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CPD Credits
6
Event Type
Live Online Event
Location
Zoom & Recording
Time (UK)
2:00 pm - 3:30 pm
Standard
£250.00
Trainee/NHS
£212.50
Thursday, January 28, 2027 - Thursday, April 29, 2027
Clinical Implications of Personality Organisation
Dr Nancy McWilliams will offer one lecture per month for four months
With Dr Nancy McWilliams
Nancy McWilliams has made a major and distinctive contribution to contemporary psychodynamic thinking by placing personality organisation at the centre of clinical understanding in a way that is unusually clear, clinically usable, and widely influential.
In contrast to the primarily descriptive and symptom-focused nature of the Diagnostic and Statistical Manual of Mental Disorders, her work develops a structurally informed, inferential approach that resonates strongly with psychoanalytic traditions concerned with meaning, development, and the patient’s subjective world. Rather than treating diagnosis as categorisation, McWilliams foregrounds how personality develops relationally and is organised, how a person experiences self and other, manages affect, defends against anxiety, and maintains or loses reality testing.
Her model of structural personality organisation, commonly articulated along neurotic, borderline, and psychotic levels, offers clinicians a way of thinking developmentally and dynamically about psychological functioning. It helps the therapist anticipate the likely transference–countertransference field and adjust technique accordingly, particularly in relation to stability of identity, defensive organisation, and capacity for symbolic reflection.
Layered on this structural model, McWilliams’ elaboration of personality styles such as depressive, narcissistic, paranoid, schizoid, and others provides a clinically rich account of enduring patterns of affect regulation, relational expectation, and defensive adaptation. These are not treated as fixed “types,” but as meaningful configurations that reflect both early developmental necessity and ongoing psychic organisation.
This series will have direct implications for psychotherapeutic technique. It will sharpen the clinician’s judgement about timing, interpretation, and support, particularly regarding when insight can be metabolised and when it may overwhelm or destabilise the patient. It also places significant emphasis on countertransference as a central instrument of understanding, aligning closely with contemporary relational and intersubjective developments in psychoanalysis.
Programme
Both depressive and masochistic personality patterns are characterised by malignant self-regard. This lecture will differentiate between anaclitic and introjective versions of depressive psychologies and between relational and moral masochism. Subtypes of masochism will be discussed, along with clinical implications of whether one’s patient is more depressive or more self-defeating, as therapeutic stance should be significantly different depending on this assessment. Dr. McWilliams will present the treatment of a masochistic patient in this context.
This lecture will cover the long history of our conceptualisation of psychologies that arise from overstimulation and trauma, with clinical examples and implications for treatment. Extroverted versus more introverted versions of histrionic psychology will be discussed, and general principles of working with people who are at risk of being retraumatised will be emphasized. Clinical vignettes will illustrate some of the challenges posed by patients in this general group.
The DSM and ICD are notably insufficient in depicting the inner experience of both schizoid and paranoid patients. Individuals with these dynamics run the gamut from psychotically troubled to high-functioning, creative, and gratified with their lives. This lecture will explore the phenomenology and etiology of schizoid and paranoid subjective patterns, with clinical and personal examples, and with emphasis on their implications for psychotherapy.
This lecture will review the continuum from developmentally normal narcissistic concerns to malignant narcissism and severe psychopathic (antisocial) personality disorders. It will focus on different presentations of narcissistic and psychopathic dynamics, the question of treatability, and some controversies in the clinical literature about how to work with these clients. The concept of characterological psychopathy will be differentiated from the DSM description of antisocial personality disorder. Clinical implications of different types of narcissistic and psychopathic patterns will be foregrounded.
Nancy McWilliams, PhD, ABPP
Nancy McWilliams is Visiting Professor Emerita at Rutgers University’s Graduate School of Applied & Professional Psychology and practices in Lambertville, New Jersey. She is author of Psychoanalytic Diagnosis (1994, rev. ed. 2011), Psychoanalytic Case Formulation (1999), Psychoanalytic Psychotherapy (2004), and Psychoanalytic Supervision (2021) and is associate editor of both editions of the Psychodynamic Diagnostic Manual (PDM) (2006, 2017). A former president of Division 39 (Psychoanalysis) of the American Psychological Association, she has been featured in three APA videos of master clinicians. She is on the Board of Trustees of the Austen Riggs Center in Stockbridge, MA. Her books are available in 20 languages, and she has taught in 30 countries.
- Psychotherapists
- Psychoanalysts
- Psychologists
- Clinical Psychologists
- Psychiatrists
- GPs
- Counsellors
- Social Workers
- Apply McWilliams’ model of personality organisation (neurotic, borderline, psychotic levels) to develop a structurally informed clinical understanding that goes beyond descriptive DSM/ICD diagnosis.
- Differentiate core personality configurations and their clinical presentations, including depressive/masochistic, traumatised–histrionic, schizoid/paranoid, and narcissistic/psychopathic patterns, with attention to underlying affect regulation and defensive organisation.
- Use structural understanding to guide psychotherapeutic technique, particularly in determining timing, depth, and type of intervention (supportive versus interpretive) based on the patient’s stability of identity and capacity for reflection.
- Integrate transference and countertransference as central clinical tools, enhancing the clinician’s ability to anticipate relational dynamics, manage therapeutic risk (e.g., retraumatisation or destabilisation), and adjust stance across different personality organisations.
Standard Online Registration: £120
Trainee, NHS staff and Third Sector: £102
Trainee and NHS Discount: To qualify for this offer you need to be taking a course which provides core practitioner training in counselling or psychotherapy that is at least 1 year full time or two years part time and recognised by the BACP or UKCP. TR Together reserve the right to ask to see evidence of training being undertaken. Please contact [email protected] to recieve the discount code.
Group Rates (for 4 or more): Contact [email protected] for customised pricing.
Alumni: If you are a TR Alumni (TRAPC member) please email [email protected] for a discount code to add at checkout
Your CPD Certificate will be available to download from your TR Together account within 48 hours of the event.