Posttraumatic Stress Disorder: Nightmare After The Ordeal

Written by Michael G. Rayel, MD

Sarah is a 28 y/o accountant who had a traumatic past that she kept to herself. At age 15, she was grabbed by a masked man while she was jogging in a park. The man threatened to kill her with a knife and brutally raped her. She screamed but nobody seemed to have heard her.

Since that time, Sarah has developed nightmares about being raped or killed. In most days, she has suffered from flashbacks of her being attacked. Each time she watches TV shows that remind her ofrepparttar incident, she gets scared, overwhelmed, and becomes agitated. At times, she develops anxiety attacks, palpitations, sweating, and restlessness.

Sincerepparttar 126065 attack, Sarah can hardly trust people. As a result, her relationships have profoundly suffered. More recently, she’s been depressed and feeling hopeless. She hasn’t been sleeping and eating well. Her inattention has negatively impacted her work.

Based onrepparttar 126066 above symptoms, Sarah is most likely suffering from Posttraumatic Stress Disorder (PTSD). What exactly is PTSD?

PTSD is a psychiatric disorder characterized by avoidance, hypervigilance, emotional difficulties, and recall behavior such as flashbacks and nightmares after a traumatic event such as rape, war, vehicular accident, or natural disasters. Recent researches have shown that after a trauma, biochemical changes develop inrepparttar 126067 brain that can result in psychological signs as shown above.

The Intermittent Explosive Narcissist

Written by Sam Vaknin

Narcissists invariably react with narcissistic rage to narcissistic injury.

These two terms bear clarification:

Narcissistic injury

Any threat (real or imagined) torepparttar narcissist's grandiose and fantastic self-perception (False Self) as perfect, omnipotent, omniscient, and entitled to special treatment and recognition, regardless of his actual accomplishments (or lack thereof).

The narcissist actively solicits narcissistic supply - adulation, compliments, admiration, subservience, attention, being feared - from others in order to sustain his fragile and dysfunctional ego. Thus, he constantly courts possible rejection, criticism, disagreement, and even mockery.

The narcissist is, therefore, dependent on other people. He is aware ofrepparttar 126064 risks associated with such all-pervasive and essential dependence. He resents his weakness and dreads possible disruptions inrepparttar 126065 flow of his drug - narcissistic supply. He is caught betweenrepparttar 126066 rock of his habit andrepparttar 126067 hard place of his frustration. No wonder he is prone to raging, lashing and acting out, and to pathological, all-consuming envy (all expressions of pent-up aggression).

The narcissist is constantly onrepparttar 126068 lookout for slights. He is hypervigilant. He perceives every disagreement as criticism and every critical remark as complete and humiliating rejection – nothing short of a threat. Gradually, his mind turns into a chaotic battlefield of paranoia and ideas of reference.

Most narcissists react defensively. They become conspicuously indignant, aggressive, and cold. They detach emotionally for fear of yet another (narcissistic) injury. They devaluerepparttar 126069 person who maderepparttar 126070 disparaging remark,repparttar 126071 critical comment,repparttar 126072 unflattering observation,repparttar 126073 innocuous joke atrepparttar 126074 narcissist's expense.

By holdingrepparttar 126075 critic in contempt, by diminishingrepparttar 126076 stature ofrepparttar 126077 discordant conversant –repparttar 126078 narcissist minimisesrepparttar 126079 impact ofrepparttar 126080 disagreement or criticism on himself. This is a defence mechanism known as cognitive dissonance.

Narcissistic Rage

Narcissists can be imperturbable, resilient to stress, and sangfroid. Narcissistic rage is not a reaction to stress - it is a reaction to a perceived slight, insult, criticism, or disagreement (in other words, to narcissistic injury). It is intense and disproportional torepparttar 126081 "offence". Raging narcissists usually perceive their reaction to have been triggered by an intentional provocation with a hostile purpose. Their targets, onrepparttar 126082 other hand, invariably regard raging narcissists as incoherent, unjust, and arbitrary.

Narcissistic rage should not be confused with anger, though they have many things in common.

It is not clear whether action diminishes anger or anger is used up in action - but anger in healthy persons is diminished through action and expression. It is an aversive, unpleasant emotion. It is intended to generate action in order to reduce frustration. Anger is coupled with physiological arousal.

Another enigma is:

Do we become angry because we say that we are angry, thus identifyingrepparttar 126083 anger and capturing it – or do we say that we are angry because we are angry to begin with?

Anger is provoked by adverse treatment, deliberately or unintentionally inflicted. Such treatment must violate either prevailing conventions regarding social interactions or some otherwise a deeply ingrained sense of what is fair and what is just. The judgment of fairness or justice is a cognitive function impaired inrepparttar 126084 narcissist.

Anger is induced by numerous factors. It is almost a universal reaction. Any threat to one's welfare (physical, emotional, social, financial, or mental) is met with anger. So are threats to one's affiliates, nearest, dearest, nation, favourite football club, pet and so on. The territory of anger includes not onlyrepparttar 126085 angry person himself, but also his real and perceived environment and social milieu.

Threats are notrepparttar 126086 only situations to incite anger. Anger is alsorepparttar 126087 reaction to injustice (perceived or real), to disagreements, and to inconvenience (discomfort) caused by dysfunction.

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