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The relationship between stress and in vitro fertilization outcome
Published in David K. Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham, Textbook of Assisted Reproductive Techniques, 2017
In contrast to the psychoanalytic approach (which works by making the patient conscious of his or her unconscious past), cognitive therapy identifies current thinking and behavior (45). For example, the combination of helping the patient understand the narcissistic injury of his or her infertility, as well as its impact on his or her interpersonal relationships and life planning, is critical. An individual may feel stress or inadequacy when her belief that “I cannot be a real woman unless I get pregnant” leads her to avoid interpersonal relationships in order to escape the painful feelings that arise from feeling isolated from the fertile world.
MRCPsych Paper A1 Mock Examination 3: Questions
Published in Melvyn WB Zhang, Cyrus SH Ho, Roger Ho, Ian H Treasaden, Basant K Puri, Get Through, 2016
Melvyn WB Zhang, Cyrus SH Ho, Roger CM Ho, Ian H Treasaden, Basant K Puri
A 35-year-old male has a diagnosis of narcissistic personality disorder. He is rejected from further admission to the ward because he has made the nurses very upset by making unreasonable complaints. The nurses are begging the consultant not to admit him, although he is highly suicidal. This is an example of Acting outCountertransferenceDisplacementIrresponsibilityNarcissistic injury
Individual Clinical Issues
Published in David M. Aronstein, Bruce J. Thompson, HIV and Social Work, 2014
The experience of living with HIV infection is ongoing and changing, and it challenges the most resilient self. Despite the narcissistic injury that accompanies an HIV diagnosis, negotiating the course of living with the virus often is marked by tremendous psychological growth. The work done in psychotherapy can be reparative of the many underlying issues that surface as a result of the diagnosis. Neither the disease course of HIV nor the course of psychotherapy is linear in its progression, but rather each passes through subtle phases. One moves from the initial crisis toward achieving a sense of balance while integrating HIV into the overall functioning of the self. However, as relapses occur, treatment may be marked by the patient’s diminished capacity to function as he or she is forced to cope with new infections and the accompanying medical treatments. An opportunity for growth occurs as the patient negotiates the cycles of relapses and remissions.
The Mask of Suicide
Published in Archives of Suicide Research, 2022
Antoon A. Leenaars, Gudrun Dieserud, Susanne Wenckstern
The suicidal person has problems in establishing or maintaining attachments (with a person[s] or with another ideal[s], such as employment). Most frequently, there was/is a current and/or longstanding disturbed, unbearable interpersonal problem, although other relational (attachment) problems were evident. A calamity prevailed; some of the reported problems were: relational (marital) break-up, abuse in childhood, death of a parent, parental divorce, family secrets, parental conflict, bullied at school, loss of job, work-related problems, business failure, unaccepted by a person (e.g., lover, father, mother), divorce from partner, separated from lover, and more. A positive development in those same disturbed relational aspects may have been seen as the only possible way to go on living, but such a development was seen as not forthcoming. Loss, rejection, abandonment, etc., most often in the interpersonal realm was seen as an unbearable narcissistic injury (although the injury may, for example, be at the workplace or school). The person's psychological needs were frustrated. Based on Henry Murray’s outline of needs (Leenaars, 2017; Murray, 1938), the following list was most evident in the informants’ narratives: autonomy, counteraction, dominance, harmavoidance, infavoidance, inviolacy, and rejection (see Table 2 for definitions). The injury and frustrated needs led to unbearable pain and in some, maybe many, masking, and finally death.
Management strategies for borderline and narcissistic personality disorders in dermatology practice: a review
Published in Journal of Dermatological Treatment, 2022
Vidhatha Reddy, Bridget Myers, Stephanie Chan, Nicholas Brownstone, Quinn Thibodeaux, John Koo
It is very important for patients with NPD to be in positions of power. These patients are often highly competitive and pursue careers in which they maintain superiority over others; as such, they cannot tolerate being in positions that they perceive as inferior. This inherent characteristic may lead to confrontation in a clinical setting, where patients with NPD can feel disempowered by their physician (24). As a means of compensating, patients with NPD can display domineering or arrogant behavior. This in turn, can make medical providers feel uncomfortable or slighted and may lead to conflict. Because patients with NPD can prove frustrating to work with, medical providers may try to dismiss these patients from their practice, which can lead to further issues, such as the patient pursuing endless complaints to the medical board or social media outlets or even taking legal action against the provider. The underlying reason for this is that patients with NPD, despite presenting with a façade of confidence, are actually very sensitive to rejection or abandonment. Typically, patients with NPD are unaware of the cognitive dissonance between these underlying insecurities and the overconfident ways in which they present themselves to others until they are challenged by others. When this occurs, patients with NPD typically become angered because the provider threatens the patient’s overinflated ego. This phenomenon is referred to in psychiatry as ‘narcissistic injury.’
Post-traumatic stress in the medical setting
Published in American Journal of Clinical Hypnosis, 2020
As I have explored in previous works (Appel, 2003, 2017) lasting medical illness and traumatic bodily injury will be inextricably bound up with suffering as an emotional state. Medical illness or injury often wound the self and may threaten psychological integrity or cause narcissistic injury. When medical illness or injury creates lasting disability, the established identity will be challenged, as the remembered sense of self may be in conflict with present experienced self. “Chapman and Gavrin (1999, p. 223) state that ‘suffering is the perception of serious threat or damage to the self, and it emerges when a discrepancy develops between what one expected of one’s self and what one does or is. For Cassell (1991), suffering is the consequence of perceived impending destruction of the person or of some essential part of the person’ (as cited in Appel, 2017, p. 399). The literature around these issues has addressed how an increased awareness of one’s vulnerability often triggers an awareness of one’s mortality following a traumatic episode. Soeken and Carson (1987) pointed out that the onset of an illness or disability may be the first opportunity of one’s life to confront and contemplate the finite nature of life.