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Use of magnetic ear beads – Treatment of the „ almost Untreatable “. EURO-NADA, September 20 – 21, Graz Christian Döring. use of magnetic ear beads as an additional option are frequently favored

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use of magnetic ear beads treatment of the almost untreatable

Useofmagneticearbeads– Treatment ofthe „almostUntreatable“

EURO-NADA, September 20 – 21, Graz

Christian Döring

slide2

use of magnetic ear beads as an additional option are frequently favored

  • good experiences with “untreatable” patients - severe personality disorders or complex trauma, severe addiction problems
  • beginning in individualized sessions
center of substance dependence
Center ofSubstanceDependence

„Heavy User“

„AlmostUntreatable“

„Untreatable“

center of substance dependence1
Center ofSubstanceDependence

Treatment of the „almost Untreatable“:

  • Biological, psychological and/or social situation are frequently decompensated in terms of acute mental crisis, escalating family conflicts, cognitive performance limitations and/or physical impairments
  • Challenges:

- high degree of aggressiveness, impulsiveness and lack of social

integration

- suicidal tendency

- delinquency and substance use

- manipulation and disturbance

slide10

The treatment of the "untreatable" patient-revisited

World J Gastroenterol. 2003 May;9(5):885-7

Kirsner JB

Section of Gastroenterology, Department of Medicine, University of

Chicago, USA, [email protected]

Abstract

  • The limits of medicine have not yet been reached. Numerous human illnesses initially thought to be incurable are reversible under unique and unpredictable individual circumstances. This paper, and the preceding companion publication, describes instances of the successful treatment of patients previously labeled as untreatable, including instances of severe ulcerative colitis and Crohn\'s disease.
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The Almost Untreatable Narcissistic PatientOtto F. KernbergNew York Hospital Cornell Medical Center Westchester Division 21 Bloomingdale Road White Plains, NY 10605, [email protected]

Abstract

  • Clinical experience in the Personality Disorders Institute at Weill Cornell Medical College suggests that patients with borderline personality organization and a narcissistic personality disorder have a more serious prognosis than all other personality disorders functioning at the borderline level, and that those who in addition present significant antisocial behavior have an even worse prognosis (Clarkin, Yeomans, and Kernberg 1999; Stone 1990). This negative trend culminates in a group of practically untreatable patients with antisocial personality disorder, who represent the most severe cases of pathological narcissism. There are also patients with severe narcissistic personality disorder, functioning at an overt borderline level with significant antisocial features, but not presenting an antisocial personality disorder proper, who at times respond to treatment, while others do not. These patients are explored here, with a focus on particular psychotherapeutic techniques that have proven helpful, as well as on the limits of these technical approaches.
slide12

NICE Guideline NICE

  • Nice Guideline
slide13

PSYCHOSIS WITH COEXISTING SUBSTANCE MISUSE (2011)

When working with adults and young people with known or suspected

psychosis and coexisting substance misuse, take time to engage the

person from the start, and build a respectful, trusting, non-judgemental

relationship in an atmosphere of hope and optimism. Be direct in your

communications, use a flexible and motivational approach, and take into

accountthat:

• stigma and discrimination are associated with both psychosis and

substancemisuse

• some people will try to conceal either one or both of their conditions

• many people with psychosis and coexisting substance misuse fear

being detained or imprisoned, being given psychiatric medication

forcibly or having their children taken into care, and some fear that

theymaybe ‘mad’.

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