#clinical case

[hissuicide]

Get to Know Me

⌜ ⌝ ılı.lıllılı.ıllı. ᴺᵒʷ ᵖˡᵃʸᶦⁿᵍ; Fourth of July 1:07 ——◦———— -4:39

↠ⁿᵉˣᵗ ˢᵒⁿᵍ ↺ ʳᵉᵖᵉᵃᵗ ⊜ ᵖᵃᵘˢᵉ ᴠᴏʟᴜᴍᴇ : ▮▮▮▮▮▮▯▯▯

⌞ ⌟

Hi. This is my blog. Stay a while but respect my boundaries and dni list. I'm mentally ill and disgustingly suicidal. Don't want to be here. Don't know why I'm here but upset that I am. This isn't my only blog. I was tired of suppressing my true thoughts on my first account so I made this one to be more raw and open with no judgement.

Content warning: self harm and suicide

About me:

black woman (she/her)

writing

reading

books

dark pieces of literature

love

books that end in tragedy

Feel free to message me. Always willing to talk

I hate men (men can still follow and interact but if you're gonna be offended with certain posts/try to argue with me I'll block you)

DNI:

racists

if you're not pro Palestine

bigots, terfs, transphobes, homophobes, ablesists

nsfw accs that get off on self harm

anti recovery

gore

bots and blank accounts

ed accounts

[killjoy-prince]

House M.D. but it's when Wilson and House says each other's name

[violent138]

Alfred sends Cass to forcibly take out wrangle anyone refusing to take a much-needed sick day.

The Batfam draws straws and sets up bets to decide how many people will try and take down Cass when she's got pneumonia.

[kirby-the-gorb]

[feroluce]

Lucid Dreamer (1/2)

part 2

Gepard notices that it's been. Quiet lately. Like weirdly quiet. TOO quiet. He hasn't seen Sampo Koski in almost a week, which is about the longest he's ever been absent. And he is NOT worried. He's not! So what if they've been getting along more lately! So what if Gepard sometimes looks for him in his favorite hiding places! So what if he's been dreaming about blue hair and green eyes! It's nothing!!

But they're….strange, these dreams. Gepard doesn't usually remember what he's dreamt. It's out of his mind seconds within waking up. But these stick with him, they won't leave him be, they feel different somehow.

He dreams of Sampo bringing food to the frontlines and eating breakfast in his tent with him. Sampo always sneaks him extras. He dreams of chasing Sampo through the alleyways, Sampo sometimes letting himself be caught, Gepard sometimes catching him, and trying to ignore how it feels more like a game now more than anything else. He even dreams that Sampo tags along with him on one of his few civilian days. Sampo runs errands with him, prattles about inane bullshit while Gepard picks out groceries for the week, drags Gepard into some bakery he's never been to but he thinks Serval mentioned once.

And sometimes, it feels so close to reality, that Gepard half expects to see Sampo, shamelessly swaggering into the frontlines with all the guards' breakfast like his wanted poster wasn't only recently taken off the walls of Belobog. He's disappointed when it's always someone else instead. He tells himself his disappointment is ridiculous and if Sampo wants to go prowl around the Snow Plains or wherever he is, then fine. It's not any of his business.

…But it IS his job to investigate any unusual criminal activity relating to the frontlines. And the frontlines are Sampo's usual haunting grounds, and this is unusual activity, and Sampo IS technically a criminal, so it is absolutely part of his duty to look into this - is what Gepard tells himself the entire tram ride down into the Underground.

Natasha tells him he's gone, and Gepard has to steel himself. He knew Sampo made enemies wherever he went, there are a lot of people who would love his head on a platter, but he didn't think-

Natasha corrects him that she means literally gone. As in off-planet. Sampo always leaves her a note before he goes anywhere, so she knows not to expect any supply runs from him. He should be back in exactly two weeks. Thank the Preservation.

Gepard goes back home. He waits.

The uneasiness doesn't leave him.

"Where did you go?" Sampo stops dead in the middle of some story about Seele, and how you'd think someone with as blunt a mouth as her wouldn't have so much trouble asking a woman out, even if that woman IS the Supreme Guardian, and stares at him. He nearly fumbles his cigarette.

"Ahaha, what do you mean, I'm right here?" Sampo smiles at him the same way he always does. Gepard has no idea why he asked. It just popped out. He can never tell when Sampo is lying, anyway.

"I don't know. I feel like I haven't seen you in a long time." Gepard idly mouths at his own cigarette. He almost never smokes, but he wants to ration their stocks of Blizzard Immunity, and it helps with the cold. It's seemed colder lately, for some reason.

Gepard flicks his lighter once, twice, sighs at the third time because a metal prosthetic and thick gloves make the damn things so difficult. Sampo reaches over and wordlessly kisses the end of his cigarette to Gepard's, lighting it. "Thank you."

Nothing happens for almost a full 30 seconds. Something churns behind Gepard's ribcage. Because Sampo never leaves a "thank you" hanging. This is the part where he gives his spiel about how helpful and kind he is and Gepard either brings up how long his rap sheet was before Bronya helped clear his name, or just stares deadpan because seeing Sampo squirm is weirdly satisfying.

"…I'll be back in one more week."

Gepard jolts awake in his cot, mouth dry and eyes bleary.

The hell.

The next dream he has, Sampo looks tired. Sometimes he seems normal. Sometimes he says strange things, like how he wishes he'd gone to some restaurant in Belobog. Ate his favorite food more recently. Brought something with him. Gepard asks why he can't do that now. Where would he bring something? Sampo only shrugs. His rebuttals have less energy.

Gepard doesn't know if he wants to dream more, or less.

He ticks down the days on his calendar. Natasha hasn't told him any different. She promised she would if she got any kind of message. Sampo returns tomorrow, from whatever vacation or seedy business dealings he's been off having. He is not excited about it. He is not looking forward to it. He's not!!

Gepard falls asleep late that night, unable to settle. He dreams again.

He's alone. There are tons of people everywhere, the frontlines are always crowded. But he's alone. They all pass right by him as though he were a ghost. Gepard starts to walk before he realizes his feet are even moving.

He checks the trashcans in the dead end alley. He checks the supply crates that someone always stacks too high because they don't feel like finding more space for them. He pauses to check the soldiers that march past him, watching their footprints in the snow.

He finally finds Sampo on the rooftop along the northernmost wall, the one that looks out over the plains, towards Everwinter Hill, towards where the Stellaron had once been kept. With a full moon and an entire land of white snow, Gepard can almost see clear out to the horizon.

"Found you." Sampo stiffens, and Gepard is almost prepared for him to sprint off the roof. He doesn't. But he doesn't relax either. Gepard sits down next to him and stares out at the wastelands.

"…I fucked up." It wasn't what Gepard had been expecting. Sampo never 'fucks up,' Sampo just gets into incidents that are entirely, supposedly, not his fault and that he just happens to always be within the vicinity of.

"What did you do now?" It must be really bad if Sampo is coming to the Silvermanes for protection.

Instead, Sampo ignores his question completely. "See out over there? Right on the other side of that mountain. There's a safe house that way. It's hidden under a lot of snow and dead trees, but it's there. And in that safe house is a box full of letters. I need you to deliver those letters for me."

Gepard's brow furrows. It's a weird favor to ask. Sampo would never tell anyone where his hidden safehouses were. It defeated the whole purpose of a hidden safe house.

Something is wrong, something is really really wrong.

Gepard turns back to look at him again and startles, all of his questions dying in his throat, because the entire left side of Sampo's head is suddenly matted down, dark and sticky, his skin is dyed red red red-

"In three more months, there's gonna be something big happening." Gepard grabs Sampo's hand and it feels slick and warm against his palm. "I won't be here. So I need you to do my end of things for me." Gepard tries to keep hold, but something is fading, something is slowing, the sun is coming up but the colors are all wrong, everything feels like encroaching fog, Sampo's hand slides right through his. "I was gonna come back with my mask to finish setting the stage, but…" Gepard makes a frantic grab for Sampo's wrist, the air twists, he comes back empty-handed. "They have you. And you're the Iron Wall of Belobog. So it'll be ok."

Gepard finally manages to find his grip, snatches the front of Sampo's dark wet jacket and yanks him forward to hold onto him, and this close up, he can see it better, his colors are bleaching out, leaking outside the lines as if Sampo will become part of the background, as if he's fading into the strange fog that's been closing in on them. His fingers are already starting to feel empty again.

"Wake up."

Gepard jolts awake, uncurls his hands from where they're fisted in the blanket, scrubs the dampness off his face. Breathes. Breathes. Breathes. Today is supposed to be the day.

He throws on his civilian clothes, and he goes down to the shipyard the IPC had built. He finds a spot where he can see every person that returns to Belobog, and he waits.

And he waits and he waits and he waits.

No one he recognizes appears.

[hauntedselves]

Clinical Formulations of Narcissistic PD

Clinical formulations and case conceptualisations are introduced in this post.

These are all generalisations and theories of how NPD develops, not something that is supposed to be true for everyone with NPD.

Psychodynamic model

Freud suggests parents either overvaluing or neglecting (or both) a child can lead to NPD & especially inability to form healthy, lasting relationships and regulate self-esteem

"In other words, [NPD] is the outcome of insufficient gratification of the normal narcissistic needs of infancy and childhood."

Kohut theorises that narcissists' ability to form a cohesive sense of self and others was developmentally arrested in childhood, resulting in grandiosity & idealising others

"Narcissistic injury" = fragmentation of the self

Kernberg suggests grandiosity & exploitation result from maternal emotional abuse

Grandiosity is an "emotional escape valve"

Grandiosity & entitlement mask the "real self" that is "split off"

The real self unconsciously holds rage, fear, envy, deprivation

Defensive structure is same as BPD but difference is grandiosity

Biosocial model

NPD is primarily the result of environment, especially "parental indulgence and overvaluation, learned exploitive behavior, and only-child status"

Special treatment from caregivers leads children to believe that the "world revolves around them", and therefore they expect the same outside the home

When special treatment outside the home doesn't happen, they "experiment with demanding and exploitive tactics and subsequently develop considerable skill in manipulating others"

"At the same time they come to believe that most others are inferior, weak, and exploitable."

NPD is self-perpetuating through sense of superiority, lack of self control, sense of entitlement, and dismissing of those who reject their world / self-view

Cognitive-Behavioural model

Key feature of NPD is self-aggrandisement

Core beliefs:

> Deserving of special treatment

> Not bound by social norms and rules

Conditional beliefs:

> Others should be punished for not recognising their specialness

> To maintain that special status others should be subservient to them

Instrumental belief:

> Always strive to demonstrate their superiority

> See themselves as special, superior, entitled to special favors and treatment, and vulnerable to loss of status

> View others as inferior but potential admirers

Main pattern of behaviour is "seeking prestige, power, position, and wealth as a way of reinforcing their image of superiority", using "manipulation and guile" if necessary

The primary schema is superior & special (/ entitlement & grandiosity)

> Superior schema "shaped by flattery, indulgence, and favoritism"

> Special schema shaped by "rejection, limitations, exclusion, or deficits"

> Common denominator is the belief that the individual is different in some way

Three subtypes:

> Self-centered impulsive type

> Ruthless impression-management type

> Acceptance-oriented impression-management type

> Each type is centred around an impulse control deficit developed in childhood

> "Specifically, these individuals learned to seek reinforcers without having to work for them. This resulted in their development as self-indulgent, egocentric, and impulsive individuals."

> Ruthless & Acceptance-oriented types focus on creating favourable impressions with others, but struggle with long-lasting healthy relationships because of their empathy deficits

Interpersonal model

People with NPD were raised in an environment of "selfless not contingent" love, leading to insensitivity to others' needs

The caregiver was over-adoring, but there was also a constant threat of a "fall from grace", with pressure to be the perfect child

The constant overbearing love means that any criticism or disappointment hits very hard

"In short, there is extreme vulnerability to criticism or being ignored, together with a strong wish for love, support, and admiration from others. Noncontingent love and presumptive control of others is expected and even demanded. If support is withdrawn, or lack of perfection is evident, the self-concept degrades into severe self-criticism."

Integrative model

People with NPD are hypersensitive

Seen as exceptional children, leading to pressure to perform

As children likely had highly developed speech and interpersonal skills

Life purpose: "I’m special and unique, and I am entitled to extraordinary rights and privileges whether I have earned them or not."

World-view: "Life is a banquet table to be sampled at will. People owe me admiration and privilege."

Goal: "Therefore, I’ll expect and demand this specialness."

Defense mechanisms: rationalisation and projective identification

Parental injunction: "Grow up and be wonderful—for me."

"The illusion of specialness, disdain for others’ views, and a sense of entitlement lead to an underdeveloped sense of social interest and responsibility. This, in turn, leads to increased self-absorption and confirmation of narcissistic beliefs."

- From Sperry, Handbook of Diagnosis and Treatment of DSM-5 Personality Disorders (2016)

[eggofthefish]

watched ep 26 and my god, Nikkie is so delightfully evil aftermath doodle under

[wavesoutbeingtossed]

Just read Lilly Jay’s divorce essay and wow, even though the circumstances are wildly different, the loosely similar theme to TTPD of speaking your saddest story to reclaim your personhood (in the public eye) and share your truth with others to help heal are quite striking to me.

The “sponge works best when it’s wet” metaphor seems pretty apt too.

[bekaterrier]

Happy Audio Drama Sunday! I've started working my way through my holiday backlog, so some of these episodes are from a couple of weeks ago.

@storiesfromylelmore Episode 209 - Detention: After their wild escapade last episode, the trio are in detention (worth it), and they're as hilarious as ever. I wanted to shout out the sound scaping, the rain on the windows was very soothing; noticeable but not distracting from the episode. Also I want to know what the lunch ladies were gossiping about, Ms. Yesrith and who??? I have the feeling that Keryth wasn't really supposed to be able to summon the School Blessing. Also I'm adding Blessings to my internal database of the lore of Ylelmore! 🏫

SFY Patreon Minisode - Knight AU: Y'all it is so cute to hear the kids in this AU. You definitely need to join the Patreon to hear the whole thing, it is worth it! ⚔️

Case Study: IREC-A59 - Update: No new episode, but I did get the chance to chat with the writer over the holidays! The plan for the show is 4 seasons, which have already been broadly mapped out. S1 will be 20 episodes, and work on the writing for season 2 is already underway! I can't wait for more of the world building to be revealed, as it sounds like there's a lot of thought that went into it. Also I really hope they eventually release a bloopers reel for S1 because the stories I heard sound ridiculous. 🚀

@starfallpod Act 1 Scene xviii: Oh Fel...oh Leona... </3 I'm very glad that they had their talk and are back to being besties (them not getting along was just not right), but man were those some tough things they had to share. Can we not just bundle them up with a bunch of food and keep them safe somewhere? Nothing more bad will happen to them right?? 🎭

@vestaclinicpod S2 Teaser Trailer: I. Am. So. Excited!!! S2 coming in early 2025, with cases run by the whole Vesta Clinic team!! ⚕️

@monkeymanproductions's Waiting For October S1 Episode 3 - Small Town: By the end of this episode, I just wanted to bundle Karo up in a big hug. It's clear she went through a lot as a child, and while we learned some, there's still a lot she's not saying. As someone from a small town, I can totally understand how coming back is both comforting and bringing up old wounds. It's made especially tough when a minstrel won't stop following you around singing about your life without the complete picture (not that I've had that particular event happen to me...) 🪕

@midnightburgr Welcome to the Horizon Part 9 - The Mountain: Drunk June is the best. Drunk June being proven right is even better! I'm with her, I also snorted when Deidre said the full "Deidre Peppercorns" out loud, and yes, that Verge moment was hot. I am falling in love with each of these Hood's Pocket weirdos more each episode, Edgy Steve and Flat Doug included. Also, "I mean, look at you. Of course you fell from the sky." SO smooth Deidre!! Now what up with this comet?! ☄️

[skibasyndrome]

after lake smut I shall provide hallway smut 🫡 I will just throw promo-based fics at the wall and see what sticks until the season finally airs

[cryptiduni]

“white mourning.”

[butts-bouncing-on-the-beltway]

Desperately trying to be hysterical all night again in advance of my doctor's appt in the morning because honestly I'm barely holding onto sanity as it is lmao

The amount of pre-appt research I do never stops turning up horrifying new pieces of information like this one:

Like my guy I can barely manage to stomach the ½ teaspoon of electrolytes I put in my water every day and you want me to eat SIX GODDAMN TIMES THAT MUCH??????

I would rather fling myself into a dying star I'm so fucking serious

[idontmindifuforgetme]

Can dementia be prevented?

Reducing the risk of it yeah, w a healthy lifestyle. Preventing it no. The first patient I saw w the specific case of dementia I’m studying is a literal heart surgeon 💀 not the average bear at all. Big brain & healthy (according to his wife) & yet started showing symptoms over a course of 6 years.

It’s so fucking scary what dementia does to you. It’s far from just being cognitive stuff/memory loss. Your behavior changes, your cognitive skills are impaired, your motor skills take a hit. The heart surgeon I’m talking about is struggling w mouth function rn, bc his muscles are atrophying as a direct result of his dementia. He legit went from operating cardiovascular surgeries last October to now not being able to speak. It’s different from case to case, but when it’s aggressive it’s fucking aggressive. The neurologist I’m shadowing was talking about how she doubted if he’d “still be here within the year” and I wanted to throw up bc what do you mean if he’ll still be here!!

[hoth-and-cold]

Now hold on a minute

[codename-adler]

[ THIS IS COMING FROM A PLACE OF LOVE ]

TW: Riko Moriyama, violence & abuse, sh, death

i want people to lean so hard into Riko’s villainy. i want us to explore the abysmal dark side of Exy’s little psycho. i want you to write me the most horrific acts this fucko has perpetrated.

there is. so much potential there. yes, he is both victim and abuser, we’ve been over that. so? his babygirl aesthetic doesn’t have to die just bc he likes to hurt people and scheme fucked-up plots on the side! he can have his cake and eat it! we don’t have to rehabilitate him. we can make him worse. we can love him because he’s mad. we can find worth in his depravity. he is such a crucial character to the story, but he’s important because he’s big bad, he’s insane, he’s a raging bitch, and we! should! love him! for it! never been anything wrong with liking villains now has there?

give him the mic. showcase his voice. even if it’s a demonic screeching or a cold, cold laugh tearing the corners of his mouth. describe the crazy eyes. dive into them.

nobody knew outside the Nest. and even inside, only the closest. his victims. that is horrifying, but astounding too!! a masterclass in manipulation. doesn’t it keep you up at night? can you imagine Kevin losing hope of ever escaping because who will believe him? do you see him in his bed at Palmetto, still not convinced he’ll ever pull out from under Riko’s thumb, because that man can manipulate anyone onto his side? what if the Foxes choose Riko’s version?

what if Riko hadn’t stopped just at Seth? what about the Foxes’ families?

what does he keep in his room? under his bed? in the bathroom?

what did he really do to Thea?

when was the first time he lashed out? what was he thinking? what was his first instinct? how did he hone his skills for violence? who taught him? is he self-taught in the arts of the knife? why cutting and not something else? or are knives the only skill set he got to show us before the end?

when did violence stop being an outlet and start being a pleasure?

how many animals are buried on Evermore’s grounds?

how many people?

was there ever a first kill? who? why? how?

did he self-harm? for relief or euphoria? curiosity or therapy?

when did Kevin start noticing a change in his behaviour? when did he start being worried? for Riko? for Jean? for himself?

how everywhere was Tetsuji ? in everything?

did Riko laugh?

did he cry?

what’s the #MeToo going to look like in the aftershocks? who starts it?

what’s the documentary going to be like? who will be part of it? how many years does the investigation take? how far down does the rabbit hole go?

the versions and secrets are infinite.

and so, like Riko: let us go wild!

[tj-crochets]

Hey y'all! Weird question time, but let me preface it by saying these are not symptoms I am currently experiencing and also I have talked to doctors about this, I just didn't think to put the two things together For all the migraine havers out there, do you have tachycardia when you have migraines? Either like during the whole migraine, or only with migraines bad enough to cause stomach issues?