Lisa Find Love

Fear of going to the dentist is a common health-care related anxiety. Patients often express a broad range of triggers, such as the fear of pain, claustrophobia, needles, sounds, or sensations. Unfortunately, long term avoidance of oral healthcare can lead to deeply debilitating problems that can be physically, psychologically and socially impactful. Our mouth represents a center point for our survival, by impacting our ability to eat comfortably and communicate. So, caring for this immensely important part of our bodies is crucial for both our general health and psychological wellbeing. 

Often minor dental problems can be easily ignored. Many people may be aware that something feels wrong or isn’t right in their mouths. It might be an area where food becomes stuck, it could be a sharp or rough part of a tooth, or it could be the experience of sensitivity to hot, cold or sweet foods. It may simply manifest as a general feeling of irrigation around the gums. Unfortunately, most minor dental problems tend to progress to major dental problems with time and ignoring small issues can culminate into a larger and more impactful concern. 

There are many aspects of dental treatment recognized as specific causes or triggers of anxiety. Undergoing dental treatment is a very multi-sensory experience. There is the feeling associated with having the teeth, lips, cheeks tongue and gums touched. There is the sound of the drill and suction. There is the taste of the gloves, instruments, and materials, the sight of the tools and instruments, and the smell that every dental practice seems to have. For some people, this can culminate in an overwhelming experience. 

For others, it is a specific part of the dental experience that induces their anxiety. The most common of these are the fear of needles or injections, the sound or feel of the drill, and the experience of people within their personal space. In many cases, a previous dental experience (often as a child) has become the nucleus of the anxiety. In these circumstances, many patients report that the experience of pain and the feeling of powerlessness are the areas of greatest concern. 

Unpacking common dental anxieties

It’s difficult to address something that can’t be identified. Exploring and unpacking the negativity associated with any previously difficult experience(s) is the first step. Sometimes this is best done with a counselor or psychologist, depending of the severity of the trauma. However, opening up to a friend or family member that is available to accompany and support you throughout any interactions with a dentist can also be very important. The outcome that you are trying to achieve is to be able to identify and articulate the components of dental treatment that you find difficult, so that these many be carefully minimized or avoided.

Anxiety associated with experiencing pain can be one of the easiest phobias to address. Often this has developed as a result of experiencing unexpected pain during a dental procedure. This may have been when a filling was being placed, or a tooth was being removed, and typically causes tense anticipation and fear during subsequent dental interactions.

The use of local anesthesia and local anesthesia placement techniques have developed considerably. There are many strategies and approaches that we commonly take to ensure “profound anesthesia” prior to undertaking a procedure. Clinically, it is often appropriate to take a trust-building approach with patients who carry this form of anxiety, where we aim to complete simple procedures in a pain-free manner in order to build a patient’s confidence and experience with the normal sensations associated with dental treatment.

Needle phobia can also be easily mitigated. Many dental procedures can be performed without the need of anesthesia, and there are new non-traditional forms of delivering local anesthesia that don’t involve a conventional syringe. Utilizing local anesthetic delivery devices can allow a patient to receive profound anesthesia painlessly. This technique is commonly combined with the use of a topical anesthetic that pre-numbs the area which needs to be anesthetized. 

Anxiety related to personal space and bring touched around the mouth can be very impactful and make even simple non-invasive dental care such as a check-up difficult. Phobias of this nature often derive from a feeling of helplessness, or not being in control. In many circumstances, the dental experience can be greatly improved by ensuring patients know they have the power to stop the procedure at any time, and that this will be respected under all circumstances. Many patients who experience this type of anxiety benefit from having the steps in a procedure verbally explained or narrated to them, so they can anticipate any sensations that they may experience. In my clinical experience, the core component of this anxiety relates to trust, and through familiarity with the dental team, and patient exposure to the dental setting this kind of phobia can be overcome.

Many patients suffer from anxiety related to the status of their oral health, the extent of treatment they may need, and the cost related to that treatment. This fear of the unknown can be remedied with clear and forthright communication. Every dentist is trained in clinical diagnosis and intervention, but the time and care taken to communicate in an effective way is subject to an individual’s personality. Some people can be told something once, and they’ll never forget it. Some of us need to be shown something visually, some of us just don’t get it until we experience it first-hand. As a result, finding a dentist capable of communicating your oral health status, quantifying the options available, and establishing an itemised treatment plan in a way that you can understand is essential. Identifying, and understanding is the first step towards owning your oral health, and quantifying a challenge is the first step towards solving it.

Finding a path forward:

1. Identify the aspect of dental treatment that is causing you anxiety. Understand that you are not alone, and dental anxiety is relatively common.
2. Communicate your concerns to friends and family and find someone who can accompany you during appointments. 
3. Communicate with the dentist, or dental practice you feel will be the best fit for you. For some people, prioritising quick appointments and availability is most important. For some, the gender of the doctor, their training, language or cultural background, or specific interest in managing anxious patients are more important. Dentists dedicate their professional lives to helping people through difficult procedures, and many find particular satisfaction in helping anxious or phobic patients overcome their fears.
4. Understand that dental treatment takes time, and it’s not in anyone’s best interest to jump into treating an anxious patient at the first appointment. Anxious patients often “just want it over with” and can further perpetuate their phobia by engaging in unplanned or sporadic treatment.
5. The first appointment is to meet and discuss. If an examination is possible, then this can be completed but discussing the type of anxiety, any possible triggers, and how you need to be treated is the most important outcome of this first visit. 
6. Find out the extent of any treatment that is required and ensure this is communicated to you in a way that you fully understand it. There are often a number of different options to solve a dental issue, and it is an important step in anxiety management to derive empowerment from making important decisions about the future of your oral health.
7. Taking the first step: By this stage you will have identified extent of your dental anxiety, found a suitable and sympathetic dentist, and identified the extent of your oral health needs. It’s at this stage that it’s appropriate to discuss the clinical approach that will best serve your needs, which may involve the experiential minimisation, or trust-building strategies outlined above. The adjunct use of sedation therapies may also be beneficial where appropriate.

Whether overcoming dental anxiety is to eat comfortably or is to strengthen the influential psychosocial components of self-esteem, the necessity for oral health is important for everyone. Developing an empathic and trustful relationship with an oral healthcare professional is possible and feeling empowered to approach this challenge on your own terms can become a source of strength which impacts across many aspects of our lives.

In 1967, Martin Seligman, one of the founders of Positive Psychology and his research group carried out a fascinating, if somewhat morally dubious experiment in his quest to understand the origins of depression. In this experiment, three groups of dogs were confined in harnesses. The dogs in group 1 were simply placed in their harnesses then released after a period of time, but the dogs in groups 2 and 3 did not have it so easy. Instead they were subjected to electric shocks that could only be stopped by pulling a lever. The difference was that the the dogs in group 2 had access to the lever, whereas the dogs in group 3 did not. Instead, the dogs in group 3 would only receive relief from the shocks when their pair in group 2 pressed the lever, with the result that they experienced the shocks as random events.

The results were revelatory. In the second part of the experiment, the dogs were placed in a cage and again subjected to electric shocks, which they could escape by jumping over a low partition. The dogs from groups 1 and 2 did what any dog would be expected to do and searched for an escape root, but the dogs in group 3 did not, despite no other obstacles being placed in their way. Instead, they simply lay down and whined in a passive fashion. Because they had been habituated to thinking of the electric shocks as something over which they had no control, they did not even try to escape in the way they would have done without this acquired “training”. Indeed, trying to motivate the dogs with rewards of other forms of threat produced the same passive result. Only by physically prompting the dogs to move their legs and guiding them through the process of escaping could the researchers prompt the dogs to act in the normal fashion.

This experiment introduced to the psychological community the concept of “learned helplessness”. It goes without saying that designing a similar experiment for humans would cross the line between dubious ethics and outright illegality. However, we don’t need such a controlled experiment to observe the phenomenon of learned helplessness among humans; once you understand the concept you’ll find it everywhere. One of the things Seligman’s experiment shows us, perhaps, is that the irrational defeatism and despair that characterizes depressed individuals is not so much a product of our uniquely human brains, but a result of processes that are so deeply ingrained in our evolutionary makeup that we share them with dogs.

How to Think about Mental Health

The concept of learned helplessness also has great implications for the way we think about mental health — and mental illness — in general. One way of thinking about mental illness is to look at the brain as an extremely complicated, organic machine. If everything is working correctly, the result is a happy, balanced, and productive personality. If something is not, whether it has to do with chemical transmitters, neuron pathways, grey matter, or something else entirely, then the result is one or another form of mental illness.

One problem with this model is that our knowledge of the brain is not sufficient to use it as a guide to action. You may have heard, for instance, that depression is caused by “a chemical imbalance in the brain”, but in fact there has never been any real evidence for this claim and the psychiatric industry has quietly dropped it. There is a lot of evidence that antidepressants and other psychotropic medications work at combatting certain symptoms, but there is little agreement about how or why they do so.

However, there is a deeper problem: if we conceptualize the brain as a machine, why does it so frequently “go wrong”? It is true that some mental problems are caused by pathogens or injuries to the head, and others are the result of genetic causes, but most cases of depression or anxiety are responses to adverse life experiences. We often use the concept of “trauma” to explain the mechanism by which, for example, losing a loved one can lead to prolonged periods of depression. We have used the term for so long that we forget that it originated as a sort of metaphor. Trauma comes from the ancient Greek term for wound, so by using the term we are saying that traumatic events wound the brain and that symptoms which follow are the result of this wounding. We are coming to more and more appreciate the role that trauma, especially childhood trauma, plays in a wide range of common mental health diagnoses. By looking in the brain in this way, we are essentially subscribing to the view that the brain is not only an extremely complex machine, but an extraordinarily fragile one, so fragile, one might add, that it would appear a wonder that the human race has survived at all.

However, this is not the only way of looking at the issue. Let us return to the Seligman’s experiments with dogs. These experiments were far from being the first of their kind. Indeed, they had been a mainstay of psychological research for decades. Ivan Pavlov started when he demonstrated in 1901 that a dog who heard a bell ringing every time he was given food would start to salivate when he heard the bell even when no food was present. Subsequent research would demonstrate that dogs could be trained quite easily to perform a wide range of tasks through a structured set of rewards and punishments. What Seligman’s experiment showed is that the same kind of inputs can be used not to make a dog perform a particular task, but to make it entirely dysfunctional. “Learned helplessness” describes a state that comes not from a kind of metaphorical injury so much as a process of learning in which the dog learns that the world is random, cruel, and impossible to navigate through.

So too, victims of trauma should not be seen as possessing a brain that has been damaged by outside injury, but as having gone through a process of learning under unusual circumstances. While our knowledge of the brain remains incomplete, one thing we do know is that it is not a fixed entity which will fall apart if one part is altered, but a flexible organ that grows and develops in response to different stimuli. We call this phenomenon “brain plasticity” — the ability of the brain to reorganize itself. The enormous potential of the human brain to adapt to new circumstances is what has allowed human beings to adapt to a wide variety of different environments. One of the environments that humans have had to learn to survive is that of childhood abuse and even the most extreme symptoms of complex trauma or C-PTSD, such as dissociative episodes, lose their bewildering character when they are understood as part of the process of learning to survive under adverse circumstances.

However, though the brain is plastic, it is not infinitely so. Victims of complex trauma suffer immensely from having to live with patterns of thought that were necessary to help them survive, but are profoundly maladaptive in new circumstances. What is important to understand is that when these individuals go to therapy they are not healing a wound so as to restore a pristine brain that never existed, but starting a new learning process altogether. The dogs in the Seligman’s experiment could not simply “unlearn” their learned helplessness, they had to learn to be functional again. So, too, individuals who are suffering with the after effects of complex trauma have to undergo a new learning process which therapy facilitates.

The concept of complex trauma presents a profound challenge to the way we look at mental health issues, a challenge that is also an opportunity. After much debate, it was decided not to include Complex Post Traumatic Stress Disorder in the DSM V and though many in the profession see this as a tragic mistake it is understandable. C-PTSD is much more than another diagnosis that can be slotted into the nearly 300 already found in the DSM, it is a different kind of diagnosis altogether that transcends many well-established, symptom-based classifications, and may come one day to replace them. Even more that that, however, it points the way to a different and more realistic understanding of mental health, in which it is viewed not as a default state to be restored, but as the result of a process of learning and growth.

References

• Sar, V. (2011). Developmental trauma, complex PTSD, and the current proposal of DSM-5 . European Journal of Psychotraumatology, 2, 10.3402/ejpt.v2i0.5622. https://ift.tt/2wfIP6v
• Tarocchi, A., Aschieri, F., Fantini, F., & Smith, J. D. (2013). Therapeutic Assessment of Complex Trauma: A Single-Case Time-Series Study. Clinical Case Studies, 12(3), 228–245. http://doi.org/10.1177/1534650113479442
• McKinsey Crittenden, P., Brownescombe Heller, M. (2017). The Roots of Chronic PostTraumatic Stress Disorder: Childhood Trauma, Information Processing, and Self-protective Strategies. Chronic Stress, 1, 1-13. https://doi.org/10.1177/2470547016682965
• Ford, J. D., & Courtois, C. A. (2014). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 1, 9. http://doi.org/10.1186/2051-6673-1-9
• Hammack, S. E., Cooper, M. A., & Lezak, K. R. (2012). Overlapping neurobiology of learned helplessness and conditioned defeat: Implications for PTSD and mood disorders. Neuropharmacology, 62(2), 565–575. https://ift.tt/2LHdpKo

People’s brains vary. Research has shown that some people are born with a neurological make up that can make them more emotionally or intellectually intense, sensitive, and more open to external stimuli than the general population.

They are more aware of subtleties; their brain processes information and reflects on it more deeply. At their best, they can be exceptionally perceptive, intuitive, and keenly observant of the subtleties of the environment. Yet they are also overwhelmed by the constant waves of social nuances and others’ emotional and psychic energies.

From the get-go, intense individuals’ way of seeing and being in the world is not shared by those around them. Since they think more and feel more, they also reach their limits much quicker. They are more easily affected by their surroundings and those around them, which may exacerbate the impact of any problematic events or lack in their early years.

Sadly, because of the lack of awareness and understanding both in the family and in the wider world, many intense children have grown up internalizing the belief that there is something wrong with them, or that they are somehow defective, “too much”, or even “toxic.”

Apples That Have Fallen Far from the Trees

Unique challenges arise when an emotionally intense child is born into a family in which the parents or siblings do not function in the same way.

In his perennial work Far from the Tree (2016), Andrew Soloman addresses the differences between directly inherited (vertical) and independently divergent (horizontal) identity. Normally, most children share at least some traits with their family: Children of color are born to parents of color; People who speak Greek raise their children to speak Greek. These attributes and values are passed down from parent to child across the generations through DNA and cultural norms. However, children are not always a replica of their parents; they may carry throwback genes and recessive traits beyond anyone’s control. When someone acquires a trait that is foreign to the parent, it is referred to as “a horizontal identity.” Horizontal identities may include being gay, having a physical disability, having autism, being intellectually or empathically gifted.

It can be excruciatingly difficult for any parents who are presented with children with ways of being and needs that are alien to them. A gay child being born to straight parents, for instance, raises a myriad of challenges when it comes to understanding and acceptance. Vertical identities are usually respected as identities; horizontal ones are treated as flaws. Any unconventional ways of being, including being extra emotionally intense and sensitive, are often disparaged as “illness” to be fixed, rather than identities to be accepted.  

Our culture plays a part in perpetuating this disconnect. There is something primitive in our tribal nature that makes human reject what we are not familiar with. Although our world as a whole has made huge progress in bridging the divide between class, gender, and race, awareness and respect for “neuro-divergent” traits such as emotional intensity have not broken through into public consciousness. As a society we continue to pathologize individuals who have different ways of thinking, feeling, relating to and being in the world. Under the influence of a culture that is inept at embracing diversity, some parents have come to perceive their child’s horizontal identity as not only a problem but even a personal failure or insult.

It takes extra resilience for families to learn to tolerate, accept, and finally celebrate children who are not what they initially had in mind. The fact that there is no “guide” to parenthood, especially when their child cannot be handled through conventional ways, leave a painful gap of disconnection between the parents and the child. “Parenthood abruptly catapults us into a permanent relationship with a stranger,” wrote Andrew Solomon (2016), who conducted over 4000 interviews for his book. Families of emotionally intense children are presented with a fork in the road; They can reject or scapegoat their child for their strangeness, or they rise to the occasion and allow themselves to be profoundly changed by their experience.

Unique Challenges Faced by the Intense Child

If you have been emotionally sensitive and intense all your life, you will probably recognize some of these experiences as a child:

Being Overwhelmed

From birth, intense children have more permeable energetic boundaries. They hear faint sounds, detect subtle smells and notice the most subtle changes in their surroundings. They may find certain foods too flavorful, or can’t stand to wear certain fabrics.

They can experience other people’s emotions, noises and other environmental elements as coming onto and even inside of them, or that they merge with those they encounter. At home, they feel every shift and nuanced expressions of their parents’ moods and are swayed continuously by events that do not affect their sibling as much.

Intense children are incredibly conscientious. They always try to figure out the right course of actions and can be hard on themselves. For example, they tend to assume a lot of responsibilities in relationships. When conflicts arise, they quickly conclude that they have done something wrong and become overwhelmed by self- criticism and shame.

Being shaken continuously and pierced through by their intensity and events around them, these children may never find the mental space or support to develop emotional resilience. Even as adults, they can feel very unstable and ungrounded; and in the long run, many suffer from physical pain, stifled energy and fatigue.

Feeling Existentially Alone

The intense child carries deep insights. They sense into the world’s pain, both in their immediate surrounding and in the wider world. They feel lonely to be the only one who knows what is going on beneath the social facade of normalcy and harmony; many also feel guilty for not being able to alleviate the pain and suffering they see.

On some level, they are more mature than their peers. With a psycho-spiritual age that is older than their actual one, these “old souls” feel they never had a childhood. Gifted children, especially as they enter adolescence, find that the adults in charge are not worthy of their authority.

Although they appear independent, deep down these young souls carry a longing for someone that they can wholly lean on, relate to, so they can finally relax and be taken care of. As one child described it, they feel “like abandoned aliens waiting for the mother ship to come and take them home” (Webb, 2008).

The intense child’s creativity and intuition also give them a rich and deeply-reflective inner life not shared by those around them. They grapple with existential concerns such as life and death and the meaning of life and find themselves in an absurd and meaningless world that they can do little to alter. However, when they try to share their thoughts with others, they are usually met with puzzlement or even hostility. With no one to connect with them to the depth of their being, or recognize the fullness of who they are, they carry an unshakable sense of loneliness through into adulthood.  

Losing Trust in Themselves and Others

Intense children are alert to the hypocrisies, sufferings, conflicts, and complexities of their surroundings, even before they can cognitively articulate or handle it.

The perceptively gifted child is perplexed by the contradiction between the emotional vibration they get from the adults and their surface expressions: They see through the masks of propriety, the forced smiles, or the white lies. This discrepancy causes the child to become distrustful. Seeing society’s injustice and hypocrisy so early on also lead them to feel despair and cynicism.

If when they tried to share what they see, they are shut down, they may start to doubt their own judgment, intuition, even saneness. They may also feel guilty for having these foresight. When they cannot find anyone who understands their reality, they may decide to-even unconsciously stifle their intuition and emotions, and become teenagers or adults that do not know what to believe, how to decide, or who to trust.

Getting Scapegoated

When combined with radical honesty, insightfulness can bring interpersonal challenges. The intense child feels compelled to point out what they know and are unwilling to play the game of social facade. Sadly, their truth-telling is often unwelcome in the world.

As the messengers of the inconvenient truth, they are blamed for creating discord. At best, they are a source of bewilderment but at worse, a source of ridicule. At home, they become the scapegoat. In school, they become the target of bullies or relegated to the outcasts on the fringe of schools’ cliques.

Having to choose between their authenticity and other people’s acceptance is an overwhelming challenge for any young person. The intense child may grow up feeling incredibly self-conscious about their differences from others, to the extreme, some believe that they are somehow ’toxic’ or dangerous, and live with a constant fear of being cast out from their family or social circle.

Sensing They Are “Too Much”

Intense children have intense needs. From a young age, they live with a pressure of their creativity and have a yearning for intellectually stimulating conversations, deep contemplation and answers to life’s meaning. Their inner life is pierced with moral concerns, strong convictions, idealism, perfectionism and forceful passions.  However, without sufficient understanding from the adults around them, they might be misunderstood as being intentionally difficult. As a result, their natural needs for the adequate amount of stimulation and support may then be dismissed or deprived.

Even with the most supportive parents who validate their sensitivity and speed, many intense children have an awareness that they are somehow ‘too much’ for those around them. They may be explicitly criticized, or just implicitly rejected for wanting too much, moving too fast, being too naive, too serious, too easily rattled, or too impatient. Realizing that their natural self can be overwhelming to others, they may decide to gradually shut down, to build a ‘false self,’ and to curb their excitability and enthusiasm.  

Embracing the Intense Child in You

Your home might or might not have been a haven for your sensitive, intense and gifted young soul. Being different can be lonely, but the real suffering comes from having internalized the feeling that you, as a person, is fundamentally ‘not okay.’  

If all your life you had felt like a Martian being exiled onto the earth, it might take some time to not only know but also feel in your heart that being intense is not an illness. Being intense comes with the most precious abilities and qualities.  You have an extraordinary capacity to understand and empathize with others, as well as the ability to reflect on your feelings, intentions, and desires. Across history, intensity is often paired with other forms of exceptional talents in the areas of music, visual art, sports, and creativity. Your excitabilities are not only highly related to giftedness; they are gifts in themselves. It is up to you now, to provide a safe home for your inner child. This time, under your wings, they can have a nourishing, safe, and exciting childhood.

Reference:

Solomon, A. (2016). Far from the tree. In Unknowable, Unspeakable, and Unsprung (pp. 52-60). Routledge.

Bipolar disorder is a difficult, complicated illness. And like any illness, it can naturally spill over into your relationship. As couples therapist Julia Nowland noted, “Bipolar disorder can be an emotional roller-coaster ride for the couple, with many ups and downs that mimic the disorder itself.”

But this doesn’t mean your relationship is doomed to fail.

Having a strong and fulfilling relationship is absolutely possible when both partners are committed to working as a team and creating a supportive, encouraging and accepting environment, said Lauren Dalton-Stern, LPCC, NCC, a therapist at the CARE Program at the University of California, a specialty clinic and research facility that treats teens and young adults who are experiencing early emerging symptoms of a mood disorder or psychosis.

This starts with getting extensively educated about bipolar disorder. “Psychoeducation is significant and one of the key components in the recovery and healing process that help decrease and in some cases, prevent the likelihood of relapse,” Dalton-Stern said.

Every person with bipolar disorder is different, and how the illness manifests will vary, too. The effects on a relationship will depend on the severity of your partner’s bipolar disorder and whether it’s being effectively managed. And, of course, every relationship also has its nuances. However, there are some general issues that come up. Below you’ll find a list of challenges and suggestions to help, along with additional tips for building a healthy relationship.

Challenge: You’re struggling with your own symptoms and stressors.

Bipolar disorder can be exhausting for both the person with the illness and their partner. Over time, partners also might struggle with their own depressive symptoms, such as feeling hopeless and helpless, said Dalton-Stern, who also works with couples at her private practice Tranquility Counseling.

Many studies have actually found that partners of people with bipolar disorder can become emotionally withdrawn, because they’re socializing less, taking on more of the household responsibilities and facing other stressors (like financial strain), she said.

What can help: Stern suggested establishing your own supportive network. One way, she said, is to attend support groups for people who have loved ones with bipolar disorder. You might start your search with these sites: Depression Bipolar Support Alliance; National Alliance on Mental Health; and Mental Health America. Another way is to work with a therapist.

Challenge: You’re unprepared for a manic or depressive episode.

Often couples aren’t completely prepared for an episode to occur, said Jennine Estes, MFT, a marriage and family therapist who owns a group practice called Estes Therapy in San Diego. This might be because you haven’t talked about what to do when an episode starts, or you don’t have permission to speak to your partner’s medical team, she said.

This “typically causes the relationship and both people to spiral out of control in reactive and survival ways.” Both of you might panic. You feel helpless and try to exert more and more control, trying to manage your partner’s every move, while they feel trapped and berated, and get worse.

What can help: The key is to sit down and create a written plan you both agree and feel comfortable with. It might include these components:

• Reflect on the signs your partner displays before and during a depressive or manic episode, Estes said.
• Have an agreement that if any of these signs appears—even the smallest sign—your partner must see their therapist and doctor for a medication evaluation, she said. Your plan also might specifically include you stating your concerns without blame, Nowland said: “I’m noticing _______, I feel ________; what I would like is for you to call Dr. Q.” If your partner hasn’t taken action within an agreed upon timeframe—one or two weeks—then the next step is for you to contact the doctor, she said: “I’ve raised my concerns about _______, I’m feeling _______, and in order to look after myself, I’m going to call Dr. Q.”
• Sign a medical release form to let you communicate with your partner’s therapist and doctor when concerns arise, Estes said.

Estes also recommended creating a plan for yourself. For instance, you might focus on self-care, such as attending yoga classes, meeting up with friends, meditating and seeing your own therapist. You might reach out to loved ones for support. “Typically, there is shame around a partner struggling with bipolar disorder,” she said. And when you keep your shame and feelings a secret, the shame only festers, chipping away at your relationship. Lastly, you might journal to help you express and make sense of your emotions and any overwhelm triggered from not having your partner present.

Challenge: An episode rattles your relationship.

When your partner is having an episode or has been hospitalized, they naturally become unavailable to you. They can’t give you emotional support or meet your needs. Of course, “they don’t choose to be unavailable,” Estes said. They’re struggling with a very real illness. But it can still hurt the relationship — until repair can happen.

That is, partners tend to go into survival mode, trying to juggle doctor appointments, care for their partner, finances and any other household responsibilities, she said. This leads you to close yourself up emotionally and stop replying on your partner for support.

What can help: After an episode occurs, it’s critical that you communicate with each other and repair any issues. “If a repair hasn’t occurred, the relationship can become distant and grow into hostility,” Estes said. She suggested the following: Your partner needs space to share what the episode was like for them. Which is hard because it requires that you hold your “own pain, sadness, and fears and continue to support.” But it’s vital.

Once there’s stability, slowly start talking to your partner about your pain. (“People heal the more they are heard and understood,” Estes said.) It also might be difficult for your partner to hear your pain, because they’re immersed in shame or fear of having another episode. This is when it’s necessary to see a couples therapist, who can help both partners sort through their emotions and provide a safe space to openly discuss them.

Finally, your partner must take their treatment seriously, and see their therapist and doctor. If they aren’t committed to their mental health, Estes noted that it sends the messages: “You can’t count on me,” “I won’t make it safe,” and “You are on your own and will need to take care of yourself.” Which leads to you putting up your emotional armor, becoming defensive and blaming, and turning away from your relationship, she said.

Additional Tips

Nowland stressed the importance of both partners taking care of themselves. This includes monitoring (and reducing) your stress levels; eating nutrient-rich foods; engaging in physical activities you enjoy; getting restful sleep; and seeking support from others.

Similarly, remember that “you are a separate person and you don’t have to ride the same emotional roller-coaster ride as [your partner].”

Focus on increasing the positives in your relationship, Nowland said. Prepare for the tough times by “stock[ing] up on love, affection and appreciation to weather those storms.”

Try your best to remain patient and hopeful. “Bipolar may not be curable, but it’s one of the most treatable mental disorders,” Dalton-Stern said. Try to be empathetic, compassionate and non-judgmental both with yourself and your partner, she said. Allow yourself “to come to a place of greater acceptance, while making your partner feel unconditionally accepted regardless of their disorder.”

Nowland regularly talks to partners who don’t have bipolar disorder about the serenity prayer: “Grant me the serenity to accept the things I cannot change, the courage to change the things that I can and the wisdom to know the difference.” It’s critical, she said, to learn acceptance and surrender — which is different from resignation. She talks about surrendering to “what is,” and using practices such as meditation, yoga and mindfulness and support groups to help. When you’re able to shift your mindset, it’ll change how you approach your partner and your relationship, she said. “Accepting what we can’t change and changing what we can is something all couples could benefit from.”

Bipolar disorder comes with many challenges. Which can be exhausting and overwhelming and confusing. Both you and your partner may feel helpless and devastated. But you can navigate these challenges by being prepared, working as a team, surrounding yourself with genuinely supportive people (which might include a therapist) and repairing any issues as soon as possible.

We purchased a cafe/retail shop in July 2017, and people have since welcomed us with open arms. They treat us as if they’ve known us all our lives. People wave and speak to one another. They honk at you when they see you. At the town council meeting, at the conclusion of the business portion of the meeting, the president goes around the room to ask if there are any concerns, many of which he’ll address right then and there.

Stories About Westport

The people of Westport are a very giving community. When the hurricanes hit last year, we collected over $800 from tips to send to Samaritan’s Purse to help the victims. People look out for one another here. When we sponsored a Thanksgiving meal for the community last year, people came in to get takeout boxes for their neighbors who were too ill to attend.

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Peony

This “spherical break of colored stars” fireworks display is apparently the most common, so your chances of spotting it in the skies are pretty good. Many fireworks are named after flowers because they burst out of a shell or seed! Find out the scary statistics behind why the Fourth of July may just be the most dangerous holiday.

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Buffalo Wild Wings: Buy one, get one wings

Tuesday is the best day to visit Buffalo Wild Wings, but not for the reason you’d expect. The restaurant chain is trading in its hugely popular Tuesday half-off wings special for a BOGO boneless wings deal. You’ve gotta admit, it’s still a bargain. If you think about it, you’re still getting double the wings for half the price. Want to re-create the experience at home? We’ve got just the thing.

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We help everyone that walks in the door. We keep Asheville looking good. We repair and fix all rips and tears, as well as hem dresses, pants, and sleeves. We embroider names and logos on anything the customer asks. We are great folks to know! We sewed up Bon Jovi’s pants when he was in town. We fixed Elton John’s jacket, and monogrammed a jacket for Reba. We’ve sewn patches on a jacket for Bob Morgan, the Memphis Belle Pilot. We made a shirt for Glenn Campbell. I have a million stories of the people we have sewn for. We did the balloons for the movie “My Fellow American,” and met James Gardener and Jack Lemon. I made a pair of sailor pants for Robin Williams when I lived in California, where Reggie Jackson was also a customer.

Stories About A Stitch N Time

Once, we had a customer who was 6’4″ and 250lbs. Her wedding dress needed to be tailored, and she was getting married on Christmas day. I spent Christmas Eve tailoring the dress and adding beads for her big day.

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Kent, Connecticut

One of the many towns that has been compared to Gilmore Girls‘ Stars Hollow is Kent, Connecticut. It has the same main street appeals, including locally owned stores and town events and festivals. Twinkly lights wrap around charming inns on Kent’s main street, giving off a cozy New England vibe. These are the nicest places in every state in America.

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Why we need protein

Protein is a critical part of our diet—we need it to feel full, have energy, build and repair muscle, process nutrients, and boost immunity, among other vital roles.”Protein is made up of amino acids that are the building blocks of body tissues, including muscles, blood vessels, hair, skin, and nails. It’s also involved in the production of enzymes and hormones that help the body to function normally,” says Kaleigh McMordie, a registered dietitian nutritionist. Why are these amino acids so important? McMordie gives a quick anatomy lesson (in case you spaced out in 10th grade): There are some amino acids that the body can synthesize, but others, called essential amino acids, we must get through our diet. Animal protein sources, such as meat, fish, milk, and eggs, contain all nine essential amino acids while most plant-based protein sources don’t have the full complement of amino acids in the exact right amounts (there are some exceptions, like soybeans). “That’s why it is important to include a variety of protein sources in order to get all of the essential amino acids, especially for vegetarians,” McMordie says. And if you’re a regular exerciser, protein is especially important, according to diet and lifestyle dietitian and registered nutritionist, Keith Akoob, EdD. “Protein not only builds muscle, but it also repairs and maintains muscle,” he says. “Muscle cells, like all living tissue, have a life. They eventually need to be replaced, so repair and maintenance are critical roles for dietary protein.” Don’t miss 7 signs you might not be eating enough protein.

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Easy come, easy go.

Whether they win $500 million or $1 million, about 70 percent of lotto winners lose or spend all our money in five years or less. These are the 13 things rich people never spend their money on.

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“The reason I exercise is for the quality of life I enjoy.” – Kenneth H. Cooper

In the search for effective ways to experience positive outcomes in the all-important life aspects such as overall health, well-being and mortality, one of the sleeper strategies to consider involves adopting an ancient Chinese practice called tai chi. Here are some of the benefits of tai chi documented by research.

Live longer.

Tai Chi is a mind-body practice that originated in China and remains today the most common form of exercise for adults in that country. In addition to the much-researched benefits for reduced mortality from moderate-intensity exercise, such as you get from regular walking and jogging, researchers found the first evidence that tai chi also promotes longevity. The greatest benefit from tai chi was obtained from those who self-reported engaging in the practice 5-6 hours per week.

Improve muscle strength, balance and flexibility.

A systematic review of older patients with chronic conditions who engaged in regular tai chi exercise found that, in addition participants’ physiological and psychosocial benefits, the practice also appeared to promote better balance control, flexibility, strength, respiratory and cardiovascular function. Researchers noted, however, that it was difficult to state firm conclusions about the reported benefits and called for more well-defined studies to drill down to specific, verifiable results. In other research, a clinical trial of older women with osteoarthritis who completed a 12-week tai chi exercise program found participants experienced improved arthritic symptoms (less pain), balance and physical function. Researchers urged a larger-sample longitudinal study to confirm use of tai chi in arthritis exercise management.

Boost cognitive function.

Although the fact is that cognitive decline is prevalent among older adults (about 40 percent of older adults in America have some form of cognitive impairment, such as dementia and Alzheimer’s Disease), it need not be considered a foregone conclusion. Nor should getting older need be synonymous with cognitive decline. A growing body of evidence points to the benefits to older adults from practice of tai chi in the areas of global cognitive and memory functions, especially verbal working memory. A meta-analysis found agreement with the findings of numerous studies on the benefits to cognitive function from physical exercise, and researchers recommended tai chi as an alternative mind-body exercise to improve older adults’ cognitive functioning.

Improve COPD symptoms.

An Australian study found that a modified tai chi program – Sun-style tai chi — helped boost exercise capacity and improved participant’s chronic obstructive pulmonary disease (COPD) symptoms. Researchers noted that tai chi has “highly clinically relevant effects on endurance and peak exercise capacity in people with COPD.”

Get better night-time sleep quality.

A 2016 pilot randomized controlled trial evaluating the benefits of tai chi qigong (TCQ) on night-time sleep quality of older adults with cognitive impairment found better quality of both sleep and life than a control group not participating in tai chi qigong. Since more than 25 percent of older adults with cognitive impairment suffer impaired sleep quality, the search for nonpharmacological approaches to improve the quality of night-time sleep is gaining momentum. Due to their low physical strength and medical condition, however, many older adults with cognitive impairment cannot engage in certain exercises. Thus, developing exercise programs tailored to mental conditions and reduced physical well-being is important. Results from the pilot trial showed tai chi qigong participants benefited from improved sleep qualities in the areas of sleep duration, sleep efficiency, and the mental health component of quality of life. Researchers noted that, as a low-intensity exercise, TCQ is an appropriate intervention to improve night-time sleep quality in older adults with cognitive impairment.

Improve symptoms of fibromyalgia.

In a study comparing the effectiveness of tai chi and aerobic exercise on fibromyalgia symptoms in patients, researchers found that tai chi resulted in similar or greater symptom improvement than aerobic exercise. Longer-duration tai chi provided greater improvements, researchers noted, concluding that the mind-body approach of tai chi may be a viable therapeutic option in the multidisciplinary management of fibromyalgia.

See improvements in cardiovascular fitness.

Millions of Americans exercise to help boost their cardiovascular health. Yet, many who do so do not realize the research-backed evidence that certain types of exercise specifically benefit cardiovascular function. Indeed, zeroing in on what types of exercise benefit the heart in healthy adults is only recently attracting researcher interest. A review of 20 studies of healthy adults comparing tai chi exercise with non-intervention found that tai chi has a significant impact in improving heart efficiency by reducing resting blood pressure, resting heart rate, and enhancing stroke outcome and cardiac output at quiet reading. The review also found significant improvement in respiratory function from tai chi exercise.

Reduce risk of falls.

Among older adults, the risk of falling is an ever-present and major concern. As such, finding therapeutic approaches to help reduce fall risk in this cohort is of major importance. A 2016 review  of 10 randomized controlled trials examining tai chi’s effect on fall reduction found the ancient Chinese exercise demonstrates a significant protective effect on fall prevention risk among older adults. Researchers noted the need for additional trials to determine both optimal duration and frequency of tai chi programs and optimal style of such programs for older adults.

Reduce prenatal anxiety and depression.

A 2013 study of tai chi and yoga treatment for prenatal women with anxiety and depression found that the tai chi group had lower scores in depression and anxiety, as well as lower scores in sleep disturbance at the end of the 12-week, once-per-week sessions.

Obtain moderate benefits for chronic nonspecific neck pain.

Chronic pain sufferers are always on the lookout for effective pain relief that is nonaddictive, effective and safe. A 2016 study found that a 12-week program of tai chi resulted in more than 50 percent pain reduction in 39 percent of patients with chronic nonspecific neck pain, compared with more than 50 percent pain reduction in 46 percent of study participants engaging in conventional neck exercises. Researchers noted that both tai chi and conventional neck exercises are safe and effective. They said further that tai chi may be a suitable alternative to conventional neck exercises.

Watch Hill, Rhode Island

Unless you own a home in Watch Hill, you’ve probably never even heard of this affluent coastal enclave. Here’s what you’re missing: a walkable village with cedar-shingled cottages, waterfront mansions (ahem, Taylor Swift), blue hydrangeas, beautiful beaches, an ice cream shop, and an old-timey carousel. If you want to stay the night, can book a room at the Ocean House, an enduring grande dame hotel, or the recently revamped Watch Hill Inn. Don’t miss these other romantic small town destinations across the country.

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Give them a receipt

To make the teeth-for-treats transaction feel even more legit to your little one, make sure the Tooth Fairy leaves them a receipt under their pillow. Some adorable versions created even have a spot to rate the “tooth quality” and a barcode for authenticity. Here’s where you can get printable Tooth Fairy Receipts.

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No family tree is cooler than that of the British royal family. Who wouldn’t want to be related to the ever-stylish Queen Elizabeth II? What’s interesting about the royals in particular is that many of them have titles determined by how they’re related to Her Majesty. Here, we break down who’s who in the Windsor family.

First comes Her Majesty, the Queen, who holds the highest level of the royal hierarchy. As the heir of the British Crown and constitutional monarch of Commonwealth realms, she has the utmost authority. Her husband is Prince Philip, the Duke of Edinburgh.

The Queen’s four children are: the Prince of Wales (the eldest son), the Duke of York (the second son), the Earl of Wessex (the youngest son), and the Princess Royal (the Queen’s daughter).

Charles, the Prince of Wales, was married to Diana, the Princess of Wales, until they divorced in 1996. Together, they had two sons: William, the Duke of Cambridge, and Harry, the Duke of Sussex. (Did you know Harry isn’t Prince Harry’s real name?) Prince Charles’ second and current wife, Camilla, uses the title the Duchess of Cornwall because the other title was too much associated with Diana. Prince William’s wife, Kate Middleton, has the title the Duchess of Cambridge. Their sons, George and Louis, are both Princes of Cambridge, while their daughter Charlotte is the Princess of Cambridge. Prince Harry’s wife, Meghan Markle, is now the Duchess of Sussex. Don’t miss these myths about the royal family that are completely false.

Andrew, the Duke of York, married Sarah, the Duchess of York. Before they divorced in 1996, they had two children, Princess Beatrice of York and Princess Eugenie of York. If one were male, his title would be Prince of York.

Edward, the Earl of Wessex, is married to Sophie, the Countess of Wessex. Their son James has the title Viscount Severn and their daughter is Lady Louise Windsor.

Princess Royal is the title given to a British monarch’s eldest daughter, but her husband receives no royal title. Princess Anne is currently married to Vice-Admiral Timothy Laurence.

Sadly, even though the Queen considers her corgis as family, the pups are not included in the family tree.

These powerful individuals have captured the world with their sophistication and grace, but that doesn’t mean they have evaded the spotlight of some juicy rumors. These are the 18 craziest conspiracy theories about the royal family.

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You fully rinse dishware before loading

You might have heard that it’s a no-no to move dirty plates directly from the table to the washer—that caked-on food won’t completely come off during the cycle, right? When Consumer Reports tested dozens of dishwashers and loaded them up with the dirtiest plates they could muster, they found that the models did an “excellent” or “very good” job at getting them spotless. If you’re running a load right after a messy meal, just “scrape off large food particles and do not pre-rinse. Your dishwasher detergent’s job is to cling to food and help wash it away,” says Finishdishwashing.com. But if it may be days before your dishwasher is full enough to run, lightly rinse the plates first to prevent the dishwasher from getting smelly.

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Hobby Lobby has everything you could possibly ever want to give your home the design upgrade it desperately needs. You’re guaranteed to find good deals any time you step into the store, but we have news that every Hobby Lobby enthusiast will flip for: there’s a sale that can get you up to 90 percent off certain items.

Twice a year, Hobby Lobby has a secret sale on their home accents department that can net you some serious savings. The first one happens right after Mother’s Day and the second right after Christmas, according to hearthookhome.com. Remember, it’s a secret—meaning it’s definitely not advertised, so make sure to mark your calendars so you don’t forget! Find out other insider secrets to help you save at all your favorite stores, too.

Items typically start at a 50 percent to 66 percent off discount. Items that are still left after a few weeks will be discounted by 80 percent and then 90 percent shortly after. So, if you’re patient you’ll be able to snag a few extra knickknacks for your shelves for practically nothing.

The good news is that Hobby Lobby constantly has sales running and there are always great finds in the clearance section, so don’t fret if you need to get some summer décor and can’t hold out until the next secret sale. The bad news? There are a few items that never go on sale, such as cards or gift wrap, specialty paper, party supplies, licensed products, Cricut machines, or cake decorating and candy making supplies. Try finding deals on those at your local dollar store—and be sure to find out the items you should always be buying while you’re there.

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Tile countertops

Tile countertops have made a comeback in recent years as they are less expensive than many other countertop materials, but they are difficult to maintain because they are prone to chips and grout stains. Instead, research the pros and cons of other countertop materials such as laminate, marble, and stainless steel. There are plenty of other countertop options to meet your needs and budget.

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Flavor: Cold Sweat

Where to get it: Sunni Sky’s Homemade Ice Cream, Angier, North Carolina

What’s in it: Ice cream base, hot sauces, and pequín, habanero, and Thai chili peppers (store owners ask you to sign a waiver before you eat this!) Check out how to make ice cream without an ice cream maker.  

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Washing your hair too often—or not enough

Okay, you got the memo: Cleansing your hair more than you need to can strip away the natural oils that keep it healthy, thus making it more brittle and prone to breaking. And while the trend of washing less and less often is catching on, experts warn to tread lightly. “The pores on your scalp can become congested from excessive oil, which will attract even more dirt and debris,” says Lauren E. Hack, hairstylist and co-founder of LAUREN+VANESSA salon in New York City. Your best bet: Reduce the number of times you shampoo to three to four times a week. “In between shampoos, soak up oil with a light coat of dry shampoo on your roots and use a boar bristle brush to distribute hair oils from root to tip for extra natural shine and conditioning,” suggests Nick Penna, owner and lead stylist at SalonCapri in Boston. Check out these home remedies for dry, damaged hair.

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Black Cats

Long ago, visitors to English homes were expected to greet the family cat with a kiss to bring good luck. And in the 16th century, it was white cats that were a sign of bad luck, not like today’s belief that black cats crossing your path means misfortune.

More cat lore around the world: In Scotland, if a black cat happened to appear on the doorstep, the family believed their wealth would increase. In Italy, fisherman’s wives kept company with black cats to prevent disasters at sea. And back in the day, some folks thought a cat’s sneeze forecasted rain, while others believed unusually playful behavior signaled a storm was brewing. Seems there’s a black cat superstition for every culture. Here’s the reason behind the five most popular superstitions.

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It’s caused by inflammation

You’ve probably heard of common skin conditions like psoriasis and eczema, but do you also know about rosacea? If not, you’ve got to listen up. “Rosacea is abnormal blood vessel growth in all layers of the skin, caused by internal problems and inflammation within the body and skin,” says Julia T. Hunter, MD, a dermatologist and founder of Wholistic Dermatology. This abnormal blood vessel growth is the result of low thyroid, fungal overgrowth internally, gut inflammation, and chronic sun overexposure, she says. Don’t miss these 6 new rosacea treatments that will help end the redness.

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We’re all capable of abuse when we’re frustrated or hurt. We may be guilty of criticizing, judging, withholding, and controlling, but some abusers, including narcissists, take abuse to a different level. Narcissistic Abuse can be physical, mental, emotional, sexual, financial, and/or spiritual. Some types of emotional abuse are not easy to spot, including manipulation. It can include emotional blackmail, using threats and intimidation to exercise control. Narcissists are masters of verbal abuse and manipulation. They can go so far as to make you doubt your own perceptions, called gaslighting.

The Motivation for Narcissistic Abuse

Remember that narcissistic personality disorder (NPD) and abuse exist on a continuum, ranging from silence to violence. Rarely will a narcissist take responsibility for his or her behavior. Generally, they deny their actions, and augment the abuse by blaming the victim. Particularly, malignant narcissists aren’t bothered by guilt. They can be sadistic and take pleasure in inflicting pain. They can be so competitive and unprincipled that they engage in anti-social behavior.  Don’t confuse narcissism with anti-social personality disorder.

The objective of narcissistic abuse is power. Narcissists may intentionally diminish or hurt other people. It’s important to remember that narcissistic abuse stems from insecurity and is designed to dominate you. Abusers’ goals are to increase their control and authority, while creating doubt, shame, and dependency in their victims. They want to feel superior to avoid hidden feelings of inferiority. Understanding this can empower you. Like all bullies, despite their defenses of rage, arrogance, and self-inflation, they suffer from shame.  Appearing weak and humiliated is their biggest fear. Knowing this, it’s essential not to take personally the words and actions of an abuser. This enables you to confront narcissistic abuse.

Mistakes in Dealing with Abuse

When you forget an abuser’s motives, you may naturally react in some of these ineffective ways:

1. Appeasement. If you placate to avoid conflict and anger, it empowers the abuser, who sees it as weakness and an opportunity to exert more control.
2. Pleading. This also shows weakness, which narcissists despise in themselves and others. They may react dismissively with contempt or disgust.
3. Withdrawal. This is a good temporary tactic to collect your thoughts and emotions, but is not an effective strategy to deal with abuse.
4. Arguing and Fighting. Arguing over the facts wastes your energy. Most abusers aren’t interested in the facts, but only in justifying their position and being right. Verbal arguments can quickly escalate to fights that drain and damage you. Nothing is gained. You lose and can end up feeling more victimized, hurt, and hopeless.
5. Explaining and Defending. Anything beyond a simply denial of a false accusation leaves you open to more abuse. When you address the content of what is being said and explain and defend your position, you endorse an abuser’s right to judge, approve, or abuse you. Your reaction sends this message: “You have power over my self-esteem. You have the right to approve or disapprove of me. You’re entitled to be my judge.”
6. Seeking Understanding. This can drive your behavior if you desperately want to be understood. It’s based on the false hope that a narcissist is interested in understanding you, while a narcissist is only interested in winning a conflict and having the superior position. Depending upon the degree of narcissism, sharing your feelings may also expose you to more hurt or manipulation. It’s better to share your feelings with someone safe who cares about them.
7. Criticizing and Complaining. Although they may act tough, because abusers are basically insecure, inside they’re fragile. They can dish it, but can’t take it. Complaining or criticizing an abuser can provoke rage and vindictiveness.
8. Threats. Making threats can lead to retaliation or backfire if you don’t carry them out. Never make a threat you’re not ready to enforce. Boundaries with direct consequences are more effective.
9. Denial. Don’t fall into the trap of denial by excusing, minimizing, or rationalizing abuse. And don’t fantasize that it will go away or improve at some future time. The longer it goes on, the more it grows, and the weaker you can become.
10. Self–Blame. Don’t blame yourself for an abuser’s actions and try harder to be perfect. This is a delusion. You can’t cause anyone to abuse you. You’re only responsible for your own behavior. You will never be perfect enough for an abuser to stop their behavior, which stems from their insecurities not you.

Confronting Abuse Effectively

Allowing abuse damages your self-esteem.  Thus, it’s important to confront it. That doesn’t mean to fight and argue. It means standing your ground and speaking up for yourself clearly and calmly and having boundaries to protect your mind, emotions, and body. Before you set boundaries, you must:

1. Know Your Rights. You must feel entitled to be treated with respect and that you have specific rights, such as the right to your feelings, the right not to have sex if you decline, a right to privacy, a right not to be yelled at, touched, or disrespected. If you’ve been abused a long time (or as a child), your self-esteem likely has been diminished. You may no longer trust yourself or have confidence. Seek therapy, get support, and read 10 Steps to Self-Esteem-The Ultimate Guide to Stop Self-Criticism and watch the webinar How to Raise Your Self-Esteem.
2. Be Assertive. This takes learning and practice to avoid being passive or aggressive. Get How To Speak Your Mind―Become Assertive and Set Limits and the webinar How to Be Assertive. Try these short-term responses to dealing with verbal putdowns:

• “I’ll think about it.”
• “I’ll never be the good enough wife (husband) that you hoped for.”
• “I don’t like it when you criticize me. Please stop.” (Then walk away)
• “That’s your opinion. I disagree, (or) I don’t see it that way.”
• “You’re saying . . .” (Repeat what was said. Add, “Oh, I see.”)
• “I won’t to talk to you when you (describe abuse, e.g. “belittle me”). Then leave.
• Agree to part that’s true. “Yes, I burned the dinner.” Ignore “You’re a rotten cook.”
• Humor – “You’re very cute when you get annoyed.”

3. Be Strategic. Know what you want specifically, what the narcissist wants, what your limits are, and where you have power in the relationship. You’re dealing with someone highly defensive with a personality disorder. There are specific strategies to having an impact. Read the steps and scripts in Dealing with a Narcissist: 8 Steps to Raise Self-Esteem and Set Boundaries with Difficult People.
4. Set Boundaries. Boundaries are rules that govern the way you want to be treated. People will treat you the way you allow them to. You must know what your boundaries are before you can communicate them. This means getting in touch with your feelings, listening to your body, knowing your rights, and learning assertiveness. They must be explicit. Don’t hint or expect people to read your mind.
5. Have Consequences. After setting boundaries, if they’re ignored, it’s important to communicate and invoke consequences. These are not threats, but actions you take to protect yourself or meet your needs.
6. Be Educative. Research shows that narcissists have neurological deficits that affect their interpersonal reactions. You’re best approach is to educate a narcissist like a child.  Explain the impact of their behavior and provide incentives and encouragement for different behavior. This may involve communicating consequences. It requires planning what you’re going to say without being emotional.

Get Support

To respond effectively requires support. Without it, you may languish in self-doubt and succumb to abusive disinformation and denigration. It’s challenging to change your reactions, let alone those of anyone else. Expect pushback when you stand up for yourself. This is another reason why support is essential. You will need courage and consistency. Whether or not the narcissist makes changes, you’ll get tools to protect yourself and raise your self-worth that will improve how you feel whether you stay or leave. CoDA meetings and psychotherapy provide guidance and support.

If you’d like more information on narcissism and relationships with narcissists, see www.whatiscodependency.com/blog. Email me if you’d like a copy of a “Checklist of Narcissistic Behaviors.”

Warning: If you’re experiencing physical abuse, expect it to continue or escalate. Get help immediately. Read “The Truth About Abusive Relationships.”

© Darlene Lancer 2018