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Krittle: Dr Karen buy generic viagra plus 400mg line erectile dysfunction pumps cost, when dealing with the specifics of the abuse and you receive a diagnosis of Multiple Personality Disorder (MPD) or Dissociative Identity Disorder (DID) how do you defend your diagnosis with the "church goers" and their belief that you are just possessed and need religious intervention? In fact cheap viagra plus 400mg otc impotence from diabetes, I am working with a DID ( Dissociative Identity Disorder ) patient who was told she was evil and a "bad seed" and a priest attempted to "exorcise" her. The Incorporation Therapy accomplished what prayer alone cannot. In fact, as part of the Incorporation, it is necessary for individuals to access their God or higher power in order to incorporate. Most psychoanalysts would say at least 4-5 years on the couch is necessary, and since I was trained along those lines and am an analyst myself, would have said the same thing. However, since we live in an age where insurance benefits are almost non-existent anymore, I have looked for more creative ways to speed up the process. Like I mentioned earlier, there are many wonderful book references on my website which provide a wealth of information. Of course, bibliotherapy has nothing to do with psychoanalysis, but it gives additional support to the process. StarsGirl9: Is there any way to deal with flashbacks while in the middle of the day, say, if something is triggering them at work? Karen: One of the techniques I teach my patients is to fix your eyes on a focal point, put your feet on the ground and take three deep breaths and focus on something pleasant. Another thing I require my patients to do is write a list of 50 positive affirmations and recite this list FIVE times a day in front of a mirror for 6 months. An example of a positive affirmation would be: I am creative for me, or I am intelligent for me, I am sober and focused for me, I am talented for me, I am loving to me for me, etc. It is important that NO negative statements are part of this list. The objective is to reprogram the negative abuser values with new values, which are unique and special for you. Remember, one bad apple can spoil a whole bunch and one negative comment can ruin all the 49 positive affirmations. Karen, the intensity and constant reappearance of the traumatic memories and feelings associated with the sexual abuse can be very tough to live with. Karen: I have been fortunate enough to have established a good enough relationship with patients early on, so when they become suicidal, I make them contract that they will call instead of follow through. Since I am in private practice, I make it a policy to be available by phone when necessary and expect patients to reach out when in crisis. This provides a great opportunity for them to learn how to trust. Having been a victim of ANY kind of trauma is a tragedy and it takes time to work through the issues. David: I noticed some first-time visitors in the audience tonight. You can click on this link and sign up for the mail list at the top of the page so you can keep up with events like this. Again, thank you for coming and staying late to answer questions, Dr. And I want to thank everyone in the audience for coming and participating. Her expertise centers around psychological trauma and Dissociative Identity Disorder (Multiple Personality Disorder). The discussion focuses on getting your alters to work together. Our topic tonight is "DID/MPD: Working Within the Multiple System". Pratt has worked in the field for fifteen years, and has extensive experience with Dissociative Identity Disorder.

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Be sure to tell them that this is a choice you made and you were not ready for their self-injury help and support earlier discount viagra plus 400mg overnight delivery erectile dysfunction pump uk, but need it now viagra plus 400 mg amex erectile dysfunction diabetes permanent. You do not have to accept their value judgments about your self-injury. Let the person know you are telling them because you trust them, not because you are trying to punish, manipulate or guilt-trip them. You want their understanding, not their guilt and besides, self-injury is always your choice. If you have a friend or a counselor that you trust, you may want them to be present to give you support, but do not expect them to tell the other person for you. If they have any questions later or ask for signs and symptoms of self-injury, then you can give them the details in another conversation once they have had a chance to absorb what you told them. To stop your self-injurious behavior, you have to first realize that you have a problem, and then you have to communicate with others. Relationships, in any form, are extremely important. You can get support from them which can help you overcome self-injury. I know it seems difficult to disclose your self-injury to others, but perhaps these tips on how to talk to someone about self-injury will make the process a little easier. Telling someone you self-injure is not a spur of the moment conversation. It takes careful planning and consideration BEFORE talking to a friend or family member about your self-harm behaviors. When talking to someone about your self-injury, make sure that you are in a comfortable, safe place. It is important that the conversation is not rushed or interrupted by other people. If this means leaving your house and going somewhere more private, do so, but make sure it is a place that you both will feel comfortable talking. Make sure the person that you are talking to understands that you are disclosing this information to them because you trust, love, and want to share every aspect of yourself with them. Also, make it clear from the beginning that you are not looking for pity or using your self-injurious behavior as a manipulative tool. Letting someone know how you feel from the beginning will set a good foundation for your discussion. They may feel inadequate because they somehow allowed you to do this to yourself. The way you choose to broach this issue will play a large role in the way the person you are talking to reacts. If you try to use your self-injury as a weapon against them in an argument, you will probably receive a bad reaction - not the sympathetic, understanding reaction that you want. If you have been seeing a therapist or counselor about your SI, you might want them to sit in on your discussion. They already understand your behavior and may be able to explain it in a way the other person can understand. If they act as a moderator or intermediary, they may fend off possibly miscommunications or misunderstandings. Many of these prejudices revolve around myths concerning what SI is. Before you begin discussing your self-injurious behavior with this person, gather as much information on it as you can, and be prepared to dispel their preconceived notions about self-injury. Printing up websites or getting pamphlets on the subject can be helpful reading material for the person you are going to talk to. You wanted them to be understanding and accepting, but they also may need you to be willing to talk more about the self-injury than you had originally intended. Be prepared to answer their questions, even if the questions seem harsh and judgmental. They may ask if you want therapy, what they can do to help you, or why you self injure to begin with.

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