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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5119
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Youre up late :) Will my sister Nancy have to hit a rock

Customer Question

You're up late :)
Will my sister Nancy have to hit a rock bottom before she realizes she has a serious issue to deal with? Her attacks on people are escalating. My brother, Chuck had to ban her from his facebook page and Kat had to point blank tell her that she can't talk to her if she's going to keep trying to hurt and upset people.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

Dr. Z :

Hello again,

Dr. Z :

I am obviously not the only one that is up late too ;)

Customer:

I'm still babysitting dogs. LOL

Dr. Z :

Most likely with her disorder, she will never hit rock bottom because she does not think that she has a problem, it is everyone else that has the problem

Dr. Z :

To her she sees nothing wrong with her behavior, which is why her disorder is so hard to treat.

Customer:

So it's best when she's this mean just to not respond?

Dr. Z :

Yes I would say it is best to not respond when she is acting out like that

Customer:

That's what I was wondering about. I talked to my brother about some things we discussed. He was pretty shocked at her most recent behavior. He had previously emailed both of them with being specific about the meanness that has to stop.

Dr. Z :

It does have to stop, but for Nancy she does not feel that she did anything wrong and may justify her meanness by saying that Chuck was just being too sensitive or he misunderstood.

Customer:

Is there a reason she's escalating now?

Dr. Z :

Usually they escalate when their self-esteem is low or when they feel they have not been getting enough attention.

Customer:

She may be particularly jealous that Marti has been the center of attention, so to speak, recently.

Dr. Z :

That is a possibility

Customer:

Kat dealt with her guilt issue very well. Her therapist actually faxed her info on grief. Kat made a card for Ken telling him all the wonderful things she remembered about Marti (and their whole family.) She figured she was trying to make him feel better by telling him, but that what would make him feel better was talking about Marti, and it's helped her start to deal with the reality of Marti's death.

Dr. Z :

That is great that Kat is doing so well, I was pretty confident that she would adjust and bounce from this, but it is good to hear that she is working through her grief well. And I like the card that was a good touch, what about her feeling like she wanted to tell Ken about how she pushed him when she was a young girl?

Customer:

Her therapist suggested she might be in the grasping at straws stage and that if she could make Ken feel better by confessing, it sort of made Marti's death less real because she could call his (and her) sadness something else.

Dr. Z :

Interesting interpretation by her therapist, I like it

Customer:

It's easier to feel guilt at times than extreme sadness, and especially really dealing with death in a new way.

Customer:

Kat told me about it and asked the question of the ages: why is death so hard?

Dr. Z :

I agree because with guilt you are blaming yourself, so there is a sense of control, but not always with extreme sadness

Customer:

When she made the card which is almost a booklet, she didn't feel the need to confess anymore. She felt the loneliness, but also the joy of remembering and having had a real relationship that is worth missing.

Customer:

yes! the sense of control, the sense that it isn't really real.

Dr. Z :

Good for her, if I am sure the card was very cathartic for her and brought a big smile to Ken's face

Dr. Z :

Yes it is a perception of control, but perceptions are very strong for some people

Customer:

It did both and we got to talk about how it helps Ken (and others) by talking about the person who died.

Customer:

She's also really learning she can handle her strong emotions.

Dr. Z :

Good for Kat, I knew that it would be an adjustment period with handling the death of a loved one, but once she started to adapt, her therapeutic techniques would start to kick in for her.

Dr. Z :

Now she is just realizing how invaluable they are for her

Customer:

Yes! even alone in the truck. Her emotions aren't handling her, she's handling them.

Dr. Z :

That is good, really impressive of her :)

Dr. Z :

I guess this just shows her that she can handle almost anything thrown at her in the future, that should give her strength and relief because some individuals always worry about the next crisis that may or may not come, but Kat will know that she has the skills to handle it

Customer:

LOL it's kind of funny because for 4 years straight at school one of her target behaviors was "I will ask for help when I need it" and she's asking for help from both her therapist and myself.

Customer:

exactly!

Dr. Z :

It is a sign of strength and humility to ask for help

Customer:

She told me recently that she didn't know I worried when she's driving. I told her I don't spend my days worrying, but that I know she has a dangerous job. Worrying is like rocking in a rocking chair....gives you something to do but you don't go anywhere.

Customer:

I made sure she knew that I don't worry any more about her than if she had a 9 to 5 job but had to get there in lousy weather.

Dr. Z :

I understand, and its your job to worry about her, but as long as it does not go to obsessional or severe anxiety, then I think worrying about her is normal.

Customer:

exactly, it's like how you are concerned about anyone

Dr. Z :

Yep and it is perfectly natural, it is a way to show that you care

Customer:

I'd go nuts if I obsessed about it. But I know she does her best to be safe, and neither she or I have control about other drivers.

Dr. Z :

That is true, and if she is a good driver, then I am sure she will be safe. I understand where you are coming from, I used to work as a psychologist in a maximum state prison, and a maximum security state hospital and my mother worried about me too

Customer:

Yes, just because there are added elements of danger. But I can trust that she does all her safety inspections of her truck and I know of times where she refused to drive when she felt it was too unsafe with the wind or ice or whatever.

Customer:

That she can control, but she will never be able to control other drivers.

Customer:

She's looking forward to learning how to Skype.

Dr. Z :

She is being safe and responsible on the road, and that is all you can ask for, which is good. I am sure she is great driver and always prepared for other drivers.

Customer:

As prepared as anyone can be, and she has a good head on her shoulders.

Dr. Z :

Thats good, I just used skype last night with a colleague in New Mexico, it is very convenient

Customer:

She was perturbed about Nancy calling and ranting about Chuck. How do I explain the difference between someone being psychotic (which she's familiar with) and someone just telling lies?

Customer:

Is there a point where a narcissist is psychotic?

Dr. Z :

Well psychosis is someone not in their right mind and not able to control their own actions, but with Nancy she has a personality disorder and while it is strong, she is able to differentiate between right and wrong and can control her own actions

Dr. Z :

Do you mean psychotic or psychopathy? They sound similar but very different?

Customer:

I'm not sure. I know that when Kat was psychotic, she couldn't control her thinking. I think Nancy can control her thinking, but for whatever reason, she goes off on bizarre lies.

Dr. Z :

Okay so you do mean psychotic because narcissist can become psychopathic, which is really really bad. But with Nancy her personality disorder will not creep into psychosis, her bizarre lies are from her own undoing and she was in control and had full faculties when she said those lies.

Dr. Z :

The only way for someone to have narcissistic traits and be psychotic is if they had a delusional disorder, but that does not sound like Nancy here.

Customer:

For instance, what she went off about to Kat about Chuck, was that he doesn't have the vision problems he claims to have. Chuck's best vision was 20/400 and it's worse than that now. He's blind in one eye (totally) and they don't even use numbers anymore with his vision uncorrected. He has macular degeneration in the good eye. It's 20/50 corrected, but to read he both needs his contacts and reading glasses, and he has to hold what he's reading within inches of his eye.

Dr. Z :

Yeah this is not psychosis, she is lying because she may feel that if she lies about Chuck then it may cause some family members to resent him and then they can start to trust her and talk to her more, therefore giving her more attention

Customer:

LOL Nancy was trying to explain to Kat that Chuck didn't need anyone to drive him anywhere.

Customer:

That's what I thought, more attention getting than actually really believing what she says deep down. Especially since she was mad at him for calling her on what she said about me, which I don't really know and don't care to know. He took it down and banned her from his page.

Dr. Z :

Really? With that eyesight you just mentioned. Nancy is trying to say anything bad about others to cause conflict and try to get people on her side. This is about attention and control

Dr. Z :

Good for him, he should not take this lying down.

Customer:

Yes, she told him the only reason I drove him was to make myself look good (and apparently that was the nicest thing she said) and then said Chuck was just too lazy to drive himself and didn't really want to go, but when I offered, he felt trapped.

Customer:

Like he had to make himself the "caring brother" who wanted to go to the funeral.

Dr. Z :

This is definitely classic NPD by using lies to manipulate others to try to curry favor, attention, and control

Customer:

Kat felt bad enough because she thought he was teasing when he held a menu about an inch from his eye, and that he had to hold it to the side to be able to see it. He doesn't have vision except on the sides.

Dr. Z :

Yeah that happens because the rods are plentiful on the sides of the eyes and they are usually resistant to macular degeneration. Kat shouldnt have to feel bad, but it is nice that there are family and friends willing to drive him

Customer:

She learned about his vision problems and was impressed at what he still can do. She always knew he couldn't see well, just didn't know how hard it was for some people.

Dr. Z :

It can be for some people, eyesight is very sensitive and complicated too

Customer:

That's one of the things he taught her. It's not just visual acuity, but "how" one sees things.

Customer:

But she understood well why he gets headaches when he has to really use his eyes.

Dr. Z :

That is true, headaches can happen when you are trying hard to focus with your eyes

Customer:

She has auditory processing problems so she could understand what he was saying. She can hear fine, but it took years to learn to understand what people were saying. They had a hard time understanding why, when she could hear well, she couldn't always understand speech.

Dr. Z :

So she understands how when one of your five senses are not working properly how it can effect you as a person sometimes.

Customer:

yep

Customer:

and she really respects him for doing what he can instead of complaining about what he can't do

Customer:

I guess that I can tell Kat that when Nancy settles down some, she can talk to her when she's being nice and doesn't have to talk to her when she's not.

Dr. Z :

That is the best advice you can give with someone with Nancy's disorder, unless Nancy truly goes to intensive therapy to get help

Customer:

You know, I'm so glad that Kat's disorder was different. She knew there was something wrong and tried hard to get it fixed. With Nancy's disorder, she truly doesn't think there's anything wrong with her so she won't seek help.

Dr. Z :

Exactly and this is why with NPD it has a low success rate for treatment, because the person does not think there is anything wrong with them

Customer:

Thanks again for your time. This is so helpful to me. I know how to understand more what's really going on.

Dr. Z :

Anytime, I am always happy to help. And congratulations to Kat on doing so well with her grief, that is welcome news to me

Customer:

I'm pleased with it too! We'll still be working on it until we work through it. That's all we can do.

Dr. Z :

Thats true, but she is making positive steps and that is a good sign :)

Customer:

for sure!

Customer:

Have a good night! Babygirl has finally settled down so we can sleep. She's like a hyperactive kid!

Dr. Z :

Haha sounds like some typical dogs that I grew up with. You have a great night and a great start to your week :)

Customer:

nite!

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5119
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and other Mental Health Specialists are ready to help you
Expert:  Dr. Z replied 1 year ago.
I forgot to mention this last night because I was having computer issues and I was too tired to fix them, but I wanted to thank you for the positive review and very generous bonus, I truly appreciate it :)

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