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The professional consensus is that narcissistic patients are difficult to treat. They often present with an internal emptiness and despair, envious aggression, incapacity to love, tendencies toward idealization and devaluation, and vulnerability to shame. Although narcissistic dynamics are universal and often benign, their excesses and enactments, for example narcissistic rage, can do significant interpersonal and social harm. The high interpersonal costs of narcissism make it an urgent clinical concern.
Dr McWilliams will explore narcissistic dynamics using case examples, covering the range from normal to highly pathological versions of narcissistic psychology, including Kernberg’s “malignant narcissist”, Cooper’s “narcissistic-masochistic” character, and Shaw’s “traumatic narcissist”. She will discuss highly arrogant clients as well as those who present with more hidden, covert manifestations of problematic narcissism.
The etiology of narcissistic dynamics will be explored, along with some reasons that narcissistically impelled clients are highly susceptible to feeling shamed. Such dynamics can make it challenging for clinicians to keep them engaged in therapy.
The first session will offer an overview with the final two sessions devoted to treatment approaches to support clinicians working with this population
14.00 Introductions
14.05 Identifying Pathological Versions of Narcissism
This presentation will offer a view on the continuum from normal or “healthy” narcissism to malignant narcissism and psychopathy. Dr McWilliams will include arrogant versions of narcissism represented notably in the DSM’s Narcissistic Personality Disorder as well as converse presentations including covert, hypervigilant, or closet narcissism. Etiology will be discussed as well as the underlying pursuit of perfection often found in these clients.
14.45 Q&A
15.00 Break
15.15 Treating Pathological Narcissism 1
Citing both clinical and empirical literatures, Dr. McWilliams will review treatment possibilities for narcissistically impelled patients. Emphasizing the history of clinical controversy in this area, she will mention several competing understandings and recommendations for working with narcissistically driven individuals. Several practical strategies will be shared that she has found clinically effective in reducing narcissistic behavior, including ways to help the narcissistic person express normal dependency, remorse, and gratitude.
16.00 Q&A
16.15 Break
16.30 Treating Pathological Narcissism 2
In this third and final session Dr McWilliams will continue to offer treatment possibilities.
17.15 Q&A
17.30 End
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.
Learning Objectives:
Standard Registration: £90
Trainee/NHS staff: £76.50
Group Rates (for 4 or more): Contact makeritafaumui@trtogether.com for customised pricing.
Trainee 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.
Alumni: If you are a TR Alumni (TRAPC member) please email anitabruz@tavistockrelationships.org for a discount code to add at checkout
Your CPD Certificate will be available to download from your TR Together account 48 hours after the event.