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Serotonin combats depression, builds self-esteem and a positive outlook, and creates feelings of calm. Relish this feeling. This is your whole body breathing. As you exhale, you may sense the inner energy of the breath spreading downward toward your feet. Feel the energy travel from the top of your head all the way down to your feet. Become totally aware of this breath. Observe any areas where the breath does not move or penetrate. With each inhalation and exhalation, let the breath flow through those areas. Everyone from time to time feels irritated. When you do feel irritated, see that it is not an enemy. Do not let it take control of your life. They can be generous. Filled with flattery, romance, sex, and promises of commitment, they can sweep their partners clean off their feet. This passion, however outwardly focused it might seem, is really an expression of the narcissist's selfishness, directed at their own fantasies, projections, and expectations of the partner and the relationship, not the reality. This, in turn, provides the kind of attention and satisfaction that the narcissist craves. Because narcissists tend to be pragmatic in the way they see relationships, they tend to focus on their own goals rather than their partner or the relationship. That doesn't mean that they don't form a connection with their partner, it's just that any such connection is based more on friendship and shared interests. With no motivation to continue the romantic facade, the narcissist turns cold, supporting their partner's needs and desires when it's convenient and ignoring them when it's not. They also begin to criticize their partner and get angry when challenged or don't get their way. This process devalues their partner and soon the narcissist has to look elsewhere for an ego-boost.

Given that narcissists tend to see relationships in pragmatic and transactional ways, or as conquests rather than relationships at all, this pattern of behavior shouldn't come as a surprise. It also supports healthy sleep. Clearly, having access to increased supplies of serotonin can be terrific when you are struggling with PMS, painful periods, or perimenopause. However, SSRIs don't help rebalance your stress hormones and they don't address the diet, lifestyle, or psychological issues that contributed to your stress in the first place. Furthermore, hormonal imbalance isn't just a mood issue. I want you to be in glowing health throughout your life--through perimenopause, menopause, and beyond. If antidepressants make you feel well enough to cope with your life stresses and make some key changes, I'm all for them. But if your practitioner uses them to mask the hormonal issues, I'm concerned because I want to be sure that the underlying problems are solved and that your potential hormonal dangers are overcome. After all, no one ever got depressed because they were suffering from a Prozac deficiency. Depression is a complicated condition that is at least partly set off by hormonal imbalance. Rebalancing your hormones and restoring hormonal health is the most important thing you can do to combat your depression. Breathe in through your nose and out through your mouth with awareness. With every breath, become more aware of the breath. You do not need to wipe out the irritation, but rather treat it with compassion as if holding a baby in your arms. This breathing exercise brings awareness and your irritation is gradually transformed. We have to stop, pay attention, breathe, and transform anger into compassion. Visualize a triangle in your mind. Visualize a triangle and move point to point during this. If there are ways you have harmed yourself or not loved yourself or not lived up to your own expectations, this is the time to let go of the unkindness you feel toward yourself. Say, for all of the ways I have harmed or hurt myself, knowingly or unknowingly, I offer myself forgiveness.

You can do this as part of your daily meditation and let your intention to forgive yourself work over time. Nor should it surprise anyone to learn that the narcissist has a great deal of trouble sustaining the relationship they worked so hard to get. In relationships, intimacy and vulnerability are necessary to keep the relationship healthy, but narcissists tend to value power over intimacy, and they have a visceral hate for vulnerability. These relationships, when they do end, leave the partner confused, hurt, and feeling betrayed, but the narcissist feels better because they can begin the chase again with someone new and their carefully hidden and shielded weaknesses have not yet been discovered. Narcissists can do romance, that's well established. They can love-bomb with the best of them, but once you get past all that, love is a union between two people that, according to Erich Fromm's 1945 work, The Art of Loving, entails effort to develop knowledge, responsibility, and commitment. must be motivated to know another's wants, needs, and feelings and provide encouragement and support. We take pleasure in their happiness and try not to hurt them. That means caring, which requires empathy, and that is a quality that narcissists sorely lack. As a result, their ability to react appropriately to their partner is significantly impaired. In fact, because of their nature, narcissists have trouble with a number of things that go into loving someone. So before you start the antidepressants, try the 28-day plan in the second part of this article, which will help combat mild depression as well as hormonal imbalance. If a woman chooses birth-control pills to enable her to have an active sex life while avoiding the risks of pregnancy, that might be a wise choice. But we still don't fully understand how the pill affects a woman's body. We only know that it takes over a woman's ovarian function, so that her body does not produce its own hormones and instead depends on the pill to supply them. We don't really know anything about the long-term effects of suppressing ovulation, which is worrisome to many of us in health care. For this reason, I prefer other ways of treating hormonal issues that I consider safer, healthier, and more effective. As with antidepressants, the pill only masks the underlying imbalance problem rather than addressing it. Be sure to supplement with vitamin B and a good multivitamin. The pill contributes to lower levels of vitamin B and other nutrients, so make sure to keep restoring your body's nutritional reserves to a healthy level.

Like many of my patients, Michelle was initially overwhelmed by the thought of all the changes I was asking her to make. Make forgiveness a practice. The next time you exercise, make a point of following your breathing as much as you can. Be mindful of your body as you move, as well as your breath. Whether running, walking, or any other kind of exercise, concentrate on your breath. Your breathing may become louder to you as you become more mindful of it. If you are taken away from concentrating on your breathing, note what took you away and then quickly return to your experience. It does not matter how many times you have to do this. The important thing is to get back to following your breathing. Each moment of non-wanting is a moment of freedom. Mindfulness allows non-wanting. They see people as extensions of themselves, not as separate beings with their own needs and desires. They don't recognize the extent to which they lack emotional empathy Their defense mechanisms distort their perceptions and interactions with others in order to preserve their illusion of perfection and superiority. Do these traits mean that the narcissist is incapable of that deep, emotional connection that we call love? Essentially, yes. The love of a narcissist is intellectual rather than emotional, as is their empathy. In other words, they can understand what these feelings are in others, but they don't seem to experience them for themselves. As a result, their love will always be conditional, based on the impact of the relationship to the narcissist, which is hardly ideal for their partners. As we saw in article One, while not all narcissism rises to the level of a disorder, and not everyone with a narcissistic personality disorder is abusive, there are those malignant narcissists who, on an interpersonal level, are highly abusive.

The primary objective for the narcissist is power. I reassured her that she could make these changes at her own pace--or not at all. The important thing was that she understood how her body worked and what her options were. The first suggestion I made was that she start eating more frequently: three meals and two snacks evenly spaced throughout the day, with her first meal taken within an hour of waking up. That would help balance out Michelle's blood-sugar levels, combating insulin resistance. Eating more protein and healthy fats while cutting back on the sweets and starches would also go a long way toward achieving those goals. Exercise would help both with insulin resistance and stress relief. So would getting sufficient restful sleep. Finally, looking at the sources of stress in her life would make a huge difference for her. While this was all a lot to take in and to think about changing, Michelle was relieved to know that there were solutions. And she found it empowering to know that she could make these changes, which would improve her health, her mood, and her life. When there is clear attention, when there is just watching, there is not wanting and freedom takes its place. Sit comfortably, noticing that even in its regularity the breath goes through subtle changes. It can increase or decrease in rate and depth. The sensations that accompany the in-breath are somewhat different from the sensations that accompany the out-breath. As you relax and let the breath happen all by itself, you will be able to sharpen your attention by noticing how interesting and complex the simple act of breathing is. It is our life force, yet, normally, we pay absolutely no attention to it. During exercise, we are changing that. We are noticing the subtle changes and sensations that accompany the act of breathing. Know you are breathing in.