Sunday, January 29, 2017

Trump: The only thing we have to fear

After shocking executive actions from the White House, fear is gripping the world. The new president Trump has unleashed immigration bans, a plan to build a wall across the Mexican border, plans to cut Obamacare and more. Fear comprises our most primal emotion and we talk about it in our book series, Healing the Brain

(Book excerpt.) New York University neuroscientist Joseph LeDoux, Ph.D., and other neuroscientists have begun to examine the way the brain shapes our experience—and our memories—to generate the varied repertoire of human emotions. Specifically, as Dr. LeDoux explains, he chose to begin his inquiry by examining an emotion that is common to all living creatures: fear.

Wistar rat[edit]
Wikimedia.com
Mice serve researchers well as animal models. These very distant relatives possess well over 90 per cent of the same genes as humans.

Years of research by many workers have given us extensive knowledge of the neural pathways involved in processing acoustic information, which is an excellent starting point for examining the neurological foundations of fear. The natural flow of auditory information—the way you hear music, speech, or anything else—is that the sound comes into the ear, enters the brain, goes up to a region called the auditory midbrain, then to the auditory thalamus, and ultimately to the auditory cortex. Thus, in the auditory pathway, as in other sensory systems, the cortex is the highest level of processing.

So the first question we asked when we began these studies of the fear system was: Does the sound have to go all the way to the auditory cortex in order for the rat to learn that the sound paired with the shock is dangerous? When we made lesions in the auditory cortex, we found that the animal could still make the association between the sound and the shock, and would still react with fear behavior to the sound alone. Since information from all our senses is processed in the cortex—which ultimately allows us to become conscious of seeing the predator or hearing the sound—the fact that the cortex didn’t seem to be necessary to fear conditioning was both intriguing and mystifying. We wanted to understand how something as important as the emotion of fear could be mediated by the brain if it wasn’t going into the cortex, where all the higher processes occur.

Some other area or areas of the brain must receive information from the thalamus and establish memories about experiences that stimulate a fear response.

So we next made lesions in the auditory thalamus and then in the auditory midbrain. The midbrain supplies the major sensory input to the thalamus, which in turn supplies the major sensory input to the cortex. What we found was that lesions in either of these subcortical areas completely eliminated the rat’s susceptibility to fear conditioning. If the lesions were made in an unconditioned rat, the animal could not learn to make the association between sound and shock, and if the lesions were made on a rat that had already been conditioned to fear the sound, it would no longer react to the sound. But if the stimulus didn’t have to reach the cortex, where was it going from the thalamus?

Some other area or areas of the brain must receive information from the thalamus and establish memories about experiences that stimulate a fear response. To find out, we made a tracer injection in the auditory thalamus (the part of the thalamus that processes sounds) and found that some cells in this structure projected axons into the amygdala. This is key, because the amygdala has for many years been known to be important in emotional responses. So it appeared that information went to the amygdala from the thalamus without going to the neocortex. We then did experiments with rats that had amygdala lesions, measuring freezing and blood pressure responses elicited by the sound after conditioning. We found that the amygdala lesion prevented conditioning from taking place. In fact, the responses are very similar to those of unconditioned animals that hear the sound for the first time, without getting the shock. So the amygdala is critical to this pathway.

It receives information about the outside world directly from the thalamus, and immediately sets in motion a variety of bodily responses. We call this thalamo-amygdala pathway the low road because it’s not taking advantage of all of the higher-level information processing that occurs in the neocortex, which also communicates with the amygdala.



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Thursday, January 26, 2017

6 Books for A Buck to Fight Trump

Project Hope is sponsored by A Thousand Moms, which supports gay youth in foster care. Our campaign is to enlighten politicians, teachers, clergy, parents--any decision maker with facts and compassion about those in our country enduring extreme stress--now more than ever.

Health is controlled in large part by our brain. Think of addiction, immune diseases, birth defects.

Buy a e-version of our books and share them. Or take a look then buy the printed book on Amazon and give it to someone you think should be informed.

6 brain books for a buck

Our well-received series on the brain is now available as e-books (like Kindle). For only a $1.00 donation to www.AThousandMoms.org

Each book is 172-192 pages, illustrated with an informative glossary. AND, each book is written at a layman's level for easy understanding. Inquire about our 60-minute documentary.

Thank you!

Donate and click the book to download the e-pub.



Healing the Brain: Stress, Trauma and LGBT/Q Youth

Healing the Brain: Stress, Trauma and Development
     


Healing the Brain: Alcohol and Drugs

Healing the Brain: Domestic Violence and TBI
Understanding  the Brain: Fetal Alcohol Spectrum Disorders
Healing the Brain: Memory
     For only a $1.00 donation to www.AThousandMoms.org    Thank you!

In pregnancy, not one drink is safe


Fetal Alcohol Spectrum Disorders describes the large number of developmental disabilities accountable to drinking alcohol while pregnant. Fetal Alcohol Syndrome is the largest single, preventable cause of developmental disabilities. In our latest Healing the Brain book, we focus on this huge problem for children--a life-long matter--and for parents and for the foster care system, where many of these children come to live.

From the book:
Fetal alcohol spectrum disorders (FASDs) are serious, lifelong birth defects and developmental disabilities caused by prenatal alcohol exposure. They are 100% preventable. Still, a surprisingly large number of children are born with FASDs each year. FASDs are a public health problem we must face. The U.S. Surgeon General has stated clearly that no amount of alcohol consumption can be considered safe for a pregnant woman and that alcohol can damage a fetus at any stage of pregnancy (Office of the Surgeon General, 2005). Yet, recent U.S. surveys reveal that approximately 12% of pregnant women still drink alcohol (CDC, 2004; SAMHSA, 2007). This means 1 in 8 fetuses are exposed to alcohol and placed at risk for FASDs. Maternal alcohol use is a growing worldwide phenomenon. It affects children and families of all ethnicities in all societies. Important international collaborative research is beginning to describe the alarming scope of this problem. While community and professional awareness of FASDs have increased, expanded awareness and informed action are sorely needed. 

FASDs are considered both medical conditions and developmental disabilities. 

FASDs cause a range of lasting medical and developmental problems and result in economic losses of billions of dollars. FASDs can also mean long-standing suffering for families. FASDs are considered both medical conditions and developmental disabilities. They include a wide range of conditions, from subtle neurodevelopmental impairments to the full fetal alcohol syndrome (FAS).  Individuals with FASDs can have physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. Research shows that individuals with FASDs often have significant, long-term deficits in functional life skills.

These deficits lead to problems with day-to-day functioning as well as health care, including birth defects and increased risk for injury, unintended pregnancy, and sexually transmitted diseases. FASDs can also be associated with mental health difficulties, disrupted school and  job experiences, trouble with the law, difficulties with independent living, substance abuse, problems with parenting, and more (Bertrand et al., 2004; Streissguth et al., 2004). The median adjusted annual cost of fetal alcohol syndrome has been estimated at $3.6 billion, but the costs associated with the entire fetal alcohol spectrum are surely much higher.
 

Tuesday, January 24, 2017

The Man Who Couldn’t Remember

Our new release, Healing the Brain: Memory gives readers insight into the memory systems in our brain. They make us who we are:

This is the power of memory: a system that captures pictures, smells, sounds, events, directions--endless amounts of information every day--and then seconds or decades later calls it up for us. Memories--what we've learned and what we've done--in a large sense make us who we are. To appreciate this, think if your ability to form any new memories were suddenly cut off.

Who would you be? By studying people who've lost their memories, scientists have learned enormous amounts about how learning and memory work in healthy brains. And what they used to think was relatively straightforward they've since found is fascinatingly complex, thanks in large part to one man.


hm.jpg
Nova/PBS
The man known as H.M. made perhaps the most important contribution to the study of memory after an operation left him unable to form new long-term memories.

In 1953, radical, experimental brain surgery was used on a patient with severe epilepsy. The operation on "H.M." worked, but left him with almost no long-term memory. His case has helped scientists understand much more about the brain. For decades, the Connecticut native, known only by his initials, H.M., was the most famous patient in the study of memory and the human brain. He was a research participant for 53 years, first at the Hartford Hospital with William Beecher Scoville and Brenda Milner, then at the Montreal Neurological Institute, and after 1964 at MIT and Massachusetts General Hospital. At H.M.’s death in 2008, his full name was revealed: Henry Gustav Molaison.

The horrendous price that H.M. paid for an operation that essentially ended his seizures was a severe case of amnesia--an inability to acquire new memories, to commit to memory even the simplest events of his day or the world around him, and then to effectively retrieve those memories. This unintentional experiment, never repeated, showed that the hippocampus and medial temporal lobes are where the brain converts short-term memory into long-term memory.
       
H.M. could remember everything that happened prior to the operation. He could remember the trauma of his childhood. He could remember going to elementary school, to high school, working in the assembly plant. What he couldn't do was hold on to new information for more than a few minutes.

Monday, January 23, 2017

Trump exploits and benefits from fear, our most powerful emotion

Volumes will be written about how Donald Trump sits in the White House despite low poll numbers, and a historically low popular vote.

One element of power, examined from Machiavelli on down, is the exploitation of fear, or the acquiescence to it. Trump is the new Teflon president, fast outpacing Ronald Reagan. The more he is critiqued for obvious lies, the more support he gains, irregardless of public polls. He sits in the White House despite losing the popular vote in historic proportions.

In our book, Healing the Brain, we look at fear, the most powerful emotion of all mammals. It can be said that Trump took the low road to the White House.

Neuroscientist Joseph LeDoux, in his landmark book The Emotional Brain, looks closely at the irrational mechanisms of the fear response:

Years of research by many workers have given us extensive knowledge of the neural pathways involved in processing acoustic information, which is an excellent starting point for examining the neurological foundations of fear. The natural flow of auditory information—the way you hear music, speech, or anything else—is that the sound comes into the ear, enters the brain, goes up to a region called the auditory midbrain, then to the auditory thalamus, and ultimately to the auditory cortex. Thus, in the auditory pathway, as in other sensory systems, the cortex is the highest level of processing.

So the first question we asked when we began these studies of the fear system was: Does the sound have to go all the way to the auditory cortex in order for the rat to learn that the sound paired with the shock is dangerous? When we made lesions in the auditory cortex, we found that the animal could still make the association between the sound and the shock, and would still react with fear behavior to the sound alone. Since information from all our senses is processed in the cortex—which ultimately allows us to become conscious of seeing the predator or hearing the sound—the fact that the cortex didn’t seem to be necessary to fear conditioning was both intriguing and mystifying. We wanted to understand how something as important as the emotion of fear could be mediated by the brain if it wasn’t going into the cortex, where all the higher processes occur.

Some other area or areas of the brain must receive information from the thalamus and establish memories about experiences that stimulate a fear response.

So we next made lesions in the auditory thalamus and then in the auditory midbrain. The midbrain supplies the major sensory input to the thalamus, which in turn supplies the major sensory input to the cortex. What we found was that lesions in either of these subcortical areas completely eliminated the rat’s susceptibility to fear conditioning. If the lesions were made in an unconditioned rat, the animal could not learn to make the association between sound and shock, and if the lesions were made on a rat that had already been conditioned to fear the sound, it would no longer react to the sound. But if the stimulus didn’t have to reach the cortex, where was it going from the thalamus?

Some other area or areas of the brain must receive information from the thalamus and establish memories about experiences that stimulate a fear response. To find out, we made a tracer injection in the auditory thalamus (the part of the thalamus that processes sounds) and found that some cells in this structure projected axons into the amygdala. This is key, because the amygdala has for many years been known to be important in emotional responses. So it appeared that information went to the amygdala from the thalamus without going to the neocortex. We then did experiments with rats that had amygdala lesions, measuring freezing and blood pressure responses elicited by the sound after conditioning. We found that the amygdala lesion prevented conditioning from taking place. In fact, the responses are very similar to those of unconditioned animals that hear the sound for the first time, without getting the shock. So the amygdala is critical to this pathway.

It receives information about the outside world directly from the thalamus, and immediately sets in motion a variety of bodily responses. We call this thalamo-amygdala pathway the low road because it’s not taking advantage of all of the higher-level information processing that occurs in the neocortex, which also communicates with the amygdala.



Saturday, January 14, 2017

Will I get Alzheimer's?

Alzheimer's is a scary word. What is the reality, the science, the hope? Here's a sample from Healing the Brain: Memory. Click the link to download the entire Healing the Brain Series. Six books for a buck.


Alzheimer's Disease--Facts and Treatments

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear in their mid-60s. Estimates vary, but experts suggest that more than 5 million Americans may have Alzheimer’s.


... Alzheimer's Disease - Stem ...
PlacidWay.com
While there is no cure for Alzheimer’s disease, researchers are making advances on treatments that delay the onset and progress of the disease.

Alzheimer's disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.


Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living.


The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia—a combination of two or more disorders, at least one of which is dementia. For example, some people have both Alzheimer's disease and vascular dementia.


In 1906, Dr. Alois Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).


These plaques and  tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body.

Where were you on 9/11?

Here's an excerpt from Healing the Brain: Memory. Learn more about the brain in this special offer: 6 brain books for a buck.



Emotions and “flashbulb” memories.
Your emotional state when an event occurs can greatly influence your memory of it. Thus, if an event is very upsetting, you will form an especially vivid memory of it. For example, many people remember where they were when they learned about President Kennedy’s assassination, or about the attacks of September 11, 2001. The processing of emotionally-charged events in memory involves norepinephrine, a neurotransmitter that is released in larger amounts when we are excited or tense. As Voltaire put it, that which touches the heart is engraved in the memory.

Location, light, sounds, smells...in short, the entire context in which the memorizing takes place is recorded along with the information being memorized. Our memory systems are thus contextual. Consequently, when you have trouble remembering a particular fact, you may be able to retrieve it by recollecting where you learned it or the book from which you learned it. Was there a picture on that page? Was the information toward the top of the page, or the bottom? Such items are called “recall indexes”. And because you always memorize the context along with the information that you are learning, by recalling this context you can very often, by a series of associations, recall the information itself.

Friday, January 13, 2017

Memory Slips: It Was on the Tip of My Tongue



 



In Making Memories, Change Is Good

Learning depends on the plasticity of the circuits in the brain--the ability of the neurons to make lasting changes in the efficiency of their synaptic transmission.

The brain can thus be said to store information in networks of modified synapses (the arrangement of which constitutes the information) and to retrieve this information by activating these networks.



Our understanding of the rules that govern association and the networking of neurons goes back to the groundbreaking work done by Donald Hebb more than 50 years ago. Hebb had an intuition that if two neurons are active at the same time, the synapses between them are strengthened. This hypothesis inspired many researchers, and the first mechanism supporting it, long-term potentiation (LTP), was discovered in the early 1970s.

Memory Slips

The neurons involved in establishing a network must already be connected by synapses in order for these synapses to be strengthened or weakened. Networks are thus fashioned out of pre-existing “wiring.” Some of these pre-wired networks, such as those in the hippocampus, play a key role in the formation of memories.

 Montreal Neurological Institute

“I Have It at the Tip of My Tongue!”


Having a word “at the tip of your tongue” is a familiar but frustrating sensation. There it is, not very far, you know it, you can feel it, but you can’t find it! To make matters worse, very often another word keeps popping into your mind—you know it’s not the right one, but it keeps getting in the way so that you can’t find the one you’re looking for. 


 

Thursday, January 12, 2017

6 brain books for a buck

Our well-received series on the brain is now available as e-books (like Kindle). For only a $1.00 donation to www.AThousandMoms.org

Help us help gay youth and get some great information on your health. Thank you!

Donate and click the book to download the e-pub.


Healing the Brain: Stress, Trauma and LGBT/Q Youth

Healing the Brain: Stress, Trauma and Development
     


Healing the Brain: Alcohol and Drugs

Healing the Brain: Domestic Violence and TBI
Understanding  the Brain: Fetal Alcohol Spectrum Disorders
Healing the Brain: Memory
     For only a $1.00 donation to www.AThousandMoms.org    Thank you!

Saturday, January 7, 2017

Should I let my son play football?



Should I let my son play football? That's the question being asked by millions of American parents as they tune in to the big NFL playoff season that starts today. League of Denial, the name of a PBS show, outlined the frighteningly large numbers of former and retired football players who suffer dementia, depression, and suicide from decades of brain trauma. Here is an excerpt from our new book on Brain Trauma, Healing the Brain.

Other Factors that Influence Recovery 
Genes Evidence suggests that genetics play a role in how quickly and completely a person  recovers from a TBI. For example, researchers have found that apolipoprotein E ε4 (ApoE4) — a genetic variant associated with higher risks for Alzheimer’s disease — is associated with worse health outcomes following a TBI. Much work remains to be done to understand how genetic factors, as well as how specific types of head injuries in particular locations, affect recovery processes. It is hoped that this research will lead to new treatment strategies and improved outcomes for people with TBI. 
Age Studies suggest that age and the number of head injuries a person has suffered over his or her lifetime are two critical factors that impact recovery. For example, TBI-related brain swelling in children can be very different from the same condition in adults, even when the primary injuries are similar. Brain swelling in newborns, young infants, and teenagers often occurs much more quickly than it does in older individuals. Evidence from very limited CTE studies suggest that younger people (ages 20 to 40) tend to have behavioral and mood changes associated with CTE, while those who are older (ages 50+) have more cognitive difficulties. 
Compared with younger adults with the same TBI severity, older adults are likely to have less complete recovery. Older people also have more medical issues and are often taking multiple medications that may complicate treatment (e.g., blood-thinning agents when there is a risk of bleeding into the head). Further research is needed to determine if and how treatment strategies may need to be adjusted based on a person’s age. 
Researchers are continuing to look for additional factors that may help predict a person’s course of recovery. 

Can TBI Be Prevented? The best treatment for TBI is prevention. Unlike most neurological disorders, head injuries can be prevented. According to the CDC, doing the following can help prevent TBIs: ● Wear a seatbelt when you drive or ride in a motor vehicle. ● Wear the correct helmet and make sure it fits properly when riding a bicycle, skateboarding, and playing sports like hockey and football. ● Install window guards and stair safety gates at home for young children. ● Never drive under the influence of drugs or alcohol. ● Improve lighting and remove rugs, clutter, and other trip hazards in the hallway. ● Use nonslip mats and install grab bars next to the toilet and in the tub or shower for older adults. ● Install handrails on stairways. ● Improve balance and strength with a regular physical activity program.

Thursday, January 5, 2017

Traumatic Brain Injury: Not Just Football Anymore


It's not just football anymore. Concussions and traumatic brain injury are being investigated and treated as such in victims of domestic violence. Read about this sad breakthrough in our new Healing the Brain book.

According to an article in Science Daily, physicians and researchers at Barrow Neurological Institute have identified a link between domestic violence and traumatic brain injury. The findings could have important implications in the treatment of domestic violence survivors, both in medical and social service communities. The research, led by Dr. Glynnis Zieman, was published in the July 2016 issue of the Journal of Neurotrauma.
"Head injuries are among the most common type suffered in domestic violence, which can lead to repetitive brain injuries that often have chronic, life-changing effects, much like what we see in athletes. We found that 88 percent of these victims suffered more than one head injury as a result of their abuse and 81 percent reported too many injuries to count," said Dr. Zieman.
Abuse - Free images on Pixabay
Pixabay
Researchers are uncovering the link between domestic violence and TBI.
The research was conducted at Barrow Concussion and Brain Injury Center in Arizona, where a specialty program has been established to address traumatic brain injury (TBI) in the domestic violence survivor. The program is believed to be the first of its kind in the nation. Dr. Zieman and her team performed a retrospective chart review of more than one hundred patients seen through the program to obtain data for this research.

While concussions have been a significant topic in sports, Barrow has taken special interest in concussions and domestic violence. Barrow experts say that women who previously suffered silently are becoming more aware of the real issue of concussions from their abuse.

The Barrow program provides both medical care and social service assistance for homeless victims who have sustained a TBI as a result of domestic violence. It was created after Barrow social worker Ashley Bridwell and physicians identified a three-way link between homelessness, domestic violence and TBI. The medical team has found many victims are suffering from a full spectrum of side effects that can lead to the loss of a job, income, and eventually homelessness.

"This is the third chapter in the concussion story," says Dr. Zieman. "First it was veterans, then it evolved into professional athletes, and now we're identifying brain injuries in victims of domestic violence. And, unlike well-paid football players, these patients rarely have the support, money and other resources needed to get help."



Monday, January 2, 2017

Coping with Chaos in the White House

We all have to cope with a new reality, or surreal-ity. We cover brain essentials in our new book, Healing the Brain. But this article gives a unique psychological perspective. 

N Ziehl

Coping with Chaos in the White House

A few days ago, I wrote a post for my Facebook friends about my personal experience with narcissistic personality disorder and how I view the president elect as a result. Unexpectedly, the post traveled widely, and it became clear that many people are struggling with how to understand and deal with this kind of behavior in a position of power. Although several writers, including a few professionals, have publicly offered their thoughts on a diagnosis, I am not a professional and this is not a diagnosis. My post is not intended to persuade anyone or provide a comprehensive description of NPD. I am speaking purely from decades of dealing with NPD and sharing strategies that were helpful for me in coping and predicting behavior. The text below is adapted from my original Facebook post.

I want to talk a little about narcissistic personality disorder. I’ve unfortunately had a great deal of experience with it, and I’m feeling badly for those of you who are trying to grapple with it for the first time because of our president-elect, who almost certainly suffers from it or a similar disorder. If I am correct, it has some very particular implications for the office. Here are a few things to keep in mind:
1) It’s not curable and it’s barely treatable. He is who he is. There is no getting better, or learning, or adapting. He’s not going to “rise to the occasion” for more than maybe a couple hours. So just put that out of your mind.
2) He will say whatever feels most comfortable or good to him at any given time. He will lie a lot, and say totally different things to different people. Stop being surprised by this. While it’s important to pretend “good faith” and remind him of promises, as Bernie Sanders and others are doing, that’s for his supporters, so *they* can see the inconsistency as it comes. He won’t care. So if you’re trying to reconcile or analyze his words, don’t. It’s 100% not worth your time. Only pay attention to and address his actions.
3) You can influence him by making him feel good. There are already people like Bannon who appear ready to use him for their own ends. The GOP is excited to try. Watch them, not him. President Obama, in his wisdom, may be treating him well in hopes of influencing him and averting the worst. If he gets enough accolades for better behavior, he might continue to try it. But don’t count on it.
4) Entitlement is a key aspect of the disorder. As we are already seeing, he will likely not observe traditional boundaries of the office. He has already stated that rules don’t apply to him. This particular attribute has huge implications for the presidency and it will be important for everyone who can to hold him to the same standards as previous presidents.
5) We should expect that he only cares about himself and those he views as extensions of himself, like his children. (People with NPD often can’t understand others as fully human or distinct.) He desires accumulation of wealth and power because it fills a hole. (Melania is probably an acquired item, not an extension.) He will have no qualms *at all* about stealing everything he can from the country, and he’ll be happy to help others do so, if they make him feel good. He won’t view it as stealing but rather as something he’s entitled to do. This is likely the only thing he will intentionally accomplish.
6) It’s very, very confusing for non-disordered people to experience a disordered person with NPD. While often intelligent, charismatic and charming, they do not reliably observe social conventions or demonstrate basic human empathy. It’s very common for non-disordered people to lower their own expectations and try to normalize the behavior. DO NOT DO THIS AND DO NOT ALLOW OTHERS, ESPECIALLY THE MEDIA, TO DO THIS. If you start to feel foggy or unclear about this, step away until you recalibrate.
7) People with NPD often recruit helpers, referred to in the literature as “enablers” when they allow or cover for bad behavior and “flying monkeys” when they perpetrate bad behavior on behalf of the narcissist. Although it’s easiest to prey on malicious people, good and vulnerable people can be unwittingly recruited. It will be important to support good people around him if and when they attempt to stay clear or break away.
8) People with NPD often foster competition for sport in people they control. Expect lots of chaos, firings and recriminations. He will probably behave worst toward those closest to him, but that doesn’t mean (obviously) that his actions won’t have consequences for the rest of us. He will punish enemies. He may start out, as he has with the NYT, with a confusing combination of punishing/rewarding, which is a classic abuse tactic for control. If you see your media cooperating or facilitating this behavior for rewards, call them on it.
9) Gaslighting — where someone tries to convince you that the reality you’ve experienced isn’t true — is real and torturous. He will gaslight, his followers will gaslight. Many of our politicians and media figures already gaslight, so it will be hard to distinguish his amplified version from what has already been normalized. Learn the signs and find ways to stay focused on what you know to be true. Note: it is typically not helpful to argue with people who are attempting to gaslight. You will only confuse yourself. Just walk away.
10) Whenever possible, do not focus on the narcissist or give him attention. Unfortunately we can’t and shouldn’t ignore the president, but don’t circulate his tweets or laugh at him — you are enabling him and getting his word out. (I’ve done this, of course, we all have… just try to be aware.) Pay attention to your own emotions: do you sort of enjoy his clowning? do you enjoy the outrage? is this kind of fun and dramatic, in a sick way? You are adding to his energy. Focus on what you can change and how you can resist, where you are. We are all called to be leaders now, in the absence of leadership.