a loved is struggling with NPD consider an evaluation with a mental professional. There is hope and help out there for you.

Tuesday, October 14, 2014

Do You Text and Tell? Flirty behavior through technology can lead to deception, secrets and betrayal.

     Emotional affairs often start out as innocent friendships. Email, texting, instant messaging, and social media sites are never "closed for business" so communicating with others is a 24 hour /7day a week opportunity. This makes it easy for innocent friendships to heat-up fast. Once casual communications turn into flirty texting banter, obsessions develop around the next communication with this person, feelings of marital dissatisfaction are discussed, and these communications are kept secret from your partner, the line between innocent friendship and emotional affair has been crossed.
An emotional affair is an "affair of the heart" and is predicated upon the attachment two individuals create outside their marriage or relationship. A deep attachment develops by sharing intimate thoughts, feelings, and vulnerabilities and by relying on one another for emotional support and companionship. Many people convince themselves that because sex is not involved, they are not having an affair. But they are. Affairs, whether emotional or sexual, involve secrecy, deception and betrayal. The more emotional energy put into the other person the less there is for your partner and your relationship. Often the most devastating aspect of an emotional affair is the deep attachment that develops with this other person. This attachment is tough competition for your marriage or relationship.

     Emotional affairs generally happen when something is lacking in our relationship or within ourselves. In regards to relationships, not feeling important, desired or understood is often a trigger. Being able to connect with another person who seem to fill these voids feels good, and it's these good feelings that keep the emotional affair going. On an individual level, the emotional affair may be warding off feelings of low self-esteem and inadequacy. It's important to note that most affairs, sexual or emotional, do not end well. And when given the chance to be legitimate, often do not survive.


Below are 4 tips for healing from an emotional affair


1. Take responsibility for the emotional affair by being honest with yourself and your partner. We all make mistakes and do things we may regret. Once we no longer deny we are engaging in behaviors that are hurtful and damaging to us, genuine change, healing and understanding can take place.
2. Terminate the relationship. This will be difficult because an attachment has been made. Emotions and thoughts associated with mourning and loss should be expected. And as with any significant loss, will take time to heal from.
3. Be open to marital therapy. Marital therapy can help identify what is missing in your present relationship and the steps you can take as a couple to make your relationship better. Marital therapy can also help with exploring whether to continue or terminate your relationship.
4. Consider individual therapy. Underlying and unresolved issues surrounding intimacy can contribute to one's vulnerability to becoming involved in an emotional affair. Whether repairing your present relationship or considering a new relationship; exploring and understanding the underlying factors associated with the emotional affair will help with achieving genuinely satisfying and fulfilling future relationships and maybe even affair proof ones too.

Monday, September 1, 2014

Speed Bump Ahead! Tips for Making A Smooth Transition To Hectic Fall Days


 
     Transitioning to the hectic schedule of fall from the lazy, hazy days of summer can be just as stressful for parents as it is for kids. It is not uncommon for people and families to experience a growing sense of anxiety over getting back into the busy school and work routine.  Change of any kind can create anxiety so it is not unexpected that huge changes in our schedule would make us feel anxious too.

     Transitions are hard; they represent the reality that our lives and circumstances are continually changing, evolving and transforming. And when there is change there is also loss, the loss of what it is we are leaving behind.  Children get older and so do we. Many families for the first time this fall will experience a child going off to kindergarten, high school, college, and some will be first time empty nesters. When we process loss we gain the ability to fully embrace life’s inevitable changes and processing loss prevents us from feeling “stuck” or “stalled” in our lives as well.

     Many people and families experience loss at the start of a new year related to spending less time together, having less personal freedom and having a less flexible schedule. Becoming aware of situations and events that are likely to increase your and your families stress levels will help to actively manage anticipated anxiety and promote healthy coping behaviors. Learning to plan ahead and being able to discuss your emotions about change and loss with loved ones is important since chronic stress and depression negatively impacts our emotional health and contributes to depression, substance abuse, and even physical illness.  

Below are tips for making your transition to fall smoother:

1.      Get a full night’s sleep. A minimum of 7-8 hours of sleep per night helps to regulate mood, decrease anxiety and depression, and improves concentration.

2.      Set realistic goals for you and your family. Avoid over scheduling your family and you. Ease into active days by slowly adding activities for both your child and you as the year progresses.

3.      As a family sit down and openly discuss concerns about the up-coming year. This may include sorting out conflicts with schedules, carpools, and mealtimes.

4.      Make sure to schedule consistent “family time” during the busy week. Maintaining a deep sense of connection with those we love combats stress, depression and anxiety. And it’s a great way to add love and laughter to your new year.

5.      Give yourself a break too! Set aside time for relaxing and decompressing from the busy, hectic days of fall.
SS

Saturday, August 9, 2014

Marital and Relationship Happiness--Keys To Success

        

     


     Let's be honest, relationships are hard work. They demand a lot from us and the quality of our relationships greatly predicts our degree of happiness in life. So working on cultivating and sustaining healthy relationships is VERY important for us to do. However, the majority of relationships do not last. Current divorce statistics report 45-50% of marriages end in divorce with second and third marriages having even higher divorce rates.

     Nourishing a relationship requires us to be thoughtful, caring, compassionate, loving and also mindful of how our behaviors and expressions impact the other person.  Conflicts are bound to happen at some point during any relationship; there will be tough times when one or both individuals feel hurt, frustrated, angry, or let down by the other. Social scientists have found that how couples navigate the tough times and just as importantly the good times is a major predictor of relationship success. Kindness was found to be the biggest factor associated with fulfilling relationships. Not only is kindness important in the couple's day to day interactions but also when couples argue. Kindness during periods of conflict is determined by the couples ability to express their anger, upset and frustration without personal attacks. Kindness not only improves the quality of our relationships it also improves our own emotional well being. When we feel better about ourselves our relationships reap the benefits. And an environment of kindness naturally fosters feelings of emotional security and safety; essential ingredients for a successful relationship.

     Not surprisingly, personal criticism of each other was most associated with unhappy relationships.  Personal attacks can have lasting and devastating consequences on a relationship and it leads to feelings of contempt and resentment. Learning to be kind to each other and being mindful of our partner's feelings is the foundation needed for building strong, healthy relationships.

 Below are tips for cultivating kindness in your relationship:

1. Compliment your partner.

On a daily basis tell your partner something you liked that he or she did either that day or did recently. Research shows that when couples regularly express their gratitude to each other they remind themselves of their partner's good qualities and what attracted them to each other in the first place. Complimenting your partner on a daily basis provides a healthy dose of sparkle and helps keep a couple together over the long haul.


2. Learn to compromise.

Couples that are able to compromise have a better of chance of staying together and be happier in their relationships. Just to be clear, there is a big difference between compromise and sacrifice; which means means giving up something completely for the sake of your partner. Sacrificing creates contention and resentment. Compromise, on the other hand, requires an understanding of your partner's ideas, opinions, and knowing what is important to him or her and why. This information is helpful for negotiating compromises with our partner. It prevents us from feeling "pushed" or "controlled", the type of feelings that often inhibit productive compromises and lead to power struggles instead.


3. Remember no one is perfect.

No one is perfect or good at everything they do. We all make mistakes and bound to hurt and/or disappoint our partner at one time or another. Accepting this reality helps us to have the capacity to forgive and to resolve conflicts when they arise rather then harbor contempt and resentment, only to be brought up at a later time.



4. Communicate, communicate, communicate.

 Although the idea of our partner being someone who "fully gets us" sounds ideal, no one can actually read our minds. Learning to communicate by actively listening to your partner and using "I" statements, especially when discussing emotional topics, feelings and expectations, fosters an environment of mutual understanding and respect. When we feel understood by our partner, even when they disagree with us, genuine feelings of connection and caring are felt. All of which decreases the chances for couples to have emotionally damaging arguments.

Wednesday, July 23, 2014

Ask Dr. Durlofsky: What's In The Mailbag


Hi Dr. Durlofsky,
I came across your article on Guilt this evening and it really had me thinking how do I control this "Guilt" feeling. 

Tonight I was suppose to attend a work buddy/acquaintance's film project. Like I said.. acquaintance. He is someone I see often at work but we have never met up outside of work. He is in the process of creating footage for his independent film.

On a side note: The past two week I have been looking for a new roommate. My current roommate who is truly good friend of mine, made a big decision to move in with her boyfriend. To get the ball rolling I've been conducting multiple interviews for the past two weeks to find a similar replacement. This has no been an easy process. On Thursday I met with someone who appeared to be ideal! She had everything I was looking for in a roommate, respectful, clean, hard worker, eco friendly, athletic, active, healthy, easy going, and a home body. I got the news last night that she found a different apartment closer to her work. I was hoping to share a living space with her, it turns out it wasn't meant to be. This event in itself has been stressful and now I feel like I'm back to square one. Although I have other potential roommates in line this feeling knocked me down today. 

I made a commitment to show up at my work friend's event but I ended up letting him know I had to cancel. Due to the stressful roommate situation I felt like I wouldn't be much fun if I ended up going to this all- nighter event. 

 
My friend's response to my having to cancel plans made me feel like a horrible person. He texted me, 'Ugh..really? well, ok." An hour later he texted "Good luck with your living situation stuff." It made me feel like I am letting him down. I can't help but feel guilty when I decline someone. I know I am a great friend to those around me and typically I do try to attend the events I am invited to. I am such a giving person and usually I am right there when someone asks me to do something for them. I take it personal when someone responds back to me in a negative way because I would always try to understand where the other person is coming from. I constantly feel like I need to validate my reasons or come up with a better excuse. I don't though and try to keep it short, sweet and honest- but it doesn't always seem like that works out for me.  Do you have any idea how I can get around this feeling and stop getting caught up in a guilt trip?

All the best,
Ellen
 
 

Dear Ellen,

For most people it is hard to say, "No" to other people's requests of them. So, you are not alone in this struggle. You wrote in your email that one reason why it is hard for you to say "no" is because you fear disappointing others and feel guilty when you do actually say, 'no". The truth is that when we neglect our own needs at the expense of others we end up disappointing ourselves most of all.
 
Learning how to nurture and attend to our emotional needs is crucial to our sense of well-being and good mental health. One step in achieving this is for us to believe our needs are reasonable and that WE are "ENTITLED" to the needs we have--whatever they may be (e.g. finding a roommate, wanting to rest rather then go out and the right to change our mind) and as long as our needs are not intentionally harming another. Once we feel entitled to care for ourselves in positive and helpful ways, feelings of irrational guilt should diminish. 

Good luck,
Dr. Paula Durlofsky

 
 
Hi, Doctor,
I've always had high-power jobs. Most people regard me as fearless but, in fact, I've always been anxious to a point of terror. I have absolutely nothing to worry about: sound physical health, as much money as I'll ever need, a 55-year marriage, two wonderful and successful children and three cherished grandchildren. My get-up-and-go has gone, I can't get absorbed in anything and even the daily routine of getting-up and getting started is daunting.
Rationally, I know there's nothing to worry about but worry I do. I'm often called upon to help others and always rise to the challenge. I just can't help myself. WHY? and what on earth can I do?  MAYDAY!
 
W.S.
 


Dear W.S.,
 
It's confusing and frustrating when we can't put a finger on what is causing us to feel badly. However, from what you described in your email, it sounds like you may be struggling with depression. It is not uncommon to feel anxious and have difficulty concentrating when we are depressed. Another common symptom of depression is morning depression, clinically called diurnal mood variation (DV). Morning depression is one of the core features found in major depressive disorder (MDD). People with DV experience a worsening of depressive symptoms in the morning as opposed to in the afternoon and/or evening.
 
I recommend you see a mental health professional to be assessed for depression. Depression is treatable with psychotherapy, medications or a combination of both. 
 
Good luck!
Dr. Paula Durlofsky
 

Dear Dr Durlofsky
 
I have just come across your article called “Dealing with Uncertainty: How to Cope with Ambivalence and Decision-Making”.
 
I found it extremely interesting because I believe that it applies to me. I find it very difficult to make decisions and tend to just get swept along with other people’s lives and decisions and a lot of the time become unhappy. I have been in 2 long term relationships that I was unhappy in because I didn’t make the decision to leave. They both became mentally abusive and I am now 33, getting divorced and still worrying over a decision about whether or not I should keep the marital home my husband and I shared. My constant worrying about which path to take affects every aspect of my life including my new relationship. The same patterns seem to repeat themselves over and over again as well.
 
Is there any advice you can offer me around how I can overcome / solve this?
 
Kind regards
Emma



Dear Emma,

     It's good news to hear that you are aware of your ambivalent feelings being a pattern in many areas of your life. Self-awareness is a major step toward making real life changes. 

     Although a certain amount of ambivalence is perfectly normal, when we are consumed with ambivalent feelings we are often left feeling "stuck" and unable to move forward with our lives. Often times, we feel ambivalent because we are afraid that we will make the wrong decision, believe there is only ONE right answer, have unrealistic expectations surrounding our decision, and afraid our decisions will be irreversible. All of which is not a reality but can make us feel very anxious.  Therefore, anxiety is commonly associated with ambivalence. Our anxiety prevents us from understanding and asking ourselves important questions surrounding our decisions such as, "what do I wish to achieve with this decision and why?" Fully understanding our needs and "wishes" helps us to make better decisions and consequently to live more satisfying lives. 

     One significant way to decrease crippling ambivalence is to learn how to tolerant our anxiety. This is no easy task, but can be achieved with therapy. Once we are able to "sit with" our anxiety we gain the opportunity to understand the root of it, and we are in a much better place for making healthy and satisfying life-decisions! 

     Talking to a professional can also help you to better understand the ambivalence you have about leaving unhealthy relationships and maybe even with intimate relationships in general. Once you understand the root causes of your ambivalence you will, no doubt, be more confident in your ability to make the right decision for you.

Good luck!
Dr. Paula Durlofsky  

If you have a question you would like to ask, please email me at drpauladurlofsky@gmail.com 

Tuesday, June 10, 2014

The Green-Eyed Monster: The Positive Side of Envy


 

      We all know how badly it feels when we are envious of someone else. We feel envy when we want what someone else has or feel unhappy about the success of another. Sometimes our envious feelings are misinterpreted as feelings of hostility and anger. At other times our envious feelings are associated with feelings of shame because we feel inferior to the person we envy and the person we compare ourselves to. Envy is a secretly held emotion that we usually do not share with others. Envious feelings are not just triggered by material possessions. We tend to envy people in our community, social circle, and family who are well regarded, admired, influential, and successful.  

     Feeling envious is normal; we ALL feel it from time to time. However, persistent envious feelings contribute greatly to depression, global feelings of dissatisfaction and unhappiness. Envious feelings usually stem from deep seated feelings of dissatisfaction with our self-image, our life accomplishments and feelings of inadequacy and low-self-esteem. Deep down our envious feelings are often the result of our own wishes to have whatever the person we are envious of has such as their career, financial success, social status or material possessions. Persistent envious feelings can also damage our relationships. Envious people often diminish the people they envy in an attempt to neutralize their envious emotions. They may do this by speaking poorly about the person they envy when with others or abruptly “cut off” their relationship with the person they envy.

 

     Jealousy is often confused with envy. Jealousy is something we feel when we fear an important relationship is in jeopardy. The most common example of jealousy is when an older sibling becomes jealous of a younger sibling because he/she fears the younger sibling will take his mother/father away  from him/her. Fears of abandonment and loss are often connected with jealousy.  

 

     So the question is, “How can examining our envious feelings help us?” To begin with, an awareness of what is driving our envious feelings provides us with important self- knowledge about the things we actually want to accomplish that we were not unaware of before looking inward. This knowledge acts as a positive motivational force and can help us accomplish what it was we were envious of in the first place.  Awareness of our envious feelings also gives us the power and permission to change our envious feelings and ultimately to make BIG changes in our own lives. For example, if I was envious of a co-worker’s promotion, instead of holding myself back by accepting or giving into my envious feelings, I could create a plan of my own for getting a promotion. It’s important to realize that there will be some envious wishes that may be unachievable. For example, if you are envious of the newest celebrity on the Hollywood scene, achieving a similar career may be impossible to accomplish.

 

 

Below are 4 tips to help you find the positive side of envy:

1.      Be honest with yourself about your envious feelings. Most of us do not want to admit that we have envious feelings toward another. It’s important to remember that we all feel envy and to accept these feelings as a normal part of life.  Write a list of what exactly it is you envy about a particular person.

 

2.      Decide what you envy about another that can be realistic goals for you to pursue. We all
        have our own unique set of strengths and weaknesses. What another person is great at doing we may not be. And the opposite is true too, what we may be great at doing, someone else is not. Pursue goals that are compatible with your strengths and talents and make a plan for achieving them.

 

3.      Minimize social comparisons. It’s normal to socially compare ourselves to others and to feel competitive. These are the measures we use for our own self-evaluation. Self-esteem is determined by how well we measure up on our social comparisons. For example, if we measure up to our expectations and goals we feel good and excited. If we do not measure up we feel depressed or ashamed. Persistent social comparisons can be damaging to our self-esteem and increase our envious feelings, especially when we feel we are not measuring up to our ideal selves.  

 

4.      Interpret your envious feelings as an opportunity for growth. Examining what, who and why you envy makes you aware of what you want in your life. Remember, you would not feel as strongly about the person you envy if whatever they have is not also important or a priority for you.

 

Sunday, April 20, 2014

Emotional Acceptance: How Feeling Bad Can Be Good For You

    
       It’s only natural to want to avoid feeling negative emotions such as anger, depression, guilt, remorse or fear.  As soon we become conscious of these feelings we immediately seek ways to extinguish them. Feeling unpleasant emotions is extremely uncomfortable and very difficult to tolerate.  It is understandable that we would want to avoid them.  But, in actuality, our avoidance perpetuates the cycle of feeling bad.  When we avoid our feelings, we deny ourselves the opportunity to learn what underlies our negative emotions. As a result, avoidance creates feelings of powerless, it’s impossible “to fix” what we don’t know is “broken” in the first place so we do nothing.  

     We avoid feeling negative emotions in various ways; by over eating, over spending, over drinking, and even hyper sexual or dormant sexual behaviors are all forms of avoidance.  At first avoiding our negative emotions may seem like a reasonable response.  Negative feelings are disturbing and often times linked to the very events and circumstances we want to forget.  We can all relate to the immediate relief avoidance can provide.  However, this relief is temporary and we pay a heavy price in the long term when we avoid acknowledging and accepting our negative emotions.  The short term gain we get from avoiding our negative emotions creates more complicated problems for us in the long run.  Not only do we need to resolve the original problem, we now need to resolve the problems we’ve picked up along the way because of our avoidance behaviors.
     In actuality, our unpleasant and negative emotions (depression, anxiety, fear) are signals telling us something is wrong and these emotions need our attention and understanding rather than us ignoring them. We avoid our emotions by using defense mechanisms, such as repression, minimization, fantasy, rationalization, projection, somatization, wishful thinking, and idealization to name a few. Not all defense mechanism are unhealthy but certain ones are thought to hold us back more than others from living more authentic, richer and satisfying lives. Learning how to tolerate our negative emotions rather than defending against them allows us to understand our emotions and gives us a context surrounding them. This new understanding enables us to effectively "fix" what we realize is "broken".  


Below are 4 tips to help you tune into your emotions in order to make effective changes:

1. Develop the ability to "sit with" negative and unpleasant emotions such as depression, anxiety, fear and anger.  Tolerating negative emotions allows us to process our feelings and gives us the time to understand ourselves and our feelings more deeply.

2. Be patient with yourself. It takes time to sort out emotions and to understand the full circumstances surrounding them. Emotions are complicated and often times we feel several at once.

3. Accept that negative emotions are normal and a part of being human. Our goal should not be to never feel bad--that's impossible. Instead, learning how to manage our negative emotions should be our focus and goal.

4. Try not react impulsively in response to your negative feelings. Impulsive reactions often make circumstance and feelings worse. Instead, try to slow down your reactions by being patient and allowing yourself the time to sort out what it is your feeling and why. When you have a greater understanding of your feelings and the circumstances surrounding them, your reactions will be more effective and less damaging to you.

I would like to hear from you. How do you avoid negative emotions? Do you struggle with tolerating your negative feelings? How do you manage your negative feelings?