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Defences provide both satisfaction and a sense of security purchase betoptic amex. Otto Kernberg (1975 order on line betoptic, 1984 best purchase for betoptic, 1987) is a senior member of the Object Relations school in Psychology (comprising also Kohut purchase cheap betoptic on line, Klein, and Winnicott). Kernberg regards as artificial the division between Object Libido (energy directed at people) and Narcissistic Libido (energy directed at the self). Whether the child develops a normal or a pathological form of narcissism depends on the relations between the representations of the self (the image of the self that the child forms in his or her mind) and the representations of objects (the images of other people that the child forms in his or her mind). It is also dependent on the relationship between the representations of the self and real objects. The development of pathological narcissism is also determined by instinctual conflicts related both to the libido and to aggression. The Self is dependent upon the unconscious, which exerts a constant influence on all mental functions. Pathological narcissism, therefore, reflects a libidinal investment in a pathologically structured Self and not in a normal, integrative structure of the Self. The narcissist suffers from a Self, which is devalued or fixated on aggression. All object relations of such a pathological Self are detached from the real objects (because they often cause hurt and narcissistic injury) and involve dissociation, repression, or projection onto other objects. Narcissism is not merely a fixation on an early developmental stage. It is not confined to the failure to develop intra-psychic structures. It is an active, libidinal investment in a deformed structure of the Self. Fred - Narcissism: Socrates, the Frankfurt School and Psychoanalytic Theory - New Haven and London, Yale University Press - 1988 ISBN 0300040644Fairbairn, W. Davis, contributor) - Disorders of Personality: DSM IV and Beyond - 2nd ed. Psychoanalytic Association - 22 (1974): 292-305Stern, Daniel - The Interpersonal World of the Infant: A View from Psychoanalysis and Developmental Psychology - New York, Basic Books, 1985 ISBN 0465095895Vaknin, Sam - Malignant Self Love - Narcissism Revisited - Skopje and Prague, Narcissus Publications, 1999-2005 ISBN 8023833847Zweig, Paul - The Heresy of Self-Love: A Study of Subversive Individualism - New York, Basic Books, 1968 ISBN 0691013713 The narcissist is an actor in a monodrama, yet forced to remain behind the scenes. He feeds off other people who hurl back at him an image that he projects to them. This is their sole function in his world: to reflect, to admire, to applaud, to detest - in a word, to assure him that he exists. Otherwise, they have no right to tax his time, energy, or emotions - so he feels. According to the legend of Narcissus, this Greek boy fell in love with his own reflection in a pond. Presumably, this amply sums up the nature of his namesakes: narcissists. The mythological Narcissus rejected the advances of the nymph Echo and was punished by Nemesis, consigned to pine away as he fell in love with his own reflection - exactly as Echo had pined away for him. Narcissists are punished by echoes and reflections of their problematic personalities up to this very day. My book, Malignant Self Love - Narcissism Revisited , offers a detailed, first-hand account of what it is like to have a Narcissistic Personality Disorder (NPD). It offers new insights and an organized methodological framework using a new psychodynamic language. Inside this site, and through my book, I survey the main body of research about narcissism. I warn you though, Narcissism is a slippery subject: only with great difficulty can it be captured with words. A new vocabulary had to be invented to account for the myriad of facets and appearances - false and true - of this disease. I recommend that you start with the Table of Contents so that you can take fully advantage of the extensive information presented here. So enjoy your visit, read more about me, and come back often. Warning & Disclaimer: The contents of this website are not meant to substitute for professional help and counseling. The readers are discouraged from using it for diagnostic or therapeutic ends. The diagnosis and treatment of the Narcissistic Personality Disorder can only be done by a professional specifically trained and qualified to do so - which the author is not. We have extensively dealt with the classical, Freudian, concept of the Ego. It is a partly conscious, partly preconscious and unconscious. It maintains an inner equilibrium between the onerous (and unrealistic, or ideal) demands of the Superego and the almost irresistible (and unrealistic) drives of the Id. It also has to fend off the unfavourable consequences of comparisons between itself and the Ego Ideal (comparisons that the Superego is only too eager to perform). In many respects, therefore, the Ego in Freudian psychoanalysis IS the Self. Princeton University Press, 1960-1983]:"Complexes are psychic fragments which have split off owing to traumatic influences or certain incompatible tendencies. As the association experiments prove, complexes interfere with the intentions of the will and disturb the conscious performance; they produce disturbances of memory and blockages in the flow of associations; they appear and disappear according to their own laws; they can temporarily obsess consciousness, or influence speech and action in an unconscious way. In a word, complexes behave like independent beings, a fact especially evident in abnormal states of mind. In the voices heard by the insane they even take on a personal ego-character like that of the spirits who manifest themselves through automatic writing and similar techniques. Individuation is then nothing but egocentredness and autoeroticism. Individuation does not shut one out from the world, but gathers the world to oneself. It is the archetype of order as manifested in the totality of the personality, and as symbolised by a circle, a square, or the famous quaternity. Sometimes, Jung uses other symbols: the child, the mandala, etc. It embraces not only the conscious but also the unconscious psyche, and is therefore, so to speak, a personality, which we also are.... There is little hope of our ever being able to reach even approximate consciousness of the self, since however much we may make conscious there will always exist an indeterminate and indeterminable amount of unconscious material which belongs to the totality of the self. Technically, the Shadow is a part (though an inferior part) of the overarching personality. Inevitably, some personal and collective psychic elements are found wanting or incompatible with it. Their expression is suppressed and they coalesce into an almost autonomous "splinter personality". This second personality is contrarian: it negates the official, chosen, personality, though it is totally relegated to the unconscious. Jung believes, therefore, in a system of "checks and balances": the Shadow balances the Ego (consciousness). The behavioural and attitudinal compensation offered by the Shadow can be positive. Jung: "The shadow personifies everything that the subject refuses to acknowledge about himself and yet is always thrusting itself upon him directly or indirectly for instance, inferior traits of character and other incompatible tendencies. If it has been believed hitherto that the human shadow was the source of all evil, it can now be ascertained on closer investigation that the unconscious man, that is, his shadow, does not consist only of morally reprehensible tendencies, but also displays a number of good qualities, such as normal instincts, appropriate reactions, realistic insights, creative impulses, etc. Perhaps the complexes (also the result of incompatibility with the conscious personality) are the negative part of the Shadow. Perhaps they just reside in it, on closely collaborate with it, in a feedback mechanism. To my mind, whenever the Shadow manifests itself in a manner obstructive, destructive or disruptive to the Ego we can call it a complex. They are one and the same, the result of a massive split-off of material and its relegation to the realm of the unconscious. This is part and parcel of the individuation-separation phase of our infantile development. Prior to this phase, the infant begins to differentiate between self and everything that is NOT self.

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The severe restriction of calories does not provide the body the fuel needed to function normally order betoptic 5ml line. As a result purchase betoptic pills in toronto, it goes into starvation mode order betoptic 5ml overnight delivery, conserving energy by shutting down non-essential processes generic betoptic 5 ml with visa. Anorexia health problems include a range of medical and psychological conditions, some of which are life-threatening. If the disorder remains untreated, further anorexia health problems will occur, such as:growth of fine hair covering the body and faceAdditional physical effects and complications of anorexia include insomnia, restlessness, headaches, dizziness and fainting. The malnutrition caused by a severely restricted diet causes damage to the teeth, gums, esophagus and larynx. As the behaviors associated with anorexia continue and more body fat is lost, the medical complications become more severe. The anorexia complications can progress into heart problems, kidney damage, and even death. Conditions causing death in those with extreme anorexia include heart disease and multi-organ failure, which happens in very late stages of anorexia and is typically caused by high levels of liver enzymes in the blood. Heart disease is the most common medical cause of death for those with severe anorexia nervosa. Anorexia can cause a range of heart effects, including slow heart rhythms. Known as bradycardia, this symptom even shows up in teens with anorexia. A heart rate under 60 beats per minute leads to reduced blood flow and dangerously low blood pressure. The heart is significantly affected by the loss of minerals due to reduced consumption of food, leading to electrolyte imbalance. Many of these electrolytes, such as calcium and potassium, are essential for regulating the heartbeat. Unless the fluids and minerals are replaced quickly, electrolyte imbalance can be a serious, life-threatening condition. Other blood problems are also common, including anemia, caused by low levels of vitamin B12 in the blood. Extreme anorexia causes the bone marrow to reduce the production of blood cells. This life-threatening complication of anorexia is known as pancytopenia. Hormonal changes are one of the most serious health complications of anorexia. Changes in hormones that regulate growth, stress, thyroid function, and reproduction have wide-ranging consequences. Long-term, anorexia can result in stunted growth, hair loss, infertility, bone loss (osteoporosis), and irregular or absent menstruation. Bone loss, including loss of bone calcium or bone density, is one of the most common anorexia health problems, affecting nearly 90 percent of women with anorexia. Children and teens with anorexia fail to develop strong bones and face stunted growth due to malnutrition during critical growth stages. Weight gain will not completely restore the bone, and the longer the eating disorder persists, the more bone damage is likely. In cases of severe anorexia, patients may never regain normal menstrual cycles. If women with anorexia become pregnant before returning to a normal weight, risks include increased incidences of miscarriage, cesarean section, and postpartum depression. Her child is at risk of low birth weight and birth defects. Eating disorders are particularly serious for those who also have Type 1 diabetes, which is significantly affected by the low blood sugar caused by skipping meals. Some patients may skip daily insulin in order to further reduce their caloric intake, resulting in dangerously high blood sugar levels, which can cause coma or death. Severe anorexia can cause nerve damage, resulting in conditions such as seizures, disordered thinking or strange sensations in the feet or hands. Brain scans provide evidence that parts of the brain may undergo permanent or long-term structural changes due anorexia. Although the physical complications of anorexia are most visible, it is important not to overlook the possible emotional and psychological effects of this disorder. Those who are living with anorexia often develop severe mood swings, depression, and thoughts of suicide. Eating disorders are also tied to feelings of anxiety or guilt. Those with anorexia will often isolate themselves from others in order to hide their eating habits and the extent of the problem. They may feel out of control or helpless to do anything about the problem. Anorexia is also tied to obsessive thoughts and compulsive behaviors. Because of changes in the brain as a result of long-term anorexia, patients with this eating disorder may have difficulty weighing priorities and making logical choices. Those seeking treatment of anorexia know that it can have devastating physical and emotional consequences. The first step in getting anorexia treatment is scheduling a doctor visit. The doctor will make an official diagnosis and develop a treatment plan. With early intervention and the right treatment team, patients with anorexia can regain health and develop healthier attitudes regarding food intake. Malnutrition and starvation can have wide-ranging health consequences for those with anorexia, even if it is detected early. Hospitalization may be necessary, depending on the extent of the disorder. Outpatient treatment is also available for patients who are not in immediate medical danger due to their low body weight or complications arising from the eating disorder. The doctor will treat medical conditions such as heart problems or osteoporosis arising from the eating disorder. Nutritional intervention is an essential part of treatment for anorexia nervosa. This can occur on either an inpatient or outpatient basis. In general, those who are more than 15 percent below their healthy weight have difficulty gaining it back without a highly structured nutritional program. Those weighing 25 percent below their healthy weight may need to take part in an inpatient treatment program. Restoring nutrition reduces further bone loss, normalizes hormonal function, and restores energy levels. Often, this step must be taken before the patient can fully benefit from eating disorders therapy and other psychological treatments focusing on the underlying causes of anorexia. The goal for weight gain in patients with anorexia is usually about 2-3 pounds per week for those in an inpatient setting, and between half a pound and 1 pound for outpatients. The daily caloric intake is gradually increased, up to 2,000-3,500 calories per day. In addition, most anorexia patients also take nutritional supplements, primarily calcium and vitamin D, in order to counteract the deficiencies caused by anorexia. Although the use of a feeding tube or intravenous feeding is typically discouraged, since it interferes with a return to normal eating habits, these methods may be required for extreme cases. Nutritional counseling, a key component of anorexia treatment, involves meetings with a nutritional counselor in order to learn about balanced meals and proper nutrition. The nutritionist will also assist the patient in developing and following meal plans that provide the right nutrients and caloric intake to reach and maintain a healthy weight. For children or teens, the Maudsley Approach to nutrition may be recommended. With this approach, parents plan and supervise all meals and snacks, gradually giving more personal responsibility for nutrition and meal planning to the patient. This approach also includes weekly family meetings and family counseling. Anorexia Nervosa treatment includes not only the treatment of symptoms related to limited food intake, but also the psychological causes of the disorder.

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If antidepressants are used to treat bipolar depression order betoptic toronto, they are combined with the use of a mood stabilizer or atypical antipsychotic medication to prevent the appearance of bipolar mania generic betoptic 5ml on-line. These are used to manage the anxiety that is very common with bipolar depression buy betoptic 5 ml visa. Typical benzodiazepines and non-benzodiazepines used as medications for bipolar depression include:The last two medications are typically used as sleep medications best 5 ml betoptic. There is a risk of dependence with these drugs, but many use these drugs for anxiety and sleep without issue. Most people with bipolar depression who are successfully treated, often take several drugs simultaneously, sometimes called a medication cocktail. Results from a recent research project called the STEP-BD Project found 89% of those successfully treated for bipolar disorder required, on average, three medications from the above categories. Off-label use is an ethical and legal use of medications that have not specifically been sanctioned for use of a specific condition by the FDA. FDA Approved Bipolar Depression Medications: At this time, there are two specifically approved medications for bipolar depression treatment:Maintenance medications for bipolar maintain stability in bipolar disorder. Find out why Depakene is prescribed, side effects of Depakene, Depakene warnings, effects of Depakene during pregnancy, more - in plain English. Depakene, an epilepsy medicine, is used to treat certain types of seizures and convulsions. It may be prescribed alone or with other anticonvulsant medications. Depakene can cause serious, even fatal, liver damage, especially during the first 6 months of treatment. Children under 2 years of age are the most vulnerable, especially if they are also taking other anticonvulsant medicines and have certain other disorders such as mental retardation. The risk of liver damage decreases with age; but you should always be alert for the following symptoms: loss of seizure control, weakness, dizziness, drowsiness, a general feeling of ill health, facial swelling, loss of appetite, vomiting, and yellowing of the skin and eyes. If you suspect a liver problem, call your doctor immediately. Note too that Depakene has been known to cause rare cases of life-threatening damage to the pancreas. This problem can develop at any time, even after years of treatment. Call your doctor immediately if any of the following warning signs appear: abdominal pain, loss of appetite, nausea, and vomiting. If Depakene irritates your digestive system, take it with food. To avoid irritating your mouth and throat, swallow Depakene capsules whole; do not chew them. If you take 1 dose a day, take the dose you missed as soon as you remember. If you do not remember until the next day, skip the dose you missed and go back to your regular schedule. If you take more than 1 dose a day and you remember the missed dose within 6 hours of the scheduled time, take it immediately. Take the rest of the doses for that day at equally spaced intervals. Side effects are more likely if you are taking more than one epilepsy medication, and when you are taking higher doses of Depakene. Indigestion, nausea, and vomiting are the most common side effects when you first start taking this drug. If any side effects develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Depakene. More common side effects of Depakene may include: Abdominal cramps, amnesia, breathing difficulty, depression, diarrhea, dimmed or blurred vision, drowsiness, hair loss, indigestion, infection, involuntary eye movements, loss or increase in appetite, nausea, nervousness, ringing in the ears, sleeplessness, swelling of the arms and legs due to fluid retention, throat inflammation, tremors, vomitingLess common or rare side effects may include: Abnormal dreams, abnormal gait, abnormal taste, aggression, anemia, anxiety, back pain, belching, bleeding, blood disorders, bone pain, breast enlargement, breast milk not associated with pregnancy or nursing, bruising, changes in behavior, chest pain, coma, confusion, constipation, cough, deafness, difficulty in speaking, dizziness, double vision, dry skin, dulled senses, ear pain and inflammation, emotional upset, excessive urination (mainly children), feeling of unwellness, fever, gas, growth failure in children, hallucinations, headache, high blood pressure, involuntary jerking, irregular heartbeat, irregular menstrual periods, itching, joint pain, lack of coordination, leg cramps, liver disease, loss of bladder control, loss of coordination, menstrual abnormalities, muscle pain, muscle weakness, nosebleed, overactivity, personality disorder, pneumonia, prickling or tingling sensation, rash, rickets (mainly children), sedation, sensitivity to light, sinus inflammation, skin eruptions or peeling, spots before the eyes, swollen glands, twitching, urinary tract infection, vaginal infection, vertigo, vomiting blood, weakness, weight loss or gainYou should not take this drug if you have liver disease or your liver is not functioning properly, or if you have had an allergic reaction to it. Remember that liver failure is possible when taking Depakene (see "Most important fact about this drug"). Your doctor should test your liver function at regular intervals. Also keep in mind the threat of damage to the pancreas (see "Most important fact about this drug"). This problem can develop rapidly, so contact your doctor immediately if you experience any symptoms. In people with a rare set of genetic abnormalities called urea cycle disorders, Depakote may adversely effect the brain. Signs of a developing problem include lack of energy, repeated attacks of vomiting, and mental changes. If you suspect a problem, see your doctor immediately. Depakene has also been known to cause a very rare but potentially fatal skin condition. Contact your doctor if you notice any changes in your skin. Some side effects are more likely if you have manic episodes or suffer from migraines. Your doctor will monitor your care closely if you have one of these conditions. Because of the potential for side effects involving blood disorders, your doctor will probably test your blood before prescribing Depakene and at regular intervals while you are taking it. Bruising, hemorrhaging, or clotting disorders usually mean the dosage should be reduced or the drug should be stopped altogether. Depakene may cause drowsiness, especially in older adults. You should not drive a car, operate heavy machinery, or engage in hazardous activity until you know how you react to the drug. Do not abruptly stop taking this medicine without first consulting your doctor. A gradual reduction in dosage is usually required to prevent major seizures. This drug can also increase the effect of painkillers and anesthetics. Before any surgery or dental procedure, make sure the doctor knows you are taking Depakene. If Depakene is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Depakene with the following:Barbiturates such as phenobarbital and SeconalBlood-thinning drugs such as Coumadin and DicumarolExtreme drowsiness and other serious effects may occur if Depakene is taken with alcohol or other central nervous system depressants such as Halcion, Restoril, or Xanax. The drug is not recommended for pregnant women unless the benefits of therapy clearly outweigh the risks. In fact, women in their childbearing years should take Depakene only if it has been shown to be essential in the control of seizures. Since Depakene appears in breast milk, nursing mothers should use it only with caution. The usual starting dose is 10 to 15 milligrams per 2. Your doctor may increase the dose at weekly intervals by 5 to 10 milligrams per 2. If stomach upset develops, the dose may be increased more slowly. The daily dose should not exceed 60 milligrams per 2. Older adults generally are prescribed reduced starting doses, and receive dosage increases more gradually than younger people.

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