[Daniel]

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How to help someone with narcissism is difficult because the problem is multi-factorial.

For starters, narcissism isn’t a diagnosis, but a personality style. Narcissism becomes only a diagnosable disorder if the quality of life of the narcissist is significantly impacted. It then is diagnosed as Narcissistic Personality Disorder (NPD).

It is a personality style that is also really hard to recognize for therapists because a narcissist does know how to behave and is often very charismatic.

A third problem is one of the traits of narcissism: the lack of self-reflection. They don’t recognize their behaviour as a problem and therefore don’t seek out help in general.

Some narcissists do seek out help, but then the problem often becomes that the therapy turns into a new stage for their attention-seeking behaviour. This is why many therapies don’t seem to work.

It requires both a skilled therapist that understands narcissism and the willingness of the narcissist to work on the real problem. In these cases, CBT (Cognitive Behavioural Therapy), DBT (Dialectical Behavioural Therapy), Schema therapy and therapies that address traumas can help.

The origin of narcissism
There are different ways to become narcissistic in nature. It is often a combination of different factors. Temperament (the inherited component of behaviour) plays often a role together with other factors like for example neglect(not enough caring attention) or over-pampering (too much caring attention) in childhood. Traumas can also have a big contribution to shaping narcissism.

Narcissists that have experienced early childhood traumas result in a way of looking at life that can be described like they feel the ultimate victim.  They reason like this: “I was the one who was physically and emotionally abused in childhood, not them. They are the ones who must understand me, the ones who must adapt to what I need in every moment”.

Of course, there is much more at play. A lot of people with traumas don’t become narcissistic.

But addressing traumas often is a part of the process.

Narcissism & Nutritional Components
In terms of nutrients, there isn’t much known yet, unfortunately. At least not that I know of. I can imagine we can do a lot in the prevention stage which is in childhood.

Reversing the dynamic is a total different animal. We do know that Brain Development in Narcissistic Personality Disorder has often been altered (but not always) and it doesn’t look easily reversible.

Therapy often can help a narcissist learning how they should behave, but that doesn’t necessarily mean they learn the ability to empathize with people. It is more of a ‘knowing’ instead of ‘feeling’ and that often takes years as well.

[Daniel]

,

Disengaging and setting boundaries are the 2 main tips when you can recognize a gaslight situation.

In the case of a narcissistic personality style, the rules change a bit though. Setting boundaries can already cause a second wave of manipulation because narcissists don’t care about boundaries unless these boundaries hurt them in some way. Recognising and disengaging are the most important tools if you can’t leave the relationship. They prevent you from doubting yourself and they protect against a second wave of hurtful behaviours.

When people set boundaries, often the non-narcissistic person can reflect on their behaviour and might come back later to apologize.

Empathy as ‘trick’
There is a trick (and I will update the tip), that I don’t see talked about. You can utilise empathy.

The empathy however is for you and isn’t meant to give the gaslighter a free pass.

People who gaslight are often in a form of pain. Recognizing the pain at the moment can help you to stay calm, disengage easier and set boundaries from a place of strength.

This empathy shouldn’t be used to rationalize the behaviour of the gaslighter: He/she has a bad day or is stressed, so I won’t make a deal out of this. It is never ok to deny someone’s reality. 

Recognizing that this person might be in some form of pain can also help to let go of vengeful thoughts and feelings or rumination.

If someone else uses a different method, do share!

[Daniel]

With neuropathy, it would also be a good idea to check her vitamin B12, folate and vitamin B6. A lack of these vitamins can also cause neuropathy.

[Daniel]

Hey ,

Vitamin B1 has been shown to help with diabetic neuropathy. With neuropathy, the nerves get damaged and this can influence the speed of the emptying of the stomach.

The absorption of vitamin B1 works via transporters that are located in the gut lining. The vitamin B1 from food is freed by enzymes (intestinal alkaline phosphatases) but the rate-limiting step for absorption is determent by the saturation of these transporters.

The mononitrate and hydrochloride forms of B1 are salt forms and have a low bioavailability (between 3-6% according to this article). This has to do with the rate-limiting step I described earlier.

Benfotiamine is fat-soluble and as a result, it is much more bioavailable. Because it is fat-soluble there is some evidence it can cross the blood-brain barrier, but it is debated.

But the evidence for TTFD (Thiamine Tetrahydrofurfuryl Disulfide) to penetrate the blood-brain barrier is much stronger. The absorption isn’t as dependent on the transporters in the gut since it can travel through the cell membrane because of its chemical structure. It also has a high bioavailability. If you look for the benefits of the penetration of the blood-brain barrier, this form is the best one.

A clean TTFD supplement (free of binders and fillers) that I like is Thiamax from Objective Nutrients. It only contains a capsule.

I hope this information will make your choice easier.

[Daniel]

Hey ,

You are thinking in the right direction! Having an early and light dinner can contribute to low blood sugar at night. Workouts in the evening/late afternoon can also cause lower blood sugars at night.

The good thing is that with your glucose monitor, you can finetune when you should eat to see if you can bring up your blood sugars above 70 during the night.

Another thing you could do is consume a snack containing carbs before you go to bed, together with a little fat to slow down the absorption of the carbs. A baked apple for example.

When blood sugar drops below 70 mg/dl during the night it is called nocturnal hypoglycemia. This can cause symptoms like:
• Nightmares or sleep disturbances
• You could experience a headache, confusion, or irritability upon waking
• It could cause you to feel tired the following day
• You could experience signs of sweating like damp bedsheets and clothes.

Do you experience any of these?
Having low blood sugar at night can also be caused by other stuff. For example, low levels of cortisol can contribute to lower blood sugars. If you use cortisol lowering supplements before bedtime, you could experiment with smaller dosages or even leave them away.

Insulin resistance can also cause low blood sugars at night. The higher insulin levels together with the low dietary carbohydrates in the evening could potentially cause low blood sugars during the night.

Menstruation can also influence blood sugars… Hot and humid weather as well!! It causes the blood vessels to dilate, which can enhance insulin levels. Even drinking alcohol can affect blood sugars and lower them at night.

But the causes you mentioned would be my primary suspects as well.

Let us know what worked for you!

[Daniel]

Hey ,

In addition to Bernadette’s excellent answer, I would like to add here that it would be interesting to see his labs as well. 

In functional medicine, we look differently at labs. For example, he isn’t diagnosed with diabetes, but his labs could still show us signs of insulin resistance, which can definitely cause damage to arteries causing calcification.

In fact, if he could do only one lab, I would be curious about his fasting insulin levels.

His cholesterol/triglyceride levels are also interesting to see for ourselves. If you like to share them, perhaps we could give you even more individual advise!

[Daniel]

Hey ,

If it is working, you have found a way! Unfortunately therapy does take time and it needs work as well.

EMDR can still be an important supplemental therapy. It can help you process trauma quite fast. It is a supplemental therapy, because it doesn’t address unhealthy learned thoughts and behaviours.

Learning to trust your body is a process as well. And as far as I can tell it did a great job bringing you here today!

If you have any further questions, just let us know!

[Daniel]

Hey ,

First of all, I’m sorry to hear your story! Although I don’t know the exact details of your story, early traumatic experiences can cause anxiety with health.

For example, the loss of a parent can make you aware of how vulnerable life is, which can lead to an exaggerated sense of vulnerability and fear of death or illness.

I don’t know if this is at play in your situation.

If traumas are at play Trauma Focused-Cognitive Behavioural Therapy (TF-CBT) often is a great form of therapy that can help. But it does take time. Eye Movement Desensitization and Reprocessing (EMDR) is another tool that can help you process your trauma and can be a great supplemental therapy. Did you try these forms of therapy?

Processing traumas is probably part of your healing journey. Finding meaning in what happened to you is part of this journey as well. 

Cognitive Behavioural Therapy is also great when you want to reduce anxiety around your health. But you have to feel good and trust your therapist as well. The last part is a big success factor for making the therapy work.

Educating yourself about how the body works can also be a part of your journey. The school where I was taught functional medicine learned us that the body has so many healing systems. The body has great resilience. It doesn’t want to get sick or die. 

Yes, we can get sick. But this often only happens when we haven’t supported our body in the right way for a while. Let me give you 2 examples:
• It takes about 10 years for diabetes to manifest. It is often an accumulation of lifestyle circumstances over these 10 years that causes diabetes.
• Calcification of arteries is also strongly influenced by lifestyle factors. Yet we often don’t see calcification happening above the age of 40 and often in combination with a life of bad lifestyle habits.

What we teach here is how to support those healing systems. Knowledge about those systems can also help you reduce your anxiety. Have you tried for example following one of the courses here?

I hope these tips can help you.

[Daniel]

Hey ,

This supplement contains kelp (brown seaweed) extract which is high in iodine. Recommended for adults is that we consume 140 mcg daily.

Since I don’t know this supplement, I will provide you details on iodine amounts and thyroid health.

How much iodine is in brown seaweed/kelp
Although some sources mention that kelp can contain around 1000 mcg of iodine in 1 gram of kelp, the amount can vary greatly per batch, making it hard to determine the amount of iodine in kelp supplements.

What happens with high dosages of Iodine?
Low iodine intake can cause hypothyroidism, but less known is that a high intake of iodine can also aggravate thyroid issues. In fact, some people can experience hypothyroidism with daily dosages of iodine above 2 mg because they can’t adapt to the amount of iodine and it in time starts to inhibit thyroid hormone production. Some people can experience hyperthyroidism with these amounts of iodine and other people have no problem at all. 

Kelp & Thyroid medications
I know that patients taking levothyroxine (medication used with hypothyroidism) are advised to avoid using kelp products since it can alter the amount of medication they should use in an unpredictable way (you can find more information about that here). It is probably for this reason, the warning is on the product.

Advise
Since the amount of iodine isn’t specified here and I don’t exactly know what the concentration of iodine in the kelp extract is, I can’t answer the question with certainty, but I suspect the warning is there for people who are on levothyroxine or other thyroid medication.

Perhaps if you send them an email, they can clarify what they mean with their warning

[Daniel]

Hey ,

When I formulated the first version of my answer in my enthusiasm I recommended magnesium citrate since I was focused on writing tips that address constipation. I corrected this response quite fast, but for some reason, you still have read the older version.

With CKD-3, magnesium taxes the kidneys and it is important to stop supplementing. The best recommendation here is to avoid magnesium supplements unless her doctor advises her otherwise.

[Daniel]

Hey ,

There can be several reasons why your mouth feels irritated or your tongue feels scalded and your suspicion is right: acid reflux/gastritis is one of them. Keeping an open mind is important since there can be other reasons like allergies, post nasal drip and infections for example.

Some other lifestyle factors could also cause an irritated mouth. For example acidic foods & (soft) drinks, dental materials and overuse of mouthwashes. Some people push their tongue against their teeth, bite the tip of their tongue or grind and clench their teeth. All these things can cause or contribute to these symptoms as well.

Gastritis/Acid Reflux
Since you mentioned you have gastritis and acid reflux symptoms, I will zoom in on this part. Here are some common causes:
• H. Pylori overgrowth. H. Pylori is a bacteria that most people have and it normally lives in small numbers in or on the lining of the stomach. When the stomach becomes less acidic, H. pylori can start growing and cause some damage causing inflammation in the stomach (gastritis). In the gut health masterclass we have a video about how to reduce an H. Pylori overgrowth – just click here.
• Stress reduces the secretion of digestive juices like stomach acid. You can see that living and eating in a stressful state can be the root cause of gastritis. With low stomach acid, you could also experience acid reflux. The reduced acidity of the stomach can lead to acid leaching into the oesophagus, where the tissue is much more sensitive to the acid.
• Food sensitivities can also cause acid reflux. If you as well experience a post-nasal drip, then eliminating dairy might be a good starting point.
• Nutrient deficiencies can also be at play. PPI’s reduce stomach acid, but stomach acid is needed to digest iron & vitamin B12 as well. These nutrients, when you lack them, can also cause a scalded tongue or an irritated mouth. Other nutrient deficiencies that could play a role are zinc, folate and vitamin B6. Usually, with nutrient deficiencies, the presence of these symptoms is not developing over a night. But at the very least it would be a good idea to check your iron & vitamin B12 serum levels when you are using PPI’s for a longer while.
• Hiatal hernia. When your stomach is pushed through the diaphragm we talk about a ‘Hiatal Hernia’. This can also cause the stomach to produce less stomach acid and can be at the base of developing gastritis as well.
• Hypothyroidism can slow down stomach acid production causing low stomach acid as well.

In the library, there is a handout about acid reflux which you can find here. I recommend you take a look at it. Much of the advice above you will find in a summarized version over there with many practical tips on what you can do to reduce symptoms of gastritis and acid reflux.

When your tongue is scalded because of acid, the tongue is damaged and will need to heal first. This can take a couple of days in many cases, but it could take up to 1-2 weeks in more severe cases. But here are some tips that could help you reduce the irritated feeling in your mouth or reduce the scalded tongue.
• Salt water solutions can cleanse your mouth and help when bacteria are causing an infection following a tongue burn. Take care not to overdo it, though. Too much salt can irritate the injury. Dissolve about 1/8 a teaspoon in eight ounces of water, rinse and then spit out the saltwater mix.
• Cool drinks, cool foods or sucking on ice could help reduce some of the pain your feel in your mouth.
• Coat your tongue with milk. Many people use milk to reduce the heat when they have eaten spicy foods. Milk can also soothe a burned tongue.
• Coat your tongue with manuka honey. Honey has antibacterial properties. Keeping your mouth free of bacteria can prevent infection while your tongue is healing.

I hope these tips can provide you with some relief!

[Daniel]

 Just to be sure: on the images with the list of medications you posted, she only uses Furosemide?

As Bernadette mentioned, getting her to move more and addressing her insulin resistance can help her reduce stress on the veins and heart. In this case, relatively easy advice (walking more, reducing sugar/carbs, etc) can already impact her health a lot.

Adding in some practical advice to address constipation:

• Eat plant foods. Make sure she gets enough fibre
• Physical inactivity can also contribute to constipation
• Healthy fats like Extra Virgin Olive Oil and avocado can improve gut motility as well. 
• Drink enough water (but this one should be consulted with her doctor because she is in the third stage of Chronic Kidney Disease and uses perhaps medications on which drinking too much can be contraindicated). Water is also important for gut motility.
• Be aware that magnesium supplements that are often recommended for constipation are not good advice because this can tax her kidneys.

Good luck!

[Daniel]

Hey ,

Usually, water retention can happen because of various reasons. Sometimes it is just as simple as that a person doesn’t move enough, since lymph fluid moves in the body through body movement. But a lack of movement can also cause slower blood flow in the veins in the arms and legs since blood in these parts isn’t only dependent on the heart pump function.  

Other problems that could cause water retention are kidney issues, liver cirrhosis, heart problems use of medications and hormonal changes.

How old is your mother? Perhaps you could share more about your mother’s health (including other current medications she might be using) to narrow things down.

Assessing pictures only without context can cause misinformation. Perhaps you know if her doctor diagnosed her with venous insufficiency? Or something else?

[Daniel]

 Yes, the article was written with this in mind.

This stuff isn’t thought in school, but in my opinion, it should be. We all have used one or more of these methods ourselves. They are common.

Recognizing these methods can be the first step toward personal growth. Manipulation isn’t always used ‘to get what you want’, but it can also be a way of protecting your self-image for example. 

Once you can see through these tactics, you can actually learn a lot about yourself! And as a bonus, you can learn a lot about others.

If you know how to recognize these patterns, you can also start finding out how to say the same in a way that actually can strengthen your relationships or keep them more ‘clean’.

Reasons, why people use these methods are often related to insecurity and low self-esteem. These types of feelings are just as well a form of stress that can contribute to disease! 

For most people, when they use these tactics, it gives a lot of stress as well. Situations often escalate. Provided that narcissism doesn’t play a role, people often end up with feelings of guilt or shame about their behaviours as well.

These feelings of shame and guilt can strengthen low self-esteem making it more likely to resort to these methods.

[Daniel]

, thank you for sharing this. I think you bring up a valuable point here as well! There are definitely things we can do as friends and family.

Survivors that are in these toxic romantic relationships can feel isolated. Partly of shame or feelings of being judged by friends and other people. And this comes on top of the self-judging these survivors are already doing.

Often these people are best helped by friends who don’t judge – even as it is quite hard as a friend to express your concerns. Learning about these manipulation techniques can help you understand what they are going through.

Understanding the basics of these behaviours as a friend can help them retain the confidence that they have left… and even build it up!

I will make sure I spend some time explaining how to do this as well!