Text 9. Taming the Beast: Pathological Narcissism

(from Self Help and Psychology Magazine, by Sam Vaknin, Ph.D,1999)

(1) Many textbooks (and many patients) claim that the psychodynamic therapies when applied to personality disorders are ineffective. Functional (cognitive, behavioral) treatments should be preferred in certain cases and regarding certain aspects of the disorder. This article is addressed to those individuals living with Narcissistic Personality Disorder. To such a Narcissist, I would recommend a behavioral-cognitive-functional and less protracted type of therapy.

(2) A good self-help start: Know and accept thyself. This is what you are. You are intelligent. You are very inquisitive. You are a Narcissist. These are facts. Narcissism is an adaptive mechanism. It is dysfunctional - but it saves you from a LOT MORE dysfunction or even a-function. Make a list: what does it mean to be a Narcissist in your specific case? What are your typical behavior patterns? Which types of behavior are counterproductive, irritating, self-defeating or self-destructive? Which are productive, constructive and should be enhanced DESPITE their pathological origin?

(3) Decide to suppress the first and to promote the latter. Construct lists of self-punishments, negative feedback and negative reinforcements. Impose them upon yourself when you exhibit one of the behaviors in the first list. Make a list of prizes, little indulgences, positive feedbacks and positive reinforcements. Use them to reward yourself when you display a behavior of the second kind.

(4) Keep doing this with the express intent of conditioning yourself. Be objective, predictable and just in the administration of both punishments and awards, positive reinforcements and feedback and negative ones. Learn to trust your " inner court. " Constrain the sadistic, immature and ideal parts of your personality (known as " superego " in psychoanalytic parlance) by the application of a uniform codex, a set of immutable and invariably applied rules.

(5) Once sufficiently conditioned, monitor yourself incessantly. Narcissism is sneaky and it possesses all your resources because it is you. It is intelligent because you are. Beware and never lose control. With time this onerous regime will become a second habit and supplant the Narcissistic (pathological) superstructure.

(6) All the above can be amply summed by suggesting to you to become your own parent. This is what parents do and the process is called " education " or " socialization. " If your particular path to the adoption of this course is a particular therapy — go ahead. As ametaphor, a narrative, no therapeutic approach is better or worse than any other.

Text 10. The Holidays Need Not Be a Pain

(from Self Help and Psychology Magazine by Miryam Ehrlich Willia'font-size:14.0pt;'>

(1) For many people who have fibromyalgia (FM) the conventional greeting at this time of year, "Happy Holidays," has an ironic ring to it. Thanksgiving Day, Hanukkah, Christmas, Kwanzaa, New Year's Eve, and New Year's Day can provide bitter reminders of all the things that are expected of us, and all the things we cannot do. House guests arrive, party invitations come in the mail, andgifts must be purchased and delivered. There are cookies to bake, cards to sign and address, decorations to put up, and a host of other commitments to be met.

(2) It all seems so impossible that it's no wonder the winter holiday season is often more stressful than pleasurable. Even people who don't have FM feel the pressure, but for those who do have it, the need for strategies to get through the holidays is particularly essential. Here are some suggestions to make your holidays as pleasant and stress-free as possible.

(3) If house guests are inevitable, help them to be self-sufficient. Show them where the necessities are and encourage them to help themselves. Before introducing them to the refrigerator, mark clearly those food items that are off limits. Keeping to your normal life and sleep schedule is the most important thing you can do for yourself. You can't sit up chatting all night and expect to function the next day. Tell your guests that you have this need, and excuse yourself without apology or regret at your normal bedtime. Don't give up your bed to a guest. That's what sofa beds and guest rooms are made for.

(4) Cook ahead and freeze as much as you can. There's no law that says you have to stand at the kitchen counter to cut up vegetables for the salad. There is no virtue in doing things the hard way. Look at every task with a critical eye, and figure out the easiest way to do it. Cut corners wherever you can. Watch your nutrition. You are what you eat. Don't skip meals and make up for it in snacks.

(5) Don't fall prey to that common fear of giving a gift that the recipient will not like. Do the best you can and let it go at that. Be selective. Accept only those invitations to the parties that really appeal to you, and where you know the host will consider your needs and comfort. Avoid situations that are raucous and overstimulating. Give yourself time to unwind before you try to sleep. If you choose not to accept any invitations, or don't get any that are appropriate for your needs, consider having a party yourself. Make it a pot-luck brunch afternoon or early-evening event. Playing soothing background or ambient music will give your guests the clue that boisterousness is not appropriate.

(6) Many people, not only those with fibromyalgia, experience feelings of loss or disappointment at holiday time. If the holiday bluesget to you, write about it, or talk it out with your favorite good listener. Accept your feelings as normal, and move on. You are not here to live up to other people's expectations. Be clear about your limitations and needs - with yourself as well as with others. Avoid people who are toxic to you, surround yourself with those who are good to and for you, and enjoy yourself. Put your own needs first this year. Some times it is more blessed to receive than to give.

Text 11. Professional Groups

(from Teaching in Practice, by Andy Farquharson, 1995)

(1) Professional colleagues from the same or allied helping professions are also targets for teaching by human service practitioners. Most frequently this involves group teaching (so professional colleagues are really just a more specific target group). Practicing professionals may be invited to teach in university and college preserves programs, or more frequently they may be asked to act as a resource for in-service programs that train practitioners in new skills or offer ongoing professional development. Learning by fellow professionals may also befacilitated more subtly, in the course of collaborative work by interdisciplinary teams. In this context there is typically a continuing need to help other team members learn from the expertise each member brings to the process of cooperative problem solving.

(2) There is also an ongoing need for people in different professions to keep others informed about their roles and their individual contributions to the collaborative effort. This book should encourage professionals in the human services to take advantage of any and all opportunities toteach their peers and to facilitate collegial learning. Teaching can be as tangible and purposeful as any other aspect of professional practice. Effective teaching with professional peers can be an important way to apply many of the ideas contained in this book.

Individual Professionals

(3) A final target for teaching are practitioners themselves as they engage in ongoing professional development. In order for professionals to remain abreast of trends in a particular discipline, they must be proactive in managing their own continuing professional development. This is particularly important given the limited life span of knowledge within many human service disciplines old knowledge, skills, and attitudes are continually displaced by the wealth of new information on ways to improve professional practice.

(4) It is evident that frequently when practitioners engage in informal teaching interventions, the teaching relationship is based on an implicit understanding rather than an explicit agreement or contract between the parties. The need for such an arrangement occurs when the practitioner believes a target learner would be reluctant to assume the role of student or learner. Or the practitioner might conclude that the targeted learner or learners will resist the content of what is to be learned if it is taught in an explicit fashion. Examples of this kind ofimplicit teaching may be found in the relationship between parents and their children. In these situations teaching may need to be very subtle, because the child's awareness of the parent as a teacher can be repugnant particularly to adolescents!

(5) There are important ethical issues raised by implicit teaching and the right of people to be consciously aware of all that is taking place within the context of their relationship with a helping professional. These ethical concerns will be explored in Chapter Nine, but at this point it will suffice to note that professionals in the human services need to be constantly alert to the potential for domination and for violation ofpeople's right to self-determination. This is particularly important when a practitioner engages in implicit teaching with a client.