The Continuum of Madness, with Special Attention to Narcissism: Dr. Nancy McWilliams
Dr. McWilliams will explore the contemporary conceptualization of psychosis, emphasizing the clinical value of construing psychopathology dimensionally. The evolution of the concept of pathological narcissism will be reviewed, with emphasis on the dangers of malignant narcissism. Morning Address: Rethinking Madness: The Therapeutic Value of a Dimensional Conception of Psychotic Processes Afternoon Address: Problematic Versions of Narcissism: Clinical and Social Implications
Type of Event:
Non-CAMH Mental Health Events
February 23, 2019
10:00 AM - 4:30 PM
Innis Town Hall Theatre
2 Sussex Ave
Rethinking Madness: The Therapeutic Value of a Dimensional Conception of Psychotic Processes
The intentionally “neo-Kraepelinian” orientation (categorical concepts, with present-versus absent criteria) of the current DSM and ICD taxonomies are in some ways inconsistent with clinical experience. In the DSM, for example, there are only a limited number of conditions labeled as psychotic. Many diagnosticians and psychotherapists, in contrast, have viewed psychopathology dimensionally rather than categorically, using the term “psychotic” in the broader sense of loss of contact with consensual reality. Dr. McWilliams will argue that there is a psychotic level of many psychological conditions, not merely the schizophrenic illnesses and psychotic mood disorders. She will emphasize the clinical value of construing psychopathology dimensionally, with specific implications for the psychotherapy process.
Problematic Versions of Narcissism: Clinical and Social Implications
In contemporary conversations, the term “narcissism” is much in vogue. This talk will review the evolution of the concept of “pathological narcissism,” especially as it infuses personality structure. It will touch on both the more arrogant presentations of Narcissistic Personality Disorder (per the DSM) and the extensive literature on converse versions of narcissistic preoccupation (“covert,” depressed-depleted,” “hypervigilant,” or “closet” narcissism, as depicted in the 2017 Psychodynamic Diagnostic Manual, 2nd ed. Dr. McWilliams will discuss the range of narcissism from healthy to seriously disturbed psychologies, putting emphasis on the dangers that malignant narcissism poses to personal relationships, family connections, workplace and institutional functioning, and political processes.
1. Compare and contrast a dimensional, inferential, and contextual conceptualization of psychosis with contemporary descriptive and categorical diagnostic conventions;
2. Name three psychopathologies for which there is evidence of their existing along a spectrum from healthy to psychotic;
3. Apply to their clinical work several consequences of viewing psychotic processes as on a continuum with more normal psychologies.
1. Construe narcissistic and psychopathic psychologies in terms of underlying themes rather than observable, present-versus-absent traits.
2. Describe the continuum from normal narcissistic preoccupations through malignant narcissism to frank psychopathy and the DSM’s Antisocial Personality Disorder.
3. Describe how issues of socioeconomic and political trends, gender, sexual orientation, culture, ethnicity, and religious background may affect the diagnosis and treatment of putatively narcissistic disorders.
SCHEDULE FOR THE DAY
10 a.m. Introduction of Speaker (Dr. Kobrick)
10 – 11 Problematic Versions of Narcissism: Clinical and Social Implications (Dr. McWilliams )
11 -12 Discussion with Audience
12 - 2:00 Lunch (on your own)
2:00 – 3:00 Problematic Versions of Narcissism: Clinical and Social Implications (Dr. McWilliams)
3:00 – 4:00 Audience Discussion
4:00 Closing Remarks (Dr. Kobrick)
BIOGRAPHY OF SPEAKER
Nancy McWilliams, Ph.D., teaches 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), and Psychoanalytic Psychotherapy (2004), is associate editor of the Psychodynamic Diagnostic Manual (2006, 2017), and is on the editorial board of Psychoanalytic Psychology. She has edited or contributed to several other books and has written numerous articles on topics related to psychotherapy. A former president of Division 39 (Psychoanalysis) of the American Psychoanalytic Association, she has been featured in three APA videos of master clinicians, the most recent being “Three Approaches to Psychotherapy.” Her books are available in 20 languages; she lectures widely both nationally and internationally.