ered as a disorder. The personalities of patients can sometimes be very noncon-tributory to the quality of their care and how we go about treating them. In other situations our patient's and our own personalities can be crucial to outcome. Recognizing personality traits, being able to minimize miscommunications and distortions, maximizing coping skills of patients and building therapeutic alliances are the tools of a good physician. Patients may be histrionic (dramatic, attention seeking), obsessive (rigid, perfectionists), narcissistic (self-involved, controlling), dependent (demanding, clinging), masochistic (long suffering), schizoid (unsociable) or paranoid (mistrustful, blaming). In most cases these personalities do not get in the way of patient care. There are incidences where you may have a strong reaction to a patient's personality and feel it is affecting care. The important thing is to be able to take a step back and sort out your own feelings and thoughts. Often patients react to illness in the way that they have reacted to all problems in their lives and often physicians are seen much like other primary caretakers in their lives such as parents or other authority figures. Examples might include a dependent patient who fears abandonment, a histrionic man who is seductive with nurses, a narcissist who devalues the medical staff, or paranoid patient who appears angry and confused. It must be noted that many apparent personality disorders are in reality transient regressive behaviors in response to stress and they are not indicative of long-term problems. What makes some of these issues more pertinent in the transplant population is the seriousness of many situations and the need for good doctor/patient communication and alliance. When you find yourself having very strong emotional reactions to patients or acting out in ways that are not typical for you, then you may be dealing with a patient with a personality disorder. In these cases it is crucial to discuss your feelings with colleagues or get formal psychiatric consultation. Borderline personality disorders sometime only become clearly evident when the staff as a whole realizes that the patient is splitting the staff into all good and all bad caregivers. A true DSM IV antisocial personality is a relative contraindication for transplant. Antisocial personalities have a serious disregard for the feelings of other people. True antisocial personality must be distinguished from people who may interface with the criminal system for other reasons.

Break Free From Passive Aggression

Break Free From Passive Aggression

This guide is meant to be of use for anyone who is keen on developing a better understanding of PAB, to help/support concerned people to discover various methods for helping others, also, to serve passive aggressive people as a tool for self-help.

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