Al the info you need on the Alzheimer's disease


 

noralfa.org keyword stats



Most current MSN search phrases:

alzheimer  

Eating Disorders and the Narcissist

Patients suffering from eating disordersineffective. His eating disorders are an
binge on food and sometimes are botheffort to exert and reassert mastery over his
anorectic and bulimic. This is an impulsiveown life. At this stage, he is unable to
behaviour as defined by the DSM (particularlydifferentiate his own feelings and needs from
in the case of BPD and to a lesser extent ofthose of others. His cognitive and perceptual
Cluster B disorders in general). Somedistortions (for instance, regarding body
patients develop these disorders as a way toimage - somatoform disorders) only increase
self-mutilate. It is a convergence of twohis feeling of personal ineffectiveness and
pathological behaviours: self-mutilation andhis need to exercise even more self-control
an impulsive (rather, compulsive or(on  his  diet,  the  only  thing  left).
ritualistic)  behaviour.
The patient does not trust himself in the
The key to improving the mental state ofslightest. He is his worst enemy, a mortal
patients with dual diagnosis (a personalityenemy, and he knows it. Therefore, any
disorder plus an eating disorder) lies inefforts to collaborate with HIM against his
concentrating upon their eating and sleepingdisorder - are perceived as collaboration
disorders.with his worst enemy against his only mode of
controlling  his  life  to  some  extent.
By controlling their eating disorders,
patients assert control over their lives.The patient views the world in terms of black
This is bound to reduce their depressionand white, of absolutes. So, he cannot let go
(even eliminate it altogether as a constanteven to a very small degree. He is HORRIFIED
feature of their mental life). This is likely- constantly. This is why he finds it
to ameliorate other facets of theirimpossible to form relationships: he
personality disorders. Here is the chain:mistrusts (himself and by extension others),
controlling one's eating disordershe does not want to become an adult, he does
controlling one's life enhanced sense ofnot enjoy sex or love (which both entail a
self-worth, self-confidence, self-esteem amodicum of loss of control). All this leads
challenge, an interest, an enemy to subjugateto a chronic absence of self-esteem. These
a feeling of strength socialising feelingpatients like their disorder. Their eating
better.disorder is their only achievement. Otherwise
they are ashamed of themselves and disgusted
When a patient has a personality disorder andby their shortcomings (expressed through
an eating disorder, the therapist shouldshame  and disgust directed at their bodies).
concentrate on the eating disorder.
Personality disorders are intricate andThere is a chance to cure the patient of his
intractable. They are rarely curable (thougheating disorders (though the dual diagnosis
certain aspects, like OCD, or depression canof eating disorder and personality disorder
be ameliorated with medication). Theirhas a poor prognosis). This - and ONLY this -
treatment calls for the enormous, persistentmust be done at the first stage. The
and continuous investment of resources ofpatient's family should consider therapy AND
every kind by everyone involved. From thesupport groups (Overeaters Anonymous).
patient's point of view, the treatment of herRecovery prognosis is good after 2 years of
personality disorder is not an efficienttreatment and support. The family must be
allocation of scarce mental resources. Alsoheavily involved in the therapeutic process.
personality disorders are not the realFamily dynamics usually contribute to the
threat. If a patient with a personalitydevelopment  of  such  disorders.
disorder is cured of it but her eating
disorders are aggravated, she might dieMedication, cognitive or behavioural therapy,
(though  mentally  healthy)...psychodynamic therapy and family therapy
ought  to  do  it.
An eating disorder is both a signal of
distress ("I wish to die, I feel so bad,The change in the patient IF the treatment of
somebody help me") and a message: "I think Ihis eating disorders is successful is VERY
lost control. I am very afraid of losingMARKED. His major depression disappears
control. I will control my food intake andtogether with his sleeping disorders. He
discharge. This way I control at least ONEbecomes socially active again and gets a
aspect  of  my  life."life. His personality disorder might make it
difficult for him - but, in isolation,
This is where we can and should begin to helpwithout the exacerbating circumstances of his
the patient. Help him to regain control. Theother disorders, he finds it much easier to
family or other supporting figures must thinkcope  with.
what they can do to make the patient feel
that he is in control, that he manages thingsPatients with eating disorders may be in
his own way, that he is contributing, has hismortal danger. Their behaviour is ruining
own  schedules,  his  own  agenda,  matter.their bodies relentlessly and inexorably.
They might attempt suicide. They might do
Eating disorders indicate the strong combineddrugs. It is only a question of time. Our
activity of an underlying sense of lack ofgoal is to buy them time. The older they get,
personal autonomy and an underlying sense ofthe more experienced they become, the more
lack of self-control. The patient feelstheir body chemistry changes with age - the
inordinately, paralysingly helpless andbetter their prognosis.



1 A B C D E 72 74 75 76 77 78 79 80 81 82 83 84 85 86 87 89 90 91 92 93 95 96 98 99 101 102 103 104 105 106 107 108 109 110 111 112 113 114